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Discussion: Are H5N1 cases being under reported again?

Laidback Al

Well-known member
Discussion: Are H5N1 cases being under reported again?

No human H5N1 cases have been officially reported since June of 2015. International Health Regulations require that any county with a reportable disease inform the World Health Organization (WHO) within 24 hours of identification. In 2015, more cases of H5N1 were reported than in any previous year since the WHO starting tracking human cases. However, all of these cases occurred before July (link), most of them from Egypt.

On average since 2003, from 2.5 to 4.5 cases of human H5N1 are reported in each of the last six months of the year. This would indicate that about 20 cases of H5N1 ought to have been reported from July to December 2015. However, none have been reported.

This unusual situation has been noted by several FluTrackers? posters and Mike Coston has devoted several blog entries to this issue of infectious disease reporting in Egypt this year:

Keeping One Eye On Egypt (Again) December 22, 2015

In The Land Of Limited Press Freedom, The Internet Rumor Is King December 27, 2015

Given the abundance of recent human cases in the first part of the year in Egypt coupled with the continued outbreaks of H5N1 in poultry in that country, more human H5N1 cases could be expected. Sharon Sanders and others have been posting recent news reports of potential human H5N1 cases in Egypt. Yet, despite conflicting reports, none have been locally confirmed as official H5N1 cases.

Suspicious news items from Egypt since July include:

Egypt - Woman, 32, suspected H5N1 bird flu case in Damietta - tests pending - July 7, 2015

Egypt - Director of Menoufia Preventive Medicine expects number of suspected H5N1 cases will rise with the onset of winter - July 27, 2015

Egypt: H5N1 - 2 Suspected Cases in Damietta

Egypt: H5N1 - Young man injured in suspected bird flu in Beni Suef - tested negative

Egypt - Giza health department confirms 8 cases, 2 deaths, 6 recovered so far in 2015 - August 24, 2015

Egypt - Person, 48, hospitalized suspected H5N1 bird flu case in Gharbia governorate - September 10, 2015

Egypt - MoH says no human H5N1 bird flu cases since June 2015 - November 1, 2015

Egypt - Media: 7 people suspected H5N1 & 1 death - health dept says it is confirmed seasonal flu (H1N1pdm09?) including 2 deaths - Dakahlia

Egypt - MoH preparing for H5N1 bird flu cases this winter while claiming no cases confirmed since June 2015 - December 13, 2015

Egypt - H5N1 Bird Flu Suspect in Fayoum Hospital - Media report

Egypt - Media report of suspected H5N1 bird flu cases in Sharqia? - December 14, 2015

Egypt - Giza health department announced 8 confirmed bird flu H5N1 cases since September 2015 - MoH denies - December 16, 2015

Egypt - 31 suspected cases of bird flu H5N1, MoH test results pending - Port Said - December 22, 2015 - declared seasonal flu

Egypt - Woman, 45, hospitalized as suspected bird flu H5N1 case in Sohag, tests pending - Sohag governorate - December 23, 2015

Egypt - Menoufia MoH denies any confirmed human bird flu H5N1 cases - suspected only - December 25, 2015

Egypt - 40 suspected bird flu H5N1 cases test negative - Dakahlia - December 26, 2015

Egypt - Village foci of H5N1 bird flu discovered in poultry in Menoufia, suspected human contacts sent to hospital for testing - December 27, 2015

Egypt - Woman, 44/46, hospitalized suspect bird flu H5N1 case - tests pending - December 30, 2015 - Died

Based on the above media reports, perhaps as many as 80-90 individuals were initially diagnosed with H5N1. Many of these individuals were later reported negative for H5N1. But the final diagnosis for at least of few individuals was never reported. The lack of transparency of official reporting and the muzzling of media reporting of infectious disease outbreaks in Egypt should be a grave concern to everyone.
 
I would point out that I am not just picking on Egypt. Recently, confusing information has been reported about possible bird flu cases in Algeria in Northern Africa. (link)

And it is not just H5N1. There is a large time lag in the reporting of H7N9 infections in China. In 2015, More than 200 human cases of H7N9 were reported from China. Details on many of these cases are sketchy. For the 6 most recent human H7N9 cases officially reported from China there is a lag of 7-21 days between symptom onset and public reporting. Even though as noted above, member states are supposed to notify the World Health Organization within 24 hours under International Heath Regulations.

H5N1, H7N9, other avian and swine influenza viruses, and even MERS have the potential start a pandemic. No country wants to be identified as source of a pandemic disease. Suppression of disease outbreak information is to be expected.
 
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