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AVIAN INFLUENZA, HUMAN (49): EGYPT (CAIRO) NOT
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Date: Fri 6 Mar 2009
Source: KUNA Health [edited]
<http://www.kuna.net.kw/NewsAgenciesPubl ... lu%20Cairo>


Egyptian official denies 2 bird flu cases in Cairo
--------------------------------------------------
Egyptian Chief of Health Affairs department in Cairo Dr. Naibal
Abdul-Qader denied on Friday [6 Mar 2009] reports of emergence of 2
cases of bird flu in the Egyptian capital, excluding one case of a
child who tested positive in Faiyum province. Abdul-Qadir said in a
press release that all suspected cases of the disease were in 2
hospitals, adding that laboratory results proved that the 2 cases
were tested negative, contradicting rumors that the samples of those 2
cases were positive.

The only exception was of a 2-year old child from Faiyum province, who
was under treatment in hospital, the statement added.

[The case of this child was described in ProMED-mail archive (44)
below. - Mod.CP]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

Avian influenza - situation in Egypt - update 6
10.03.2009 - WHO

The Ministry of Health and Population of Egypt has reported a new confirmed human case of avian influenza. The new case is a two and a half year old male from Amaria District, Alexandria Governorate. His symptoms began on 3 March and he was hospitalized at Alexandria Fever Hospital where he remains in a stable condition. Infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory on 4 March. Investigations into the source of infection indicate a history of close contact with dead and sick poultry prior to becoming ill. Of the 57 cases confirmed to date in Egypt, 23 have been fatal.

AVIAN INFLUENZA, HUMAN (51): EGYPT: (MENOUFIA) SUSPECTED
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Date: Tue 10 Mar 2009
Source: Thomson Reuters Foundation AlertNet [edited]
<http://www.alertnet.org/thenews/newsdesk/LA88886.htm>


Egyptian girl contracts bird flu -- MENA agency report
------------------------------------------------------
An 18-month-old Egyptian girl has contracted bird flu and is in
stable condition, the state-run news agency quoted the Egyptian
Health Ministry as saying on Tuesday [10 Mar 2009].

The Middle East News Agency (MENA) reported that the child, from the
[Menoufia] province in northern Egypt, showed symptoms after coming
into contact with dead birds.

She is the 58th case of bird flu in Egypt. She was given the
antiviral drug Tamiflu at an Egyptian hospital, MENA said. It was not
yet known if she had the H5N1 virus.

Egypt is one of the few countries affected by bird flu that does not
compensate farmers when poultry is destroyed, though many experts say
this is the best way to ensure rapid detection of new outbreaks. Some
5 million Egyptian households depend on poultry as a main source of
food and income.

Since 2003, the H5N1 avian influenza virus has infected at least 410
people in 15 countries and killed at least 254 of them. It has killed
or forced the culling of more than 300 million birds in 61 countries
in Asia, the Middle East, Europe, and Africa.

[Byline: Will Rasmussen]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[If confirmed, this patient will be the 58th human case of avian H5N1
recorded in Egypt since 2003. This case and the previous 2 cases have
been children less than 3 years of age.

The Governorate of Menoufia is located at no. 16 on the map of the
Governorates of Egypt at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>. - Mod.CP
The HealthMap/ProMED-mail interactive map of Egypt is available at
<http://healthmap.org/r/006e>. - CopyEd.MJ]

Avian influenza - situation in Egypt - update 7
11.03.2009 - WHO

The Ministry of Health and Population of Egypt has reported a new confirmed human case of avian influenza. The new case is a one and a half year old female from Menofia Governorate. Her symptoms began on 6 March and she was hospitalized on 9 March where she remains in a stable condition. Infection with H5N1 avian influenza was confirmed on 10 March by the Egyptian Central Public Health Laboratory. Investigations into the source of her infection indicate a history of close contact with dead and sick poultry prior to becoming ill. Of the 58 cases confirmed to date in Egypt, 23 have been fatal.

