Three more Egyptians suspected of having bird flu

[Laidback Al]

Three more Egyptians suspected of having bird flu
35 minutes ago


A woman and her two children are suspected of contracting the deadly H5N1 strain of bird flu in Upper Egypt, a veterinary official reportedly said.
The 25-year-old mother, her 12-year-old son and daughter, 10, from a village in Sohag governorate, were hospitalized after showing the first symptoms of the sickness, the province's veterinary services chief Mohammed al-Masri told the official MENA news agency.
They are currently undergoing tests to determine whether they are suffering from H5N1 which has killed seven people in Egypt this year, he added.
"Preventive measures have been taken and samples were taken from poultry raised at their home before the animals were killed. The house and chicken coops were disinfected," Masri added.
Egypt -- the Arab world's most populous state -- is on a major route for migratory birds and has seen the third highest number of H5N1 cases after Indonesia and China according to Dr David Nabarro, the UN official charged with battling bird flu.
The H5N1 strain of bird flu was first diagnosed in birds in Egypt in February, and the first case in humans was announced on March 18.
In its most aggressive form, the H5N1 strain has killed more than 150 people worldwide, according to the World Health Organisation (WHO).

http://news.yahoo.com/s/afp/20061130...healthfluegypt

[christian]

Originally Posted by Laidback Al

The 25-year-old mother, her 12-year-old son and daughter, 10, from a village in Sohag governorate, were hospitalized after showing the first symptoms of the sickness, the province's veterinary services chief Mohammed al-Masri told the official MENA news agency.

Here's one of a fortnight ago, with no follow-up report to date:
Turkish Press, nov 17: New bird flu cases discovered in Egypt

Four Egyptians were admitted to hospital Thursday in the southern governorate of Sohag on suspicion of contracting the bird flu virus, according to newspaper reports Friday.
The victims ranged between nine months and 18 years and were sent to the Sohag general hospital and the regional university hospital.
Blood samples were taken from the four and sent to be tested in the central labs of the ministry of health.

Edit: I stand corrected:
http://www.alwafd.org/v2/News/NewsDe...978a542f490b3d

Google-translated from Arabic:

New hotbeds of avian influenza in Menoufia, Port Said
Nov 22, 2006
....
... spokesman also announced that the 7 »« suspected human cases in the presence of avian flu was negative outcome, the cases have been booked in hospitals Sohag, Giza and Port Said.

[Theresa42]

christian: Just a note on the 4 previous cases from Sohag -- I have assumed they tested neg because of the report you referred, but I never actually saw it spelled out anywhere that they did, indeed, test neg. The news reports simply said that 7 people from Sohag, Giza and Port Said (i.e. 3 different places) tested neg.

See this thread:
http://www.flutrackers.com/forum/sho...9&postcount=12

[Theresa42]

Originally Posted by Laidback Al

Three more Egyptians suspected of having bird flu
35 minutes ago

A woman and her two children are suspected of contracting the deadly H5N1 strain of bird flu in Upper Egypt, a veterinary official reportedly said.
The 25-year-old mother, her 12-year-old son and daughter, 10, from a village in Sohag governorate, were hospitalized after showing the first symptoms of the sickness, the province's veterinary services chief Mohammed al-Masri told the official MENA news agency.
They are currently undergoing tests to determine whether they are suffering from H5N1 which has killed seven people in Egypt this year, he added.
"Preventive measures have been taken and samples were taken from poultry raised at their home before the animals were killed. The house and chicken coops were disinfected," Masri added.
Egypt -- the Arab world's most populous state -- is on a major route for migratory birds and has seen the third highest number of H5N1 cases after Indonesia and China according to Dr David Nabarro, the UN official charged with battling bird flu.
The H5N1 strain of bird flu was first diagnosed in birds in Egypt in February, and the first case in humans was announced on March 18.
In its most aggressive form, the H5N1 strain has killed more than 150 people worldwide, according to the World Health Organisation (WHO).

http://news.yahoo.com/s/afp/20061130...healthfluegypt

I wonder if this 25 year-old mother is the same as this 25 year-old woman reported the other day?:

http://www.flutrackers.com/forum/sho...3&postcount=13

http://www.flutrackers.com/forum/sho...6&postcount=15

[HenryN]

http://www.recombinomics.com/News/09...t_Suspect.html

H5N1 Bird Flu Suspect Cases in Egypt
Recombinomics Commentary
September 8, 2006

The Directorate of Health became seizure of bin Laden, Mohamed Atta - five years - and his mother, an evening full Qasim Sawamah east of the village center Akhmim in hospital on suspicion of haemorrhagic disease caught the avian flu. Also been sent samples of bin Laden, an evening for analysis at the Ministry of Health.

The National Committee to face bird flu headed by Dr. Hatem Al-Gabali, Minister of Health that it had to take measures to isolate and execution of poultry suspected of carrying the virus after an outbreak among domestic birds last week in the revival of the rain and Kobba and the eighth district in Cairo.

