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What do you think is going on in Egypt?

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

At this point it looks like endemic H5N1 situation -

Environment to human - E2H, animal to human A2H, or bird to human B2H,

plus seasonal flu.

There are 2 big festivals now. Lots of eating.

Time will tell.
 
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...
Speaking of "nothing new" it looks like new cases today have set yet another record

Avian influenza attacked Western provinces, Menoufiya, lake and Qaliubia ferociously been detained since 81 new cases Hospital Dietetic Mahala, Tanta and dead behind the worries and Damanhour cows .. While ago when the provinces of Kafr El-Sheikh and the Suez completely any infection since the disease re-emerged with the onset of winter.
 
Re: What do you think is going on in Egypt?

niman said:
Speaking of "nothing new" it looks like new cases today have set yet another record

Avian influenza attacked Western provinces, Menoufiya, lake and Qaliubia ferociously been detained since 81 new cases Hospital Dietetic Mahala, Tanta and dead behind the worries and Damanhour cows .. While ago when the provinces of Kafr El-Sheikh and the Suez completely any infection since the disease re-emerged with the onset of winter.
Click to expand...
These 81 need to be checked off the list that we already have -- they might not all be new from yesterday. But, it could easily be 60 or something. :(

I sure hope all 81 aren't new from yesterday!

BTW -- Thursday is like Friday in Egypt 'cause the weekend there is Friday & Saturday (I think) -- so today is the equivalent of 'Bad News Friday' where Egypt is concerned.
 
Re: What do you think is going on in Egypt?

I must say that from the "chicken vaccinations" texts, and the fact that in Egipt the people have birds,.., in towns, the Dutchy post seems reasonable, other it is already an pandemic started.

Can realy an WHO member country have 81 new cases, or 50 daily new cases (like wroted in FT previously) of avian H2H flu, without that the other world countries react with their health establishment to be detailed informed about an raising pandemic?

I think that maybe not.
Why there are not news breefings from the numerous countries scientists, their individual point of view - are they all in a self-censure?

If yes, than must be on the way an international protocol of "hiding informations". No news at the mass media, after all those illnesses.

I'm a little surprised that nobody of the FT members can purge out an official breefing statement from the WHO burocrates, or the health sector.
The last news was of "non sustained, level 3", from Mr. Nabaro.

If it can't be appured if this Egipt thing is H2H after 1 week, I don't know if we at FT will have even 1 week of time for preparations if a pandemic start.
 
Re: What do you think is going on in Egypt?

tropical said:
I must say that from the "chicken vaccinations" texts, and the fact that in Egipt the people have birds,.., in towns, the Dutchy post seems reasonable, other it is already an pandemic started.

Can realy an WHO member country have 81 new cases, or 50 daily new cases (like wroted in FT previously) of avian H2H flu, without that the other world countries react with their health establishment to be detailed informed about an raising pandemic?

I think that maybe not.
Why there are not news breefings from the numerous countries scientists, their individual point of view - are they all in a self-censure?

If yes, than must be on the way an international protocol of "hiding informations". No news at the mass media, after all those illnesses.

I'm a little surprised that nobody of the FT members can purge out an official breefing statement from the WHO burocrates, or the health sector.
The last news was of "non sustained, level 3", from Mr. Nabaro.

If it can't be appured if this Egipt thing is H2H after 1 week, I don't know if we at FT will have even 1 week of time for preparations if a pandemic start.
Click to expand...
81 new suspected cases -- not 81 new confirmed cases.
 
Re: What do you think is going on in Egypt?

tropical said:
I must say that from the "chicken vaccinations" texts, and the fact that in Egipt the people have birds,.., in towns, the Dutchy post seems reasonable, other it is already an pandemic started.

Can realy an WHO member country have 81 new cases, or 50 daily new cases (like wroted in FT previously) of avian H2H flu, without that the other world countries react with their health establishment to be detailed informed about an raising pandemic?

I think that maybe not.
Why there are not news breefings from the numerous countries scientists, their individual point of view - are they all in a self-censure?

If yes, than must be on the way an international protocol of "hiding informations". No news at the mass media, after all those illnesses.