IRIN hat geschrieben:EGYPT: Bird flu cases among young children raise concerns

CAIRO, 12 March 2009 (IRIN) - An 18-month-old child contracted the H5N1 bird flu virus on 10 March, bringing the number of human cases in Egypt to 58 since records began in 2006, and prompting the World Health Organization (WHO) to ask for a study to be undertaken of the causes.

The child - from Manoufiya Province in northern Egypt - is one of several recent cases of young children to have contracted the deadly virus in a country where over five million families raise poultry for a living.

Egyptian Health Ministry spokesman Abdel Rahman Shahin told IRIN the girl exhibited symptoms of infection on 6 March after reported contact with infected birds. She was taken to hospital on 9 March and given the antiviral vaccine Tamiflu.

"Her case has stabilised but she will remain at the hospital for further check-ups," Shahin said.

The child's case is the latest in a rapidly growing number of cases of child infection in Egypt, causing concern among WHO officials.

On 4 March, a two-year-old boy from the coastal city of Alexandria (220km from Cairo) contracted the virus. The boy is being treated with Tamiflu.

Another two-year-old boy from Fayum, 85km southwest of Cairo, was infected by the virus on 1 March, Nasr al-Sayyid, the assistant health minister, said.

According to the Egyptian Ministry of Health, five cases of bird flu have been registered in 2009; 23 people have died from the virus since records began in 2006.

The rapid growth rate of bird flu infections in children is worrying, said John Jabbour, senior epidemiologist with WHO, which is asking the Health Ministry to investigate why so many children aged 2-3 are being infected.

Jabbour speculated that the reason for the increased number of cases in this age group was that families were no longer as alert as immediately after the last awareness campaign.

He warned that families with poultry must be on their guard at all times, given UN Food and Agriculture Organization (FAO) warnings that the H5N1 strain was endemic in poultry.

"This is a problem that will not go away in poultry, hence people who deal with birds cannot afford to relax. Those who come in contact with birds must make caution part of their daily routine," he said.

Changing the mindset

Jabbour said social behaviour and attitudes also played a vital role in tackling bird flu. "We are not just fighting bird flu only; we are also trying to change the mentality which says reporting a case of bird flu infection in poultry will destroy income," he said.

Assistant Health Minister Sayyed said poultry keepers were often reluctant to report suspected cases for fear that health officials would cull not only their birds but those of neighbouring families.

Egypt does not run a compensation scheme for farmers who lose poultry in a cull.

According to the latest WHO statistics, some 410 people in 15 countries and regions have contracted the virus and 256 of them have died of the disease.

While H5N1 rarely infects people, experts fear it could mutate into a form that could easily be passed from one person to another, leading to a pandemic which could kill millions.

Quelle: http://www.irinnews.org

AVIAN INFLUENZA, HUMAN (55): EGYPT (ASSIUT)
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Egypt - 59th case
Date: Wed 18 Mar 2009
Source: SAIDR [edited]
<http://www.saidr.org/en/humans.php#180309>


Avian influenza case; Assiut Governorate, El Fath District
----------------------------------------------------------
A woman, age 38, began experiencing fever and headache on 14 Mar
2009. She was admitted to Assiut Fever Hospital and given Tamiflu on
14 Mar 2009. Infection with avian influenza was confirmed on Wed 18 Mar 2009.

The woman reported contact with dead and sick poultry. She was
reported clinically free and in a good general condition on 18 Mar
2009. The Ministry of Health and Population (MOHP) reported this was
the 59th case of highly pathogenic avian influenza in Egypt.

Source of report: Amr Kandeel, Undersecretary for preventative
affairs, MOHP, Samir Refaie, Head of Epideiology and Surveillance Unit, MOHP

--
Communicated by:
ProMED Rapporteur Mary Marshall

[This report is accompanied by an excellent interactive map which
shows the geographic location and details of all human cases of avian
H5N1 influenza virus infection recorded in Egypt since April 2008; see --
<http://maps.google.com/maps/ms?ie=UTF8& ... urce=embed>.
- Mod.CP]

AVIAN INFLUENZA, HUMAN (57): AFRICA, PHYLOGENY
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Date: Thu 19 Mar 2009
Source: CIDRAP News [edited]
<http://www.cidrap.umn.edu/cidrap/conten ... ca-jw.html>


Scientists who analyzed 67 H5N1 avian influenza viruses from across
Africa report that the viruses fall into 3 distinct sublineages, or
families, and that some have mutations that make them resistant to
antiviral drugs.