It also emerged in the cases of Giza and Dakahlia, Damietta, Qena, Qalubia and Beni Suef.

The above translation details two new suspect H5N1 bird flu cases in Egypt, as well as the spread of H5N1 into many regions beyond the initial reports of outbreaks in Cairo and Sohag.

The rapid spread in Egypt raises concerns about the lack of reports in neighboring countries in Africa and the Middle East where H5N1 has been reported earlier this year.

Last year the initial reports of H5N1 migrating south began in October, but reports from residents indicated wild birds, such as mute swans, were dying in August in the Volga Delta and Danube Delta.

It seems likely that unreported cases are again in these areas this season.

Media Sources

Phylogenetic Trees

[HenryN]

The September suspect cluster above is a few miles from Sohag.

[HenryN]

Discussion of earlier cluster

http://www.flutrackers.com/forum/showthread.php?t=10045

[HenryN]

H5N1 confirmed in birds in Sohag in September

http://www.recombinomics.com/News/09...1_Egypt_2.html

H5N1 Bird Flu Re-emerges in Egypt
Recombinomics Commentary
September 4, 2006

lethal H5N1 strain of the virus were found in a village in Sohag, 345 kilometers (215 miles) south of Cairo, on Tuesday and in Cairo on Thursday.

Health Ministry official Amr Qandil said four people suspected with symptoms of bird flu in the southern province of Sohag were tested negative and discharged from hospital

The above comments on two distinct outbreaks of H5N1 bird flu in Egypt last week signal an early re-emergence of H5N1 in Africa. Last season the migration of H5N1 out of southern Siberia was first confirmed on October, although local residents near the Volga Delta in Russia and the Danube Delta in Romania reported that mute swans began dying in August.

The confirmation in Egypt this week coincides with acknowledgement of H5 in the Ukraine near Kiev, indicating that reports of H5N1 will begin earlier this year. Similarly, low path H5N1 has been reported in three states in the United States, while last season August collections in southern Canada were not reported until November.

To date only one sequence from the Canadian infections from August . 2005 has been reported and the vast majority of the H5N1 isolates from Europe in 2005 and early 2006 have not been released.

The early reports of H5N1 this season may signal more transparent reporting and earlier release of sequences.

Media Sources

Phylogenetic Trees

[HenryN]

Another earlier cluster in Sohag
http://www.recombinomics.com/News/11...1_Suhaj_4.html

Four Suspect H5N1 Patients Hospitalized in Suhaj Egypt
Recombinomics Commentary
November 16, 2006

The university hospital in Suhaj detained 3 children and a factor for the suspicion of their injury by the bird flu epidemic and they are Faten Ahmed Shawqi, its sister Manar and Shaimaa and their neighbour Mohamed Al Sayed "a worker" the child and the worker was injured by a pneumonia and a sharp descent in the heart and lost the awareness -

The above translation desscribes four suspect H5N1 bird flu patients hospitalized in central Egypt. Two patients are already unconcious, and the cluster includes three siblings and a neighbor.

Clusters in Egypt are cause for concern. The HA from a recent fatality had M230I, which matches all three seasonal flu's (Influenza A H3N2 and H1N1 as well as Influenza B. The change creates five consecutive amino acids (QSGRI) that match the receptor binding domain of infleunza B, raising ocnerns of increased human-to-human transmission.

In addition, the Qinghai strain of H5N1 has PB2 E627K and recently released sequences from patients in Egypt earlier this year has S227N, as did two of the four isolates from Turkey. Moreover, today's Nature paper describes two additional polymorphims, N186K and Q196R, which increase receptor binding and were found in patients in Azerbaijan and Iraq. Those patients were also from clusters involving human-to-human transmission.

More information on these four patients would be useful.

Media sources

Phylogenetic Trees

[HenryN]

Commentary at

http://www.recombinomics.com/News/12...Cluster_3.html

[Theresa42]

Yes -- Sohag (Suhaj) seems to be a little hotbed of bf activity -- not exactly sure why.

Back in March there were also at least 2 bf suspects in Suhaj Univ hospital:

University Hospital in Suhaj:
3/22 - Omar Khaled Mostafa (3M) - national committee announced the isolation
3/22 - Kholoud Mohamed Abdul Alim (11-month male) - national committee announced the isolation

http://www.flutrackers.com/forum/sho...27&postcount=4

[Sharpe]

Yes, I would very much like to see the sequences coming out of Sohag.

Originally Posted by Theresa42

Yes -- Sohag (Suhaj) seems to be a little hotbed of bf activity -- not exactly sure why.

