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What do you think is going on in Egypt?

Re: What do you think is going on in Egypt?

Shannon said:
What timely flow of data to the media? The WHO is present and certainly capable of cataloguing patients, especially since those who are infected are being taken to a very limited number of hospitals. In the past Theresa and others have been able to name those who are infected, that kind of news stopped last week. Others have been able to map the cases. We can no longer make a current map.

If you have information that we lack this is the time to share.
Click to expand...

It IS very frustrating to only get cryptic pieces of a story and numbers that we are unable to interpret. I wish that I did have more information to create an up to date line list and map :banghead:

My point is that the media is reporting large numbers of suspected cases as they occur. I think that is extraordinary openness given what we have experienced form some other countries lately. It means (to me) that the population and the medical community is alerted and may be more likely to detect cases as they occur.

Which brings us to Angie's excellent comment. She points out the key pieces of information to put these suspected cases in some context:

- What is the definition of a 'suspected case'? This may not be standardized, I suspect that they are casting a broad net right now.

-What are the testing protocols? Are they standardized at all? My guess is probably not- certainly information collection is not standardized even by WHO (or we are not learning of it).

And- are they collecting samples for PCR BEFORE administering Tamiflu?
 
Re: What do you think is going on in Egypt?

Nothing is going on in Egypt.
There are no new positives.
There are no new genetic sequences.
There are no new cases other than common flu.

If there were, Egypt or WHO would report this to be the case.
 
Re: What do you think is going on in Egypt?

And with that bedtime story, GR, I'm calling it a night. Sweet dreams.
 
Re: What do you think is going on in Egypt?

I think it will be good FT policy to start now with an "FT protocol" for reaching proved exact epidemic news from various world countries.

The upper can be based on the:
"New International Health Regulations Now in Force",
if some of the FT members with good WHO connections can achieve that in those Regulations exist an legal implementation of the "right of the citizens to have informations vital for their health" from the WHO.

That will be possible if the new regulations have the protocols for:
1. WHO are required also to notify the infectious event globaly to the citizens by mass media (TV, ...), and within X? hours (?)
2. The countries are required also to notify the infectious event within X? hours to their citizens (?)

If the upper questions are implemented into the WHO New Health Regulations, we will have the right to ask for detailed official information from WHO.

3. If getting formal informations from WHO will be delayed intentionaly, I don't see any way to get official informations but only:

- directly from the country doctors - this will be stoped by the country legislation to not release official informations without gov. confirmation
- directly from the news reporters at the site by internet - this can be useful, because they will not be informed about the exact health parameters of the patients till the pandemic are already spreaded
- other methods - that can be many times stamped like "rumors"

I hope that somebody of FT have a possibility to check that.
Thank You all!
 
Re: What do you think is going on in Egypt?

Shannon said:
In the past Theresa and others have been able to name those who are infected, that kind of news stopped last week. Others have been able to map the cases. We can no longer make a current map.
Click to expand...
I wasn't around yesterday (and I'm still having internet connection problems today -- aaargh) so I don't know what happened in the news yesterday yet -- but up until yesterday, the chaos surrounding the names (or lack of names) of suspected cases and negative results in Egypt has been pretty typical.

I have never been able to keep a good count of suspected cases -- my numbers have never matched the official numbers, which are never released in any consistent manner, btw. Nor have I ever been able to keep a good track of the reported negatives. As I mentioned elsewhere, in previous years I've usually just had to drop suspected cases off my list after a couple of weeks assuming that they must've tested negative at some point.

Official reporting of suspected cases by the Egyptian authorities is abysmal -- at best! The reporting from the press is simply chaotic. My lists have always just been a rough approximation of the situation in Egypt.

Edit: The Egyptian Ministry of Health used to have a bf "daily update" page on their website (separate from the Ministry of Information's bf website that most of you are familiar with) -- but it hasn't been updated since March 2007. Worth keeping an eye on, though, because periodically it does spring back into life:

http://www.mohp.gov.eg/sec/heducation/daily2.asp
 
Re: What do you think is going on in Egypt?

I understand the efforts to find and publish the names of the patients for easier tracking later from the deceased, or recovered list.

But the patients have the right to remain anonymous, and not to be placed in the newspapers - more important will be get medical recorded cases without names but tracked by their number, and the living place - maybe that will be easier to obtain from the WHO estab.?
 
Re: What do you think is going on in Egypt?

Without scientific WHO/NAMRU/EGIPT reports on FT about this Egipt surge, we can read only the semitranslated news, and speculate.

From the posts on this thread seems maybe that all that, for now,
can be human zoonotic bird flu infections caused by smugled diseased chicken, pigs, etc., distributed throughout Egipt,
and that the spreading of bf through poultry was augmented after the vaccination, maybe by asimptomatic or healthy chicken sheding the virus after the vaccination (with fault vaccines?).

