Fifth fatal human case of bird flu reported in Egypt

[Susie]

Fifth fatal human case of bird flu reported in Egypt

http://news.xinhuanet.com/english/2006-05/05/content_4510263.htm
CAIRO, May 4 (Xinhua) -- A 27-year-old Egyptian woman died of the deadly H5N1 strain of bird flu on Thursday, the fifth fatal human case in Egypt, the official MENA news agency reported. Enditem

 

[GaudiaRay]

Re: Fifth fatal human case of bird flu reported in Egypt

She lived in the greater Cairo area. 22 million people live in Cairo. 50-55 million live in the countryside.

I've described the area in the past. Think running canals, green farms, warm to hot air, and animals as the basic farm tractors and farm food.

The people in the cities will die only if the virus becomes H2H. The people in the countryside will die due to their close living situation with birds, chickens and, but for pigs, every typical farm animal...up close and personal.

It's discouraging to see yet more death by H5N1. It's totally unmanaged and it is by its very nature, unmanageable, irrespective of what the politicos in Egypt utter.

 

[Theresa42]

Re: Fifth fatal human case of bird flu reported in Egypt

She must've been pretty sick already when she was admitted to hospital -- she died very quickly (was admitted at the 'beginning of May' accrording to reports). That, or her illness progressed very rapidly.

 

[GaudiaRay]

Re: Fifth fatal human case of bird flu reported in Egypt

She must've been pretty sick already when she was admitted to hospital -- she died very quickly (was admitted at the 'beginning of May' accrording to reports). That, or her illness progressed very rapidly.

Actually, she died right on time. The average time from infection to death or first symptoms to death is 8.5 days (so I've read here or in CE).

Tamiflu is not a get out of jail free card if it's administered late in the infection. Once you get it, you die...unless you're aware and able to get antiviral into your system.

The tragedy here is that in Egypt, for one dollar, she could have taken amantadine. But, based on my conversations with some doctors who work at the pharmacies (the unbelieveably un-busy pharmacies), they have no idea at all that amantadine is an effect antiviral for H5N1, and that's gonna be the next layer of incompetence and unthought non-effort to be experienced by Egypt.

 

[Theresa42]

Re: Fifth fatal human case of bird flu reported in Egypt

Actually, she died right on time. The average time from infection to death or first symptoms to death is 8.5 days (so I've read here or in CE).

Yeah, I think you're right about that average -- it is something like that. And, she is well within that average range.

Still, I was thinking, compared to many others who seems to hold out for a week or two, she went pretty quickly. It's only May 5th in Egypt -- so she died within a 4 day period.

Just looked back at the articles about her. She was admitted to hospital on Monday and a report on Wednesday said she already had double pneumonia by then. No clues about the onset date. I am just wondering if she was sick for some days before seeking treatment, or just started feeling ill on Monday -- I doubt the latter. I bet she was at home for some days feeling pretty awful.

 

[Shannon Bennett]

Re: Fifth fatal human case of bird flu reported in Egypt

48 hours, you have two days to get the antivirals or you are toast. And if you wait the two days your prognosis still isn't good. One day is better and getting treatment prior to exhibiting symptoms is the only way to significantly overcome the disease.

 

[Theresa42]

5th fatality reportedly exposed during a culling operation around April 21st

5th fatality reportedly exposed during a culling operation around April 21st

Machine translated from Arabic:

A health / Egypt / an influenza / a death

The declaration in Egypt of the death of a fifth case by the disease of the conqueror bird flu

4-5 (an universe) - It declared here today the death of a lady that matures who the age 27 years by the bird flu disease to be this she is the fifth state that dies due to the injury by the disease within 13 states an injury since the emergence of the disease in last February.

And the spokesman to the Egyptian Ministry of Health doctor Abdul Rahman Shahin announced that the deceased has been exposed to the infection during an operation for a slaughter and the cleaning of injured house birds in its village belonging to Monoufia Governate ten days before its entrance the hospital. [She was admitted on May 1st, so that would make this reported exposure to infected birds on or around April 21st.]

And he pointed that the mixing with this mrs. were submitted to medical examinations for the assurance of their freedom of the disease where the follow-up proved the non appearance of any symptoms on any of them.