The scientists also found that some of the African viruses have
genetic markers that are characteristic of human flu viruses rather
than avian strains, according to their report, published yesterday
[18 Mar 2009] in the online journal PLoS One [see abstract below].

"These findings raise concern for the possible human health risk
presented by viruses with these genetic properties and highlight the
need for increased efforts to monitor the evolution of A/H5N1 viruses
across the African continent," says the report by a large
international team of scientists. The group includes several from
African countries and the UN Food and Agriculture Organization.

Lethal H5N1 viruses made their African debut on Nigerian poultry
farms in January 2006, the report notes. Soon afterward, the virus
cropped up in Egypt, Niger, and Cameroon, and in April 2006, it was
found in Sudan, Burkina Faso, Djibouti, and Ivory Coast. The virus
surfaced in Ghana and Togo in mid-2007 and in Benin in December 2007.
All but 2 human cases of H5N1 disease in Africa have occurred in
Egypt, whose official case count is 58, with 23 deaths. Nigeria and
Djibouti have each had one human case.

The scientists looked at 494 H5N1 gene sequences from 67 African
isolates, including the complete hemagglutinin and neuraminidase gene
segments, all collected between February 2006 and early 2008 and
representing all 11 affected countries. The analysis also included
hundreds of gene sequences from European and Middle Eastern H5N1 viruses.

The researchers determined that all the African viruses belong to
clade 2.2 and are related to the H5N1 viruses that have been
circulating throughout Europe, Russia, and the Middle East since late
2005. Clade 2.2 traces back to the outbreak of avian flu in thousands
of migratory birds at China's Qinghai Lake in the spring of 2005, the
article notes.

Detailed analysis of the hemagglutinin genes showed that the viruses
fall into 3 sublineages (labeled I, II, and IV). All 3 groups "had
been co-circulating since the beginning of the epidemic in Africa,"
suggesting that all 3 had been introduced into Africa separately, as
reported in previous studies, the report says. Just how the 3 groups
entered Africa and spread so rapidly is still unclear. But the
viruses emerged in Africa when related strains were present in
European migratory birds, "and such birds may have played a
significant role in the introduction of the virus," the scientists write.

The 3 sublineages had geographic dimensions, but the patterns were
complex. All the Egyptian isolates were in sublineage IV, which they
shared with isolates from Gaza and Israel. Strains from Burkina Faso,
Ivory Coast, Ghana, and Cameroon formed a single cluster in
sublineage I. However, the authors found all 3 groups in Nigeria, a
finding that agreed with an earlier study. Viruses collected in Sudan
were in sublineage I and closely related to those from Nigeria,
Burkina Faso, and Ivory Coast rather than to those from nearby Egypt
and Djibouti. Overall, the findings "may suggest that a certain
degree of geographical segregation has occurred in Africa" since the
initial viral introductions, the report states.

In searching signs of antiviral resistance, the team found 4 bird
isolates from Egypt carrying a mutation linked with resistance to the
older class of flu drugs, the adamantanes (amantadine and
rimantadine). They also found viruses from 2 human cases in Egypt
that had a mutation (known as N294S) that confers resistance to
oseltamivir (Tamiflu) and slightly reduced sensitivity to zanamivir
(Relenza). However, no mutations conferring resistance to oseltamivir
or zanamivir were found in any of the African viruses from birds.

The authors also found a number of isolates with genetic markers
usually found in human flu viruses rather than avian strains. In
particular, they checked the African viruses for 13 genetic markers
consistently found in the flu viruses that caused the pandemics of
1918, 1957, and 1968. They found 2, both in the PB2 gene. One of
these, known as E627K and associated with increased H5N1 virulence in
mice, was found in all the African isolates. Another was found in
just 2 bird viruses from Egypt.