My speculation is based on Egipt06 FT thread news excerpts:

"وقال المستشار عدلي حسين محافظ القليوبية إنه أصدر قرارا لا رجعة فيه بتغريم أي سيارة يتم ضبطها وهي محملة بالدواجن دون تصاريح بمبلغ‏10‏ آلاف جنيه‏..‏ مع تحويل الدواجن بعد توقيع الكشف الطبي عليها لأقرب مجزر لذبحها في حالة إذا ما أثبت الكشف الطبي صلاحيتها للاستهلاك الآدمي‏.‏
[FONT=arial (arabic)]The adviser said Adli Hussein, governor issued a ruling that the Qaliubiya irreversible fine any seized a car loaded with poultry without permits $ 10 thousand pounds .. with the conversion of poultry after a medical check for the nearest abattoir to slaughter in the case if proven medical examination suitability for human consumption.[/FONT]

[FONT=arial (arabic)]... وتداول الطيور بالمحافظة‏,‏ وإغلاق‏5‏ أماكن لتجارة وتوزيع الأدوية البيطرية ومنها لقاحات وأمصال تحصين الطيور لعدم ترخيصها‏,‏ وإحالة أصحابها إلي النيابة العامة‏.‏[/FONT]
[FONT=arial (arabic)]... the closure of 5 places for the trade and distribution of veterinary medicines, including vaccines and immunization vaccines not licensed bird, and referred to the prosecution owners Assembly.[/FONT]

[FONT=arial (arabic)]وأكد الدكتور محمود فريد مدير عام الطب البيطري أن جميع العينات التي تم الاشتباه فيها وعددها‏12‏ حالة جاءت نتائجها سلبية للفيروس‏,‏ باستثناء بؤرتين في قريتي الحدين والحوشي بكوم حمادة وتم إعدام الطيور المصابة بهما مع تكثيف حملة التحصين باللقاحات للطيور الموجودة في نطاق الإصابة‏.‏[/FONT]​
[FONT=arial (arabic)]Dr. Farid Mahmud, director general of veterinary medicine that all the samples that have been suspect and the results of 12 cases were negative for the virus, with the exception of foci in the villages and limits Alhouci Hamada was crucified birds infected with the intensified campaign by immunization vaccines for birds in the scope of infection ."[/FONT]


And to point on the contradictories with newspaper news:


[FONT=arial (arabic)]"وقال الدكتور يسري معاذ مدير عام الطب البيطري إن الحملات البيطرية مستمرة في أعمال التحصينات وكل الأمصال متوافرة‏..‏ علاوة علي متابعة الأمان الحيوي للمزارع‏..‏ لمواجهة وصول المرض‏.‏[/FONT]​
[FONT=arial (arabic)]Said Dr. Yusri forbid, director general of veterinary campaigns veterinary continuing in the fortifications and all vaccines available .. Furthermore follow safety vital farm .. to face the arrival of the disease.[/FONT]
...
[FONT=arial (arabic)]قرر المحافظ نبيل العزبي عقد برنامج تدريبي لأصحاب المقترحات والعاملين بها علي كيفية التحصين واتباع الأساليب العلمية في إجراءات الوقاية وتشرف عليه مديرية الطب البيطري والصحة والسكان تحت إشراف اللواء سامي فودة السكرتير العام للمحافظة والبدء بتدريب‏124‏ فردا علي التطعيم والتحصين‏.‏[/FONT]​
[FONT=arial (arabic)]... the Directorate of Veterinary Medicine, health and population under the supervision of Major General Sami Fouda, secretary-general of the province and begin training 124 troops Vaccination and Immunization.[/FONT] "


Can means that the veterinary vaccinations was improperly conducted before.
<!-- / message -->
 
Re: What do you think is going on in Egypt?

I hesitate to say something about Egypt, no expert at all...., but it is a good thing to discuss current situations. Somehow not many discussions at FT, or they fizzle out rather quickly.

I feel this:

Bird Flu is widespread in poultry in Egypt (OIE-report!), we would expect humans infections, especially in this season. We know H5N1 can be contagious, especially for family members. Genetic factors seem to play a role (something with sugar and umbrella's..). So emerging family clusters are not a surprise.

On the other hand we know you will not easily be infected by H5N1. If it was easy, we were in the middle of a pandemic now.
I feel WHO is right: there is limited H2H spreading, not sustained.

At the same time there is normal flu: happens every year, some years are worse than others. Flu patients are flooding hospitals in Egypt now, most of them probably "normal" flu? (I hope..)

Right now hospitals are flooded with flu patients in some regions in the USA too: http://www.click2houston.com/news/15015788/detail.html
In Australia too flu raged last winter.

Egyptian authorities could have underestimated the bird flu problem, a little late to react, right now it seems to have their attention.
Surveillance in Egypt seems to be improved, together with media campaigns, more awareness there is something like bird flu.

Right now I am not more worried about Egypt than last year, however the situation does not seem to improve, in the contrary it seems to creep slowly in the wrong direction.

- Egypt is a large country, but the people live mostly along the Nile, very close together, not easy to control bird flu here.
Authorities seem to vest their hope on vaccination of birds, was not a success in Vietnam and Indonesia.

