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  • EGYPT - March 20, 2007+ - News on confirmed/suspected cases

    Previous Egypt thread here:

    ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

  • #2
    Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

    Google-translated from Arabic:

    One [more] child in Aswan avian influenza
    March 20, 2007

    The Ministry of Health and Population yesterday, the injury to the child Yusuf Mohamed Mahmoud old two-and-a-half year contracted avian flu, raising the number of casualties to 26 cases in Egypt so far, the ministry said in a statement issued yesterday that the child entered the pathogenesis of Aswan Hospital last Friday night, the effect of the rise in temperature following because of birds suspected of being infected with the disease.

    The statement said that it was decided to transfer the child to the hospital in Manshiet Bakry Cairo [i.e. the children's hospital in Cairo] to receive the necessary treatment, his condition was stable, as well as being the work of the epidemiological investigation of all family members.

    On the other hand, the same cure girl princess Abdulatif Nayel <10 years> withheld Bhamyat Aswan, which confirmed her last week, and decides to come out of the hospital [discharged].



    Last edited by Theresa42; March 20, 2007, 03:59 PM.
    ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

    Comment


    • #3
      Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

      Hat-tip, Auburn Boy!

      Two-year-old Child In Aswan Tests Positive For Bird Flu
      11:04 AM, March 19th 2007

      A 2-year-old boy has tested positive for bird flu in the Egyptian province of Aswan, a Health Ministry source said Monday.

      Last week, three children suspected of having bird flu were hospitalized in a fever hospital in Aswan.

      Since the first outbreak of bird flu in Egypt in 2005, 13 of 25 people who contracted the illness have died.

      After an initial panic, which saw many Egyptians get rid of their birds, people in rural areas have resumed raising poultry domestically to sell at public markets or as a source of cheap protein.

      Previous cases of infection were caused by exposure to sick birds. If a person is infected the Egyptian health ministry usually monitors the other family members for signs of the disease.

      Several weeks ago, the Egyptian government suspected that a mutated strain of the virus with "reduced susceptibility" to the Tamiflu vaccine had emerged.

      Medical experts confirmed shortly afterwards that the virus had in fact not mutated to a new and more dangerous strain transmitted between humans.

      ? 2007 DPA

      ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

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      • #4
        Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

        The Egyptian government has just got to stop removing bf articles from their website!

        First it was the confirmation -- later retracted -- of the case of a woman from Beheira on 02/26 (posted by Dutchy). There was an announcement on their English bf website (but not on the Arabic version) -- which was later removed from the main index page...


        ...although it can still be viewed here:


        Now, there was an announcement on their Arabic bf website about two suspected cases in Mansoura which is no longer on the index page...


        ...although it can still be viewed here:


        I know it was originally indexed on the main Arabic page 'cause I posted it on the day it came out -- and that's how I found it.

        Oddly, it's still on the English index page:

        Two cases are suspected bird flu infected in Mansoura


        Any significance to these "removals"? I dunno. Regarding the latest one -- one of those sus cases from Mansoura is (possibly) named Ibrahim -- like two other confirmed cases from the same area.... ??
        ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

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        • #5
          Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

          3 new sus cases in Al Gharbiyah...

          Machine-translated from Arabic:

          3 cases of injury by the bird flu by the western [Al Gharbiyah]
          March 21, 2007

          Bank-to Abodhich:

          The hospitals of Tanta fevers, the district [Mahallah] and Basyoun detained three new conditions for the suspicion of their injury by the bird flu disease and they are Shaimaa Abdullah Saad "two years" from Gnzour facility and the fevers of Tanta and Mohamed Yunus Shahin entered "25 years" and an income the fevers of Basyoun and Soad Hosni Abdul Maqsoud from Samanoud center and entered the fevers of El-Mahalla El-Kubra and that after their feeling of a rise in the temperature ..Immediately have been reserved, their examination and taking samples from the blood and a touch from the throat for their sending to the central laboratories to make sure of their injury from their lack.

          http://www.algomhuria.net.eg/almessa/today/accedents/ [<< Not a permalink.]

          ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

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          • #6
            Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

            Commentary at

            Comment


            • #7
              Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

              Dr. Niman,
              You mention the word "reassortants" in your 3/21 post on your Website. What other strain could they have reassorted with? You mention in the linked post that the strain responsible for the 3 deletions is not Qinghai, so I am wondering if this marks the beginning of yet another clade. Also, since influenza likes to play "King of the Mountain," does this perhaps mean the end of the Tamiflu-resistant polymorphism?

              Thanks.

              Comment


              • #8
                Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                Originally posted by scottmcpherson View Post
                Dr. Niman,
                You mention the word "reassortants" in your 3/21 post on your Website. What other strain could they have reassorted with? You mention in the linked post that the strain responsible for the 3 deletions is not Qinghai, so I am wondering if this marks the beginning of yet another clade. Also, since influenza likes to play "King of the Mountain," does this perhaps mean the end of the Tamiflu-resistant polymorphism?

                Thanks.
                The recent isolates are both recombinants and reasortants. The Aswan sequences have HA from one source (probably Qinghai H5N1 in Aswan) and NA from Beni Suef / Fayyoum. The NA match is quite clear and sequences from Aswan will be required to identify the other parent, but the HA has a Mongolian cleavage site (these are recombinants as well as reassortants).