In other findings, the report says that 2 different reassortant
viruses representing combinations of 2 of the 3 sublineages were
found in Nigeria in 2006 and 2007. One of these became the
predominant strain in Nigeria's poultry in 2007. "The continued
circulation of A/H5N1 viruses in the African continent not only
affects the local economy but also impacts on animal and human
health," the report states. It concludes with a call for constant
efforts to monitor and control avian flu across Africa.

David A. Halvorson, DVM, an avian flu expert at the University of
Minnesota in St. Paul, said the report appears to confirm that there
were 3 separate introductions of H5N1 into Africa and that those
strains continue to circulate. Further, he said the study shows that
genetic sequencing "shows evidence for international spread within
Africa as well as evidence for local spread and that there have been
no additional introductions since the 1st ones." Halvorson also
commented that the findings regarding antiviral resistance are not
surprising: "These mutations are typical of viruses as they circulate
in a host. It seems they can mutate to resistance without any
antiviral compound present."

[Byline: Robert Roos]

--
Communicated by:
David Thomson <davidt@spc.int>

[A simplified diagram of the clades and subclades of avian H5N1
influenza virus implicated in human disease globally can be viewed at:
<http://content.nejm.org/cgi/content/full/358/3/261/F1>.

Despite the prevalence of avian H5N1 influenza virus in poultry in
Africa, so far there have been only 2 human cases (one fatal)
anywhere outside of Egypt. The results of phylogenetic analyses are
consistent with 3 separate introductions of avian influenza virus
into Africa. Although the viruses now present in Africa are similar
to strains previously found in European migratory birds, the evidence
that migratory birds played a major role in the spread of avian
influenza virus into Africa remains circumstantial.

The preceding CIDRAP report is based on the paper by Cattoli G, Monne
I, Fusaro A, et al., entitled "Highly pathogenic avian influenza
subtype H5N1 in Africa: a comprehensive phylogenetic analysis and
molecular characterization of isolates," published in PLoS ONE 4(3):
e4842. doi:10.1371/journal.pone.0004842
<http://www.plosone.org/article/info%3Ad ... ne.0004842>.

Abstract:

"Highly pathogenic avian influenza virus A/H5N1 was 1st officially
reported in Africa in early 2006. Since the 1st outbreak in Nigeria,
this virus spread rapidly to other African countries. From its
emergence to early 2008, 11 African countries experienced A/H5N1
outbreaks in poultry, and human cases were also reported in 3 of
these countries. At present, little is known of the epidemiology and
molecular evolution of A/H5N1 viruses in Africa. We have generated
494 full gene sequences from 67 African isolates and applied
molecular analysis tools to a total of 1152 A/H5N1 sequences obtained
from viruses isolated in Africa, Europe and the Middle East between
2006 and early 2008. Detailed phylogenetic analyses of the 8 gene
viral segments confirmed that 3 distinct sublineages were introduced,
which have persisted and spread across the continent over this 2-year
period. Additionally, our molecular epidemiological studies
highlighted the association between genetic clustering and area of
origin in a majority of cases. Molecular signatures unique to strains
isolated in selected areas also gave us a clearer picture of the
spread of A/H5N1 viruses across the continent. Mutations described as
typical of human influenza viruses in the genes coding for internal
proteins or associated with host adaptation and increased resistance
to antiviral drugs have also been detected in the genes coding for
trans-membrane proteins. These findings raise concern for the
possible human health risk presented by viruses with these genetic
properties and highlight the need for increased efforts to monitor
the evolution of A/H5N1 viruses across the African continent. They
further stress how imperative it is to implement sustainable control
strategies to improve animal and public health at a global level."

An interactive map of the countries of Africa is available at:
<http://www.africaguide.com/afmap.htm>.
- Mod.CP]

Avian influenza - situation in Egypt - update 8
23.03.2009 - WHO

The Ministry of Health and Population, Egypt has reported a new confirmed human case of Avian Influenza. The case is a 38-year old female from Elfath District, Assiut Governorate. Her symptoms started with a fever and headache on March 14. She was admitted to Assiut Fever Hospital on March 14 where she was started on oseltamivir the same day (March 14) and remains in a stable condition. Infection with H5N1 avian influenza was confirmed on 18 March by the Egyptian Central Public Health Laboratory. Investigations into the source of her infection indicate a history of close contact with dead and sick poultry prior to becoming ill. Of the 59 cases confirmed to date in Egypt, 23 have been fatal.