- still no good compensation scheme for culled poultry?

- reports on viral resistance against Tamiflu;

- every infected bird and infected person is a petridish for the virus;

- reassortment could happen, with normal flu and H7 circulating;

We can be very happy with Theresa42, Niman, Commonground, Treyfish, well I can not name everyone, who watch the current developments.

Last year there were several thousands of suspect cases, it seems not feasible to track them all, allthough I do not want to underestimate the Egypt trackers!

So basically I feel nothing new is going on, but the situation bears watching.
Not sure how to watch this in an efficient way.
It is important to know what is "normal" in Egypt, so if something different is going on, you will know it.
If fatalities keep going up and HCW's get infected, these indicators are mentioned often. Other indicators?
 
Re: What do you think is going on in Egypt?

If fatalities keep going up and HCW's get infected, these indicators are mentioned often. Other indicators?
Click to expand...

An increase in the number of cullers getting infected
 
Re: What do you think is going on in Egypt?

Dutchy,
Well said in post #29. I agree with your assessment.

It is important to know what is "normal" in Egypt, so if something different is going on, you will know it. If fatalities keep going up and HCW's get infected, these indicators are mentioned often. Other indicators?
Click to expand...

Tracking HCW is key in all areas. For Egypt, tracking confirmed adult males may be a signal when things change from ?normal.?
 
Re: What do you think is going on in Egypt?

Dutchy said:
I hesitate to say something about Egypt, no expert at all...., but it is a good thing to discuss current situations. Somehow not many discussions at FT, or they fizzle out rather quickly.

I feel this:

Bird Flu is widespread in poultry in Egypt (OIE-report!), we would expect humans infections, especially in this season. We know H5N1 can be contagious, especially for family members. Genetic factors seem to play a role (something with sugar and umbrella's..). So emerging family clusters are not a surprise.

On the other hand we know you will not easily be infected by H5N1. If it was easy, we were in the middle of a pandemic now.
I feel WHO is right: there is limited H2H spreading, not sustained.

At the same time there is normal flu: happens every year, some years are worse than others. Flu patients are flooding hospitals in Egypt now, most of them probably "normal" flu? (I hope..)

Right now hospitals are flooded with flu patients in some regions in the USA too: http://www.click2houston.com/news/15015788/detail.html
In Australia too flu raged last winter.

Egyptian authorities could have underestimated the bird flu problem, a little late to react, right now it seems to have their attention.
Surveillance in Egypt seems to be improved, together with media campaigns, more awareness there is something like bird flu.

Right now I am not more worried about Egypt than last year, however the situation does not seem to improve, in the contrary it seems to creep slowly in the wrong direction.

- Egypt is a large country, but the people live mostly along the Nile, very close together, not easy to control bird flu here.
Authorities seem to vest their hope on vaccination of birds, was not a success in Vietnam and Indonesia.

- still no good compensation scheme for culled poultry?

- reports on viral resistance against Tamiflu;

- every infected bird and infected person is a petridish for the virus;

- reassortment could happen, with normal flu and H7 circulating;

We can be very happy with Theresa42, Niman, Commonground, Treyfish, well I can not name everyone, who watch the current developments.

Last year there were several thousands of suspect cases, it seems not feasible to track them all, allthough I do not want to underestimate the Egypt trackers!

So basically I feel nothing new is going on, but the situation bears watching.
Not sure how to watch this in an efficient way.
It is important to know what is "normal" in Egypt, so if something different is going on, you will know it.
If fatalities keep going up and HCW's get infected, these indicators are mentioned often. Other indicators?
Click to expand...


I agree.
 
Re: What do you think is going on in Egypt?

I also agree with Dutchy. I think I will stop keeping track of every Tom, Dick and Harry, and focus on deaths, HCW's etc.
 
Re: What do you think is going on in Egypt?

The situation in Egypt is far from normal. Suspect cases peak in the spring, not January. The clues are there, but take some digging.

Clue: How many in fatal Gharbiya cluster of a year ago were confirmed?
 
Re: What do you think is going on in Egypt?

The situation in Egypt is far from normal. Suspect cases peak in the spring, not January. The clues are there, but take some digging.

Clue: How many in fatal Gharbiya cluster of a year ago were confirmed?
Click to expand...

Too tired to look, but probably one. Maybe 2.
We've only had one HCW, and never had an update on her.
We've got two administrators. But not confirmed.
No confirmed cases in a while. Seems like it is seasonal flu/tamiflu blanket success.
 
Re: What do you think is going on in Egypt?

Commonground said:
Too tired to look, but probably one. Maybe 2.
We've only had one HCW, and never had an update on her.
We've got two administrators. But not confirmed.
No confirmed cases in a while. Seems like it is seasonal flu/tamiflu blanket success.
Click to expand...
Gharbiya was tested prior to Tamiflu and was NOT seasonal flu (but was fatal with liver damage). I doubt that the families of the two dead 43 year olds would agree with the "success" characterization.
 
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