                More commentaries are coming.

                I also would not count out Tamiflu resistance. There are many mountains in Egypt with associated Kings.

                Comment


                • #9
                  Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                  Commentary at

                  Comment


                  • #10
                    Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                    Originally posted by niman View Post
                    Commentary

                    H5N1 Common Source in Aswan Egypt
                    Recombinomics Commentary
                    March 21, 2007


                    The two most recent confirmed H5N1 cases in Egypt are from the Aswan Goveronate. One patient (10F) was admitted March 13 with symptoms. The most recent confirmed case (2M) was admitted three days later with symptoms which developed on March 15. Although the latest WHO update indicated the epidemiological data failed to link the two cases, the sequences from the 10F, A/Egypt/2321-NAMRU3, and 2M, A/Egypt/2331-NAMRU-3, have identical NA sequences and the HA sequences differ by a single nucleotide.

                    The two sequences from Aswan are readily distinguished from earlier human and poultry isolates from Egypt. Although all isolates are the Qinghai strain (Clade 2.2) of H5N1 and have multiple regional markers clearly identifying the Egyptian origin of the isolates, the Aswan isolates have evidence for both reassortment and recombination. The NA sequences are similar to earlier NA sequences from Beni Suef and Fayyoum. However, the HA sequences have a novel cleavage site that matches the cleavage site reported in whooper swans in Mongolia in 2005. Although other isolates, including those from the Gharbiya cluster, link back to Mongolia, none of the prior isolates have the novel Mongolian cleavage site.

                    The virtual identity in the sequences from the patients in Aswan indicate they were infected by a common source. More information on the epidemiology would be useful. The infection of two children in Aswan who were hospitalized three days apart is cause form concern, although the sequences lack M230I and the presentations thus far indicate a mild course.


                    .
                    "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

                    Comment


                    • #11
                      Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                      Commentary at

                      Comment


                      • #12
                        Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                        Originally posted by niman View Post
                        Commentary

                        H5N1 Recombination and Reassortment in Aswan Egypt
                        Recombinomics Commentary
                        March 21, 2007


                        NAMRU-3 has generated HA and NA sequences from the two recent confirmed cases in Aswan, Egypt. Although the two cases were admitted three days apart and the epidemiological evidence indicated they were not linked, the HA and NA sequences from the two patients (10F and 2M) differed by a single nucleotide, indicating they were infected by a common source.

                        The sequences had clear evidence for both ressortment and recombination. Both sequences were clade 2.2 with a number of Egyptian regional markers. The HA sequence had G186A, G496A, C661T, C727T, C779T, G878A, C937T, G1018T, C1261T, and C1618T. All of the 2006 and 2007 Egyptian H5N1 isolates have the almost all of these markers. Similarly, the NA sequences have C150T, C236T, A703A, A740G, T1066C, G1280A, which are also markers which define Egyptian isolates.

                        However, the NA sequence found in both Aswan isolates (A/Egypt2321-NAMRU3/2007 and A/Egypt2331-NAMRU3/2007), have a number of additional markers found in two recent isolates in Beni Suef (A/Egypt/0636-NAMRU3/2007) and Fayyoum (A/Egypt/1394-NAMRU3/2007), C157A, T173C, G377A, C854A, C976T. These sub-regional markers link the NA sequences from these recent cases in central and southern Egypt.

                        The HA sequences are quite distinct. The two sequences from central Egypt share a 3 BP deletion, as well as A203G, C394T, G435A, T528C, A913G, A1603G. In contrast, the two sequences from southern Egypt share G82A, G118A, A356G, C449T, G469T, C499A, G536A, A587A, C642T, C736T, A830T, G907A, A1059G, C1614T.

                        The sequences of the additional six gene segments will further define the reassorted gene segments, but the similarities in the NA sequences and the differences between the HA sequences provide clear evidence for reassortment.

                        The sequences also have evidence for recombination. The HA sequences from central Egypt have a 3 BP deletion that matches H5N1 chicken isolates from Hunan. Thus, the 3 BP deletion is appended to the Egyptian Qinghai genetic background. Similarly, the HA sequences from southern Egypt have the novel cleavage site found in whooper swans in Mongolia.

                        The evidence of both reassortment and recombination in the recent cases from central and southern Egypt highlight genetic exchanges via dual infections. The widespread dual infections is supported by additional sequences with mixed signals in both human and poultry isolates.

                        The latest sequences highlight the overlapping flyways that cover Egypt which leads to frequent dual infections and rapid H5N1 evolution.


                        .
                        "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

                        Comment


                        • #13
                          Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                          Are there other areas with overlapping flyways that show evidence of rapid H5N1 evolution?

                          .
                          "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

                          Comment


                          • #14
                            Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                            Originally posted by AlaskaDenise View Post
                            Are there other areas with overlapping flyways that show evidence of rapid H5N1 evolution?

                            .
                            China

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                            • #15
                              Re: EGYPT - March 20, 2007+ - News on confirmed/suspected cases

                              Then throw in mutation-driving vaccinations, & it's no wonder we see what we see?

                              .
                              "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

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