Egyptian child contracts bird flu

CAIRO, April 5 (Reuters) - A 6-year-old Egyptian boy has contracted the highly pathogenic bird flu virus, the sixth case in a month in the most populous Arab country, state news agency MENA said on Sunday.

MENA named the boy as Ali Mahmoud Ali Somaa, from the Nile Delta province of Qalyubia. His case brings to 63 the number of confirmed cases of the H5N1 avian flu virus in Egypt, which has been hit harder by bird flu than any other country outside of Asia. mehr...

Quelle:alertnet.org

AVIAN INFLUENZA, HUMAN (63): EGYPT, 60TH CASE
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Date: Sat 28 Mar 2009
Source: TV5Monde, Agence France Presse report [in French, trans., edited]
<http://www.tv5.org/TV5Site/info/article ... 68.761.xml>


The Egyptian Ministry of Health and Population announced on Saturday
[28 Mar 2009] that a 2-year-old baby girl has contracted highly
pathogenic avian H5N1 influenza virus infection, the 60th case in
Egypt since the beginning of 2006. The place of residence of the
infant has not been divulged, but she is now in hospital and in
stable condition according to a Ministry spokesman.

Avian influenza has caused the deaths of 23 persons in Egypt,
predominantly young females and adult women, who are mainly
responsible for the rearing of domestic poultry in rural areas.
Despite considerable effort, the authorities have been unable to
alter the habits of the population, who, in large part, follow the
habits of their ancestors in keeping their poultry on the roofs of
their houses.

The Ministry spokesman stated that the avian influenza death toll in
Egypt had been lower than in some other countries affected by the
disease. The World Health Organization (WHO) has recently initiated
an enquiry into the reason for the apparent increased susceptibility
of young children to this virus infection. Last October [2008], an
international conference on avian influenza was held in Egypt, during
the course of which Washington allocated USD 320 million to fight
this disease, which has the potential to initiate a global pandemic.

--
Communicated by:
HealthMap Alerts via
ProMED-mail <promed@promedmail.org>

Avian influenza - situation in Egypt - update 9
WHO - 30.03.2009

The Ministry of Health and Population of Egypt has reported a new confirmed human case of avian influenza. The case is a two and a half year old female from Qena District, Qena Governorate. Her symptoms began on 23 March. She was admitted to Qena Fever Hospital on 24 March where she was started on oseltamivir the same day (24 March) and remains in a stable condition. Infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory on 26 March. Investigations into the source of infection indicate a history of close contact with dead and sick poultry prior to becoming ill. Of the 60 cases confirmed to date in Egypt, 23 have been fatal.

AVIAN INFLUENZA, HUMAN (66): EGYPT (BEHEIRA or AL BUHAYRAH)
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[1]
Date: Wed 1 Apr 2009
Source: Reuters [edited]
<http://www.reuters.com/article/africaCrisis/idUSL116466>


Egyptian boy contracts bird flu virus
-------------------------------------
A 2-year-old Egyptian boy has contracted the highly pathogenic bird
flu virus, bringing to 61 the number of confirmed cases in the most
populous Arab country, state news agency MENA said on Wed 1 Apr 2009.
Egypt, hit harder by bird flu than any other country outside of Asia,
has seen an upswing in bird flu cases over the past month, with 6 new
human infections.

The boy, from the province of Beheira in northern Egypt, was believed
to have contracted the H5N1 [avian influenza] virus after coming into
contact with infected birds, MENA quoted health ministry spokesman
Abdel Rahman Shahine as saying. The boy was taken to hospital on
Monday [30 Mar 2009] after he came down with a high fever while
visiting extended family in another province. He was being treated
with the antiviral drug Tamiflu.