I'm a little surprised that nobody of the FT members can purge out an official breefing statement from the WHO burocrates, or the health sector.
The last news was of "non sustained, level 3", from Mr. Nabaro.

If it can't be appured if this Egipt thing is H2H after 1 week, I don't know if we at FT will have even 1 week of time for preparations if a pandemic start.
Click to expand...
There have been no "confirmed" cases since the beginning of the year. Officially, these cases are testing negative, even when 43 year olds die.
 
Re: What do you think is going on in Egypt?

Theresa42 said:
These 81 need to be checked off the list that we already have -- they might not all be new from yesterday. But, it could easily be 60 or something. :(

I sure hope all 81 aren't new from yesterday!

BTW -- Thursday is like Friday in Egypt 'cause the weekend there is Friday & Saturday (I think) -- so today is the equivalent of 'Bad News Friday' where Egypt is concerned.
Click to expand...
It's only Thursday in England but the mute swans are dead and bird flu positive.
 
Re: What do you think is going on in Egypt?

Thank You Dr. Niman, and Theresa42,

I agreed that we don't know, the majority are only suspected cases.

But that's the point - we don't know if they are only seasonal flu, or B2H.

Epidemiologicaly, if indeed the Egiptian health authorities fast tests on the patients revealed avian flu
(which can be done in few minutes:
"Laster says clinics can quickly diagnose Influenza with rapid diagnostic test that simply require a quick swab of the mouth and results are available in minutes."),

than the other countries top health officials already knows that.

In that case we must obtain informations from them, or the WHO, on the ongoing pre-pandemic situation, if we cannot got them from the Egiptians.
 
Re: What do you think is going on in Egypt?

Commonground said:
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.
Click to expand...

What about the likelyhood of HCW's being covered with the Tamiflu blanket. Won't that be in a sense a false negative?
 
Re: What do you think is going on in Egypt?

tropical said:
Thank You Dr. Niman, and Theresa42,

I agreed that we don't know, the majority are only suspected cases.

But that's the point - we don't know if they are only seasonal flu, or B2H.

Epidemiologicaly, if indeed the Egiptian health authorities fast tests on the patients revealed avian flu
(which can be done in few minutes:
"Laster says clinics can quickly diagnose Influenza with rapid diagnostic test that simply require a quick swab of the mouth and results are available in minutes."),

than the other countries top health officials already knows that.

In that case we must obtain informations from them, or the WHO, on the ongoing pre-pandemic situation, if we cannot got them from the Egiptians.
Click to expand...
Test results are in the all or none category. If the test result is positive, everyone gets notified. If negative they don't. However, negative tests do not mean no H5N1 infections.
 
Re: What do you think is going on in Egypt?

It is bizarre it has gone on this long without someone demanding clarity. Either other governments are not being advised or, there is nothing to advise or, it is a wait and see mentality.

If I had to characterize this situation I would call it a, 'wait and see if the Egyptians can clean it up first', scenario. If the situation continues to deteriorate for more than say another week, then other governments will instigate restrictions on travel and implement other plans to limit their own nations infection.
 
Re: What do you think is going on in Egypt?

Perhaps the Egyptian authorities know that they are dealing mostly with seasonal flu, but are letting the population become alarmed so that changes can more easily be made regarding the custom of raising backyard chickens. Just a thought.
 
Re: What do you think is going on in Egypt?

peggy said:
Perhaps the Egyptian authorities know that they are dealing mostly with seasonal flu, but are letting the population become alarmed so that changes can more easily be made regarding the custom of raising backyard chickens. Just a thought.
Click to expand...

I was just thinking about that when I posted this (http://www.flutrackers.com/forum/showthread.php?t=48584) on another thread:

"And the intervention Amin Abaza, saying: what we are trying to do vaccinated birds rural education, and we know it is difficult to reach 100% because that means access to 8.5 million homes, mostly refuse immunization for a number of reasons attributed to the legacy and erroneous beliefs them to refuse immunization campaigns expectation that the execution of birds and other can not house searches and the success of this process is linked to the desire of the citizens in immunization supposed to be a personal awareness of what has been achieved so far completed well could make more than that and we do not put our heads in the sand and assume that there Educational home and therefore call on local agencies to tighten control over the lack of education in Cities note that something difficult to achieve, especially poultry is the cheapest animal protein is a complex process, we must take into account the many variables we are a part along with about 17.5 million families."