It's worth mentioning that the discovery of 13 cases injured with the bird flu disease took place since its appearance in Egypt from it five case was dead while 8 states were cured got all out of the hospitals.

http://www.kuna.net.kw/home/Story.aspx?Language=ar&DSNO=862627

 

[Theresa42]

WHO on the 5th fatality

WHO on the 5th fatality

Avian influenza ? situation in Egypt - update 6

4 May 2006

The Ministry of Health in Egypt has announced the country?s 13th case of human infection with the H5N1 avian influenza virus. Tests conducted by both the national public health laboratory and the Cairo-based US Naval Medical Research Unit 3 (NAMRU-3) produced positive results.

The patient is a 27-year-old woman from Cairo who was hospitalized with bilateral pneumonia on 1 May. She is presently in stable condition.

Her infection has been linked to exposure to diseased poultry during a recent visit to the Minufiyah governorate. While there, she stayed in a household where numerous chickens were slaughtered.

The woman is the first new case in Egypt reported since early April.

Of the 13 laboratory-confirmed cases in Egypt, four were fatal. Eight patients have fully recovered and been discharged from hospital.

http://www.who.int/csr/don/2006_05_04/en/index.html

 

[GaudiaRay]

Re: 5th fatality reportedly exposed during a culling operation around April 21st

Re: 5th fatality reportedly exposed during a culling operation around April 21st

the deceased has been exposed to the infection during an operation for a slaughter and the cleaning of injured house birds in its village belonging to Monoufia Governate ten days before its entrance the hospital. [She was admitted on May 1st, so that would make this reported exposure to infected birds on or around April 21st.]

Day 1 Contact
Day 2 through Day 4 - ? days Asymptomatic (this is the missing fact)
Day ? Illness Onset
Day 12 - 13 Death

If death is on Day 12 or 13, then symptoms would have appeared, on the average, on Day 4 or Day 5.

This is perfectly normal. It's also scary as all heck. This person was asymptomatic for at least two if not three days.

Question: During that two to three days, how long do you think she was shedding virus and was contagious?

 

[Goju]

Re: Fifth fatal human case of bird flu reported in Egypt

can a mutation extend the asympomatic shedding stage? Like to a week? OMG...

 

[Theresa42]

Re: 5th fatality reportedly exposed during a culling operation around April 21st

Re: 5th fatality reportedly exposed during a culling operation around April 21st

Day 1 Contact
Day 2 through Day 4 - ? days asymptomatic (this is the missing fact)
Day ? Illness Onset
Day 12 - 13 Death

If death is on Day 12 or 13, then symptoms would have appeared, on the average, on Day 4 or Day 5.

Yup. Let's build on this >>

Day 1 - April 21(?) - contact
Days 2-4(?) - April 22 - 24(?) - asymptomatic

Days 5-10 - April 25 - April 30 - sick for 6 days (progressively getting worse?)

Day 11 - May 1 - admission to hospital (double pneumonia?)
Day 13 - May 3 - announcement of double pneumonia
Day 14 - May 4 - death

No chance in Hades for Tamiflu (or anything else) to do any good....

 

[GaudiaRay]

Re: 5th fatality reportedly exposed during a culling operation around April 21st

Re: 5th fatality reportedly exposed during a culling operation around April 21st

Yup. Let's build on this >>

Day 1 - April 21(?) - contact
Days 2-4(?) - April 22 - 24(?) - asymptomatic

Days 5-10 - April 25 - April 30 - sick for 6 days (progressively getting worse?)

Day 11 - May 1 - admission to hospital (double pneumonia?)
Day 13 - May 3 - announcement of double pneumonia
Day 14 - May 4 - death

No chance in Hades for Tamiflu (or anything else) to do any good....

It's the asymptomatic window that should be of most interest to us.
If we assume 8.5 days average presentment of symptoms, then April 25 is the symptom onset date.
During the time prior to symptom onset, how long is the infected person contagious (shedding virus)?

As an aside, there were others there at the "feast"/party, children and women, who do most of the work outside of field related work (the men work hard in the fields, and as I witnessed, the women work equally as hard, at different tasks in the fields. Nobody there who's a farmer gets a free ride. Only the kids don't do field work. I saw no child under 12 or so to be at work in the fields in my 1/2 hour + Balloon Ride pass over the agricultural area below the Valley of the Kings, Luxor area, Egypt.