Egypt is one of the few countries affected by bird flu that does not
compensate farmers when poultry is destroyed, though many experts say
this is the best way to ensure rapid detection of new outbreaks.
Since 2003, the H5N1 avian influenza virus has infected at least 410
people in 15 countries and killed 254 of them. It has killed or
forced the culling of more than 300 million birds in 61 countries in
Asia, the Middle East, Africa and Europe. Some 23 Egyptians have died
after contracting the virus, most after coming into contact with
infected domestic birds in a country where roughly 5 million
households depend on domestically raised poultry as a main source of
food and income. While H5N1 rarely infects people, experts fear it
could mutate into a form that people could easily pass to one
another, sparking a pandemic that could kill millions.

[Byline: Cynthia Johnston]

******
[2]
Date: Wed 1 Apr 2009
Source: Egyptian Chronicles [edited]
<http://egyptianchronicles.blogspot.com/ ... -case.html>


H5N1 Human Infection Case Number 61
-----------------------------------
The ministry of Health in Cairo has announced the H5N1 human
infection case number 61 in Egypt, a 2-year-old boy. The boy is from
Al-Bahaira in North Delta. He was infected through dead infected
domestic poultry. He was discovered when he became very sick during
visiting his grandparents in Monfia. He was given Tamiflu and
currently is stable.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[A map of the governorates of Egypt can be accessed at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>. Beheira is
located at 4 on the map. The HealthMap/ProMED-mail interactive map of
Egypt is available at <http://healthmap.org/r/007U>. - Mod.CP]

AVIAN INFLUENZA, HUMAN (69): EGYPT (BEHEIRA) 62ND CASE
******************************************************
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Date: Fri 3 Apr 2009
Source: Thomson Reuters Foundation AlertNet [edited]
<http://www.alertnet.org/thenews/newsdesk/L3635901.htm>


Egyptian toddler contracts bird flu virus
-----------------------------------------
An Egyptian toddler has contracted the highly pathogenic bird flu
virus, the latest in an upswing of cases in the most populous Arab
country, stated news agency MENA said on Friday [3 Apr 2009]. The
case brings to 62 the number of confirmed cases of the H5N1 avian
influenza virus in Egypt, which has been hit harder by bird flu than
any other country outside of Asia and has reported 7 human infections
since 1 Mar 2009.

The 21-month-old boy is from the province of Beheira in northern
Egypt and was in a "good" condition after being treated with the
antiviral drug Tamiflu, MENA reported. The new infection came several
days after a 2-year-old boy from the same province contracted the virus.

MENA did not say how the child contracted the virus, but most
Egyptians who have fallen ill with bird flu are believed to have
contracted the virus from infected household birds. Egypt is one of
the few countries affected by bird flu that does not compensate
farmers when poultry is destroyed, though many experts say this is
the best way to ensure the rapid detection of new outbreaks.

Since 2003 the H5N1 avian influenza virus has infected at least 410
people in 15 countries and killed 254 of them. It has killed or
forced the culling of more than 300 million birds in 61 countries in
Asia, the Middle East, Africa, and Europe. Some 23 Egyptians have
died after contracting the virus, most after coming into contact with
infected domestic birds in a country where roughly 5 million
households depend on domestically raised poultry as a significant
source of food and income.

[Byline: Cynthia Johnston]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[This case is significant in that it is the 2nd young child to have
contracted avian influenza virus infection in Beheira governorate in
the course of a few days. It is assumed that these are independent
events, but that information has not been provided.

A map of the governorates of Egypt can be accessed at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>. Beheira is
located at 4 on the map.
The HealthMap/ProMED-mail interactive map of Egypt is available at
<http://healthmap.org/r/008p>. - Mod.CP]

AVIAN INFLUENZA, HUMAN (70): EGYPT (QALYUBIA), 63RD CASE
********************************************************
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<http://www.isid.org>

[1]
Date: Sun 5 Apr 2009
Source: Thomson Reuters Foundation AlertNet [edited]
<http://www.alertnet.org/thenews/newsdesk/L5255594.htm>


Egyptian child contracts bird flu
---------------------------------
A 6-year-old Egyptian boy has contracted the highly pathogenic bird
flu virus, the 6th case in a month in the most populous Arab country,
state news agency MENA said on Sunday [5 Apr 2009]. MENA stated the
boy resided in the Nile Delta province of Qalyubia. His case brings
to 63 the number of confirmed cases of the H5N1 avian flu virus in
Egypt, which has been hit harder by bird flu than any other country
outside of Asia.