Back in March there were also at least 2 bf suspects in Suhaj Univ hospital:

University Hospital in Suhaj:
3/22 - Omar Khaled Mostafa (3M) - national committee announced the isolation
3/22 - Kholoud Mohamed Abdul Alim (11-month male) - national committee announced the isolation

http://www.flutrackers.com/forum/sho...27&postcount=4

[Mellie]

http://www.recombinomics.com/News/12...Cluster_3.html
Commentary

Third Suspect H5N1 Cluster in Sohag Egypt Raises Concerns

Recombinomics Commentary
December 1, 2006

A woman and her two children are suspected of contracting the deadly H5N1 strain of bird flu in Upper Egypt, a veterinary official reportedly said.

The 25-year-old mother, her 12-year-old son and daughter, 10, from a village in Sohag governorate, were hospitalized after showing the first symptoms of the sickness, the province's veterinary services chief Mohammed al-Masri told the official MENA news agency.

They are currently undergoing tests to determine whether they are suffering from H5N1 which has killed seven people in Egypt this year, he added.

The above suspect H5N1 cluster is the third in Sohag, and raises pandemic concerns. H5N1 re-emerged in Egypt in September. H5N1 was confirmed in Sohag and Cairo areas. The confirmed positives in poultry was followed by a cluster involving a mother and son. The symptoms were described as "haemorrhagic disease".

A second cluster involved three siblings and a neighbor who were hospitalized on the same day. Two of the four suspect cases were unconscious at the time of admission and had pneumonia. The two clusters were followed by reports of a 25 year old Sohag women admitted a week ago. It is unclear if the 25F admitted last week is the same person described above. If there is only one 25F patient, then infection of the children by their mother is likely.

The three suspect clusters in Sohag increase pandemic concerns. Although the human clusters have not been confirmed, the reports of false negatives worldwide are frequent. Media reports have not provided updates on these patients or described a subsequent diagnosis for these cluster members.

The only confirmed case in Egypt this season was of a fatal infection (39F) near Cairo. The sequence of HA H5N1 from that patient has been released, and it has a number of changes from H5N1 isolated in Egypt earlier this year, although the isolate clearly has many of the Egyptian associated markers.

One of the changes was M230I. This polymorphism is in all three human influenza's (H3N2, H1N1, influenza B). Moreover, the change creates a five amino acid exact match with the receptor binding domain of influenza B for positions 226-230 (QSGRI). Influenza B is efficiently transmitted human-to-human. Moreover, recent released sequences of otter Qinghai isolates in the region identify S227N in an Egyptian patient, as well as N186K and Q196R in patients in Azerbaijan and Iraq. The newly release human H5N1 sequences contained two Azerbaijan isolates with N186K and two Iraq isolates with Q196R. The Iraq isolates are confusing because there were more human HA H5N1 Iraq sequences than confirmed cases in Iraq

Since there have now been four changes at positions in or near the receptor binding domain (N186K, Q196R, S227N, M230I) in human Qinghai isolates in the region, further recombination can bring these changes together in the same sequence. The recent Nature paper provided synergy data for Q196R and S227N, which were found in one clone from a patient in Vietnam. The presence of such changes in birds infected with Qinghai H5N1 is unclear, since these isolates are from chicken eggs, which would select away from changes that increase affinity for 2,6 gal (human) receptors.

An increase in affinity for human receptors would lead to more efficient spread of H5N1 which would initially present as familial clusters. Such clusters were reported in Turkey, where two of the four public sequences have S227N, and Azerbaijan, where two of the public human H5N1 sequences have N186K. Moreover, all of the human Qinghai isolates have the mammalian polymorphism, PB2 E627K.

Thus, although the three suspect cluster in Egypt have not been confirmed, the clustering of suspect clusters in Sohag increase concern.

Details on the current status of these patients, regardless of H5N1 results, would be useful.

[Dutchy]

The Egyptian government seems confident enough to update their news on BF, first time since november 2nd. Nothing about Sohag /Suhaj ?

If they feel 'everything is under control', we will see almost daily updates from now on...

Statement of the Supreme National Committee to Combat Bird Flu 5/12/2006

The Ministerial Committee established to combat the spread of Avian Flu, and chaired by the Minister of Health, has been continuously monitoring and reviewing developments of spread of the disease and regulations applied in the field of combating the disease as follows:

First: Three samples for persons from the governorates of (Cairo, Giza, El-Gharbia) who had been in contact with dead birds or who were employed at farms where the infection had been detected and who had shown symptoms similar to that of Avian Flu, were tested and all results were negative.

Second: Daily status report of infection among fowl:

• El-Menyia:

One positive case of infection was discovered among domestic fowl in Samallout district, where infections had previously been reported. All fowls at the infected house and neighboring ones were culled and testing of persons in contact is ongoing.

• El-Gharbiya:

One positive case of infection was discovered at domestic fowl in the Kafr el-Zayat district, where infections had previously been reported.

All fowls at the site were culled and test results of persons in contact were all negative.

http://birdflu.sis.gov.eg/html/flu0102212.htm