Let me be the devil's advocate: What better way of educating rural people about vaccinating their chickens/culling sick chickens than scare them with approximate media reports? Provoking panic, or at least letting voice to gossips, is certainly much faster than sending medical or veterinarian students talk to the head of the village...

Though, if this is the unvoiced goal of not providing decent transparent news about suspected cases, hospitalising anyone with any flu symptoms, it would be, in my opinion, a rather desperate way of tackling this crisis.

On the other hand, I just posted this article (http://www.flutrackers.com/forum/showthread.php?t=48588) about the politics of avian influenza in Egypt and it explains how various schools of thoughts can use such a crisis in such a way that even if the Government is completely transparent, it's unlikely to be believed.

And that's why we need all the various opinions of all the members of flubloggia to find out what is going on and to be objective about what is going on.
 
Re: What do you think is going on in Egypt?

CG, Theresa 42 and all else concerned. Thank you for what you do.

I think it is important to keep tracking at least the media reported suspect cases by day, to give us an overall picture. It is hard, and maybe we can only produce summaries of suspect cases by governate -with particular attention to HCWs, family groups, regional clusters, cullers etc? Or a summary report that looks at new suspect cases day by day by Governate? but then again, without the detail of what you do, we have no way to determine if they are dups or genuinely new cases.

If nothing else it provide us with a way to monitor a baseline, and the degree or elevation above that baseline. Is there anything we, collectively, can do to assist?
 
Re: What do you think is going on in Egypt?

Vibrant62 -- that's a good idea. Break up the Governorates. Each person take 3 and keep the list up to date, and look for clusters.
 
Re: What do you think is going on in Egypt?

Shannon said:
It is bizarre it has gone on this long without someone demanding clarity. Either other governments are not being advised or, there is nothing to advise or, it is a wait and see mentality.

If I had to characterize this situation I would call it a, 'wait and see if the Egyptians can clean it up first', scenario. If the situation continues to deteriorate for more than say another week, then other governments will instigate restrictions on travel and implement other plans to limit their own nations infection.
Click to expand...

I think Shannon is nearer in evaluation.

The "alarme first, than change" will harm other busines sector (turistic, ...), and that probably nobody want to do it if it is not necessary.

The "pig tranfer" problem suggest that the OIE theory of a "very stable" virus for an natural changing virus (the receptor, and other stories) can't be taken as a "rock".

The same fact that after all the widespread animal avian flu through 2 continents in 2 years, we have such "stable virus" statements at the same time when the Egiptians fear an avian flu transfer through pigs ("move them to the desert"), suggest "smoke".
 
Re: What do you think is going on in Egypt?

The MidEast is experiencing a major and extremely unusual weather condition.

It is VERY COLD THERE, NOW. In Cairo, the weather for the next 15 days ranges between 70 F high and 40 F low. That is VERY, VERY, VERY COLD.

Today, I met with a young woman whose brother lives in Northern Iran. It is freezing there. She said it has never been that cold.

The weather pattern is creating very frigid conditions in an area usually warm at this time of the year...warm being in the 50's F low and 60's F low.

So, the flu season has advanced from Spring to now, Winter.

I raise this as the reason for the rapid increase in flu cases at this time.
 
Re: What do you think is going on in Egypt?

GaudiaRay said:
The MidEast is experiencing a major and extremely unusual weather condition.

It is VERY COLD THERE, NOW. In Cairo, the weather for the next 15 days ranges between 70 F high and 40 F low. That is VERY, VERY, VERY COLD.

Today, I met with a young woman whose brother lives in Northern Iran. It is freezing there. She said it has never been that cold.

The weather pattern is creating very frigid conditions in an area usually warm at this time of the year...warm being in the 50's F low and 60's F low.

So, the flu season has advanced from Spring to now, Winter.

I raise this as the reason for the rapid increase in flu cases at this time.
Click to expand...

Good information, snow in Bagdad indeed.

In Celsius at night in Cairo it is near freezing, daytime 16 to 17 degrees.

http://www.bbc.co.uk/weather/5day.shtml?world=0080&links
 
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