Health Ministry spokesman Abdel Rahman Shahine said the boy started
suffering symptoms 2 weeks ago and was admitted to hospital a week
later, where he was treated with the antiviral drug Tamiflu. The boy
is in a critical condition and is breathing with the id of an
artificial respirator, MENA said.

On Friday [3 Apr 2009], Egypt reported a 21-month-old boy had
contracted bird flu. Since 2003 the H5N1 avian influenza virus has
infected at least 410 people in 15 countries and killed 254 of them.
It has killed or forced the culling of more than 300 million birds in
61 countries in Asia, the Middle East, Africa and Europe.

Some 23 Egyptians have died after contracting the virus, most after
coming into contact with infected domestic birds in a country where
roughly 5 million households depend on domestically raised poultry as
a significant source of food and income. While H5N1 rarely infects
people, experts say they fear it could mutate into a form that people
could easily pass to one another, sparking a pandemic that could kill
millions.

[Byline: Aziz El-Kaissouni]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

******
[2]
Date: Sun 5 Apr 2008
Source: Egyptian Chronicles [edited]
<http://egyptianchronicles.blogspot.com/ ... no-63.html>


H5N1 human infection no. 63
---------------------------
Today [5 Apr 2009] the Ministry of Health announced a 6-year-old boy
as the H5N1 human infection no. 63. The boy is from Shubra El-Khemia,
Qalyubia. The boy began to have the symptoms on 22 Mar 2009 and he
entered Ain Shams hospital in Cairo on 28 Mar 2009. He was given
Tamiflu.

It is worth to mention that Qalyubia Governorate was the [principal]
Governorate for poultry raising industry in Egypt, it was a multi
billion industry there before being hit by the epidemic.

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

*******
[3]
Date: Mon, 6 Apr 2009
Source: SAIDR (Strengthening Avian Influenza Detection & Response), Egypt
<http://www.saidr.org/en/humans.php#050409>

[This site has very informative maps and chronological lists of cases
in both humans (going back to 15 Dec 2008) and poultry (going back to
19 Sep 2008) in Egypt. - Mod.JW]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Like the 2 preceding cases reported in the past week, the victim is
a young child. In Egypt in recent weeks those affected have been
predominantly children and women, a reflection of their relatively
greater exposure to diseased poultry.

A map of the governorates of Egypt can be accessed at
<http://en.wikipedia.org/wiki/Governorates_of_Egypt>.
Qalyubia is located at 20 on the map.
The HealthMap/ProMED-mail interactive map of Egypt is available at
<http://healthmap.org/r/008G>. - Mod.CP]

Avian influenza - situation in Egypt - update 10
08.04.2009 - WHO

The Ministry of Health of Egypt has reported 3 new confirmed human cases of avian influenza. The first case is a 2 year-old boy from Kom Hamada District, El Behira Governorate. He developed symptoms on 27 March and was admitted to Naaora Fever Hospital on the 30 March where he was started on oseltamivir the same day (30 March). He remains in a stable condition. The second case is also a 2 year-old boy from the same district and was detected through the investigation around the above-mentioned case. He developed symptoms on 31 March and was admitted to Damanhor Fever Hospital on 1 April where he was started on oseltamivir the same day (1 April ). He remains in a stable condition. Both boys had contact with sick/dead poultry prior to the illness onset. Close contacts of both boys have been identified and none has shown symptoms of the infection. The third case is a 6 year-old boy from Shubra El Khema District, Qaliobia Governorate. He developed symptoms on 22 March and was admitted to Ain Shams University Hospital on the 28 March where he was started on oseltamivir on 3 April. He was exposed to sick/dead poultry prior to the illness onset. He is in a critical condition. For all of the three cases reported above, infection with H5N1 avian influenza virus was tested positive by the Egyptian Central Public Health Laboratory and subsequently confirmed by the U.S. Naval Medical Research Unit No. 3 (NAMRU-3).

Of the 63 cases confirmed to date in Egypt, 23 have been fatal.