 

[KC]

Re: Fifth fatal human case of bird flu reported in Egypt

Even currently published surveillance plans for inter-continental transportation (planes trains, and ships) will not be effective with a 0-4 day (who knows for sure) asymptomatic period with viral shedding.

We all agree (I believe) that as the asymtomatic period expands and overlaps the viral shedding period, the chances for a pandemic rapidly grows.

The only constant is preparation.

 

[GaudiaRay]

Re: Fifth fatal human case of bird flu reported in Egypt

Even currently published surveillance plans for inter-continental transportation (planes trains, and ships) will not be effective with a 0-4 day (who knows for sure) asymptomatic period with viral shedding.

We all agree (I believe) that as the asymtomatic period expands and overlaps the viral shedding period, the chances for a pandemic rapidly grows.

The only constant is preparation.

You are correct.
Again, the US Pandemic Plan completely ignores this reality vis a vis human transportation.
And, in the work setting, by stressing that a mere 3 feet is sufficient to offer protection, the Government is saying baldfaced, the workers are cannon fodder.
To me, these failures are criminal. These failures are reckless.
You got the point.

We are back to individual awareness, and very localized preparation to be self reliant, self sufficient, and for a heckuva long time period, which I consider to be unbearable yet the only option.

I'll not step up on the soapbox, but the enormous void which exists...no new vax plants (not one, but a dozen...just in the USA, as precaution, as backup), and no necessary peripherals in huge volumes, are the shout of denunciation and indictment against the Administration leadership, and Frist himself for dropping the ball he held so well in June.

 

[AlaskaDenise]

Re: Fifth fatal human case of bird flu reported in Egypt

Even currently published surveillance plans for inter-continental transportation (planes trains, and ships) will not be effective with a 0-4 day (who knows for sure) asymptomatic period with viral shedding. ....

How about a pre-flight quarantine....say in Guam? If you want in you MUST spend X days waiting thru the asymptomatic period, else no entry.

.

 

[GaudiaRay]

Re: Fifth fatal human case of bird flu reported in Egypt

How about a pre-flight quarantine....say in Guam? If you want in you MUST spend X days waiting thru the asymptomatic period, else no entry.

.

In tents, alongside the runway? Hotel rooms? The hoteliers will love the business. Nobody would leave as the entire place would be quarantined. The rooms will become infected.

The game is not going to work. It's obvious it will just collapse. I saw it at the meeting in Minneapolis. The planning is based on everything else being certeris paribus. They're kidding themselves.

 

[KC]

Re: Fifth fatal human case of bird flu reported in Egypt

AD,

A quarantine period might be a good idea... and a bad idea.

Good Idea: Keep people outside of the US, thus limiting spread of the disease.

Bad Idea: Those exposed to a quarantine (group setting) would be more likely to catch the disease due to differing exposure times.

The third cog in the wheel is various human rights organizations who usually do great things such as the ACLU... Will they be educated on the risks and need for human quarantines?

The first x question will be the asymtomatic period. Will we know it?

The second x question is how long to quarantine if we don't simply shut down the borders... and how long is it before it becomes unconstituational to keep vacationers from coming home?

 

[Theresa42]

Re: Fifth fatal human case of bird flu reported in Egypt

Even currently published surveillance plans for inter-continental transportation (planes trains, and ships) will not be effective with a 0-4 day (who knows for sure) asymptomatic period with viral shedding.

Yeah. And -- wtf -- why was the WHO trotting out the old "we can contain this thing if we act fast enough" line the other day (Tues)? I mean -- just who are they talking to at this point?

On the one hand you've got countries not reporting 'cause either they don't want to or they just don't know what's going on in remote (and not-so-remote!) areas -- and on the other hand, if/when H5N1 goes H2H, we'll have asymptomatic spreaders. I know this is nothing new to anyone here -- I just couldn't believe I was reading this the other day. Thought we'd all (including the WHO) moved past this sort of rhetoric >>

WHO says rapid containment measures could prevent bird flu pandemic
http://www.cbs47.tv/news/world/story.aspx?content_id=CC9D1003-F56F-49BB-94EF-A3BDFD8F2EC6