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

[Theresa42]

Previous Egypt thread here:

http://www.flutrackers.com/forum/showthread.php?t=18914

[Theresa42]

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].

http://www.almasry-alyoum.com/articl...leID=51908&r=t

http://www.flutrackers.com/forum/showthread.php?t=19342

[Theresa42]

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

http://www.playfuls.com/news_10_1977...-Bird-Flu.html

[Theresa42]

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...
http://birdflu.sis.gov.eg/html/flu0101.htm

...although it can still be viewed here:
http://birdflu.sis.gov.eg/html/flu01021173.htm

Now, there was an announcement on their Arabic bf website about two suspected cases in Mansoura which is no longer on the index page...
http://birdflu.sis.gov.eg/ahtml/flu0101.htm

...although it can still be viewed here:
http://birdflu.sis.gov.eg/ahtml/aflu05135.htm

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
http://birdflu.sis.gov.eg/html/flu0101.htm

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.... ??

[Theresa42]

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.]

http://www.flutrackers.com/forum/showthread.php?t=19418

[HenryN]

Commentary at

http://www.recombinomics.com/News/03..._Cleavage.html

[scottmcpherson]

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.

[HenryN]

Originally Posted by scottmcpherson

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.

[HenryN]

Commentary at

http://www.recombinomics.com/News/03...an_Common.html

[AlaskaDenise]

Originally Posted by niman

Commentary at

http://www.recombinomics.com/News/03...an_Common.html

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.


.

[HenryN]

Commentary at

http://www.recombinomics.com/News/03...mbination.html

[AlaskaDenise]

Originally Posted by niman

Commentary at

http://www.recombinomics.com/News/03...mbination.html

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.


.

[AlaskaDenise]

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

.

[HenryN]

Originally Posted by AlaskaDenise

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

.

China

[AlaskaDenise]

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

.

[HenryN]

Originally Posted by AlaskaDenise

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

.

Actually, the rate of evolution is linked to many factors, including the diversity of the H5N1 in the dual infections. China has a great deal of H5N1 genetic diversity as well as dual infections, with some selection pressure applied by mismatched vaccines.

[HenryN]

Here is a travel log of interest

EF382360 A/Egypt/0636-NAMRU3/2007 NA (6) 1412 2007 H5N1
CY019410 A/Indonesia/CDC1046/2007 NA (6) 1398 2007 H5N1
CY019418 A/Indonesia/CDC1046T/2007 NA (6) 1398 2007 H5N1
CY019426 A/Indonesia/CDC1047/2007 NA (6) 1399 2007 H5N1
CY019434 A/Indonesia/CDC1047S/2007 NA (6) 1402 2007 H5N1
ISDN137807 A/Feline/Indonesia/CDC1/06 NA (6) 1331 2006 H5N1
CY014234 A/feline/Indonesia/CDC1/2006 NA (6) 1331 2006 H5N1
ISDN133317 A/Indonesia/283H/2006 NA (6) 1393 2006 H5N1
ISDN133324 A/Indonesia/286H/2006 NA (6) 1396 2006 H5N1
ISDN138750 A/Indonesia/292H/2006 NA (6) 1350 2006 H5N1
ISDN136851 A/Indonesia/304H/2006 NA (6) 1305 2006 H5N1
ISDN140928 A/Indonesia/542H/2006 NA (6) 1362 2006 H5N1
ISDN187439 A/Indonesia/569H/2006 NA (6) 1317 2006 H5N1
ISDN187447 A/Indonesia/583H/2006 NA (6) 1333 2006 H5N1
ISDN137812 A/Indonesia/CDC326/06 NA (6) 1331 2006 H5N1
CY014239 A/Indonesia/CDC326/2006 NA (6) 1331 2006 H5N1
ISDN137809 A/Indonesia/CDC326n/06 NA (6) 1331 2006 H5N1
CY014236 A/Indonesia/CDC326N/2006 NA (6) 1331 2006 H5N1
ISDN137802 A/Indonesia/CDC326t/06 NA (6) 1331 2006 H5N1
CY014229 A/Indonesia/CDC326T/2006 NA (6) 1331 2006 H5N1
ISDN137808 A/Indonesia/CDC329/2006 NA (6) 1331 2006 H5N1
CY014235 A/Indonesia/CDC329/2006 NA (6) 1331 2006 H5N1
ISDN137803 A/Indonesia/CDC357/06 NA (6) 1331 2006 H5N1
CY014230 A/Indonesia/CDC357/2006 NA (6) 1331 2006 H5N1
CY014398 A/Indonesia/CDC610/2006 NA (6) 1374 2006 H5N1
ISDN183703 A/Indonesia/CDC610/2006 NA (6) 1374 2006 H5N1
ISDN183711 A/Indonesia/CDC623/2006 NA (6) 1370 2006 H5N1
CY014406 A/Indonesia/CDC623/2006 NA (6) 1370 2006 H5N1
ISDN183719 A/Indonesia/CDC623E/2006 NA (6) 1379 2006 H5N1
CY014414 A/Indonesia/CDC623E/2006 NA (6) 1379 2006 H5N1
ISDN183727 A/Indonesia/CDC624/2006 NA (6) 1369 2006 H5N1
CY014422 A/Indonesia/CDC624/2006 NA (6) 1369 2006 H5N1
ISDN183735 A/Indonesia/CDC624E/2006 NA (6) 1369 2006 H5N1
CY014430 A/Indonesia/CDC624E/2006 NA (6) 1369 2006 H5N1
ISDN204138 A/Indonesia/CDC669/2006 NA (6) 1378 2006 H5N1
CY014486 A/Indonesia/CDC669/2006 NA (6) 1378 2006 H5N1
ISDN204146 A/Indonesia/CDC669P/2006 NA (6) 1378 2006 H5N1
CY014494 A/Indonesia/CDC669P/2006 NA (6) 1378 2006 H5N1
CY014531 A/Indonesia/CDC739/2006 NA (6) 1378 2006 H5N1
CY014539 A/Indonesia/CDC742/2006 NA (6) 1378 2006 H5N1
CY014545 A/Indonesia/CDC759/2006 NA (6) 1378 2006 H5N1
CY017664 A/Indonesia/CDC835/2006 NA (6) 1398 2006 H5N1
CY017672 A/Indonesia/CDC836/2006 NA (6) 1398 2006 H5N1
CY017680 A/Indonesia/CDC836T/2006 NA (6) 1398 2006 H5N1
CY017656 A/Indonesia/CDC940/2006 NA (6) 1398 2006 H5N1
ISDN132408 A/Indonesia/239H/2005 NA (6) 1327 2005 H5N1
ISDN132416 A/Indonesia/245H/2005 NA (6) 1361 2005 H5N1
ISDN137811 A/Indonesia/CDC287e/05 NA (6) 1331 2005 H5N1
CY014238 A/Indonesia/CDC287E/2005 NA (6) 1331 2005 H5N1
ISDN137800 A/Indonesia/CDC292n/05 NA (6) 1331 2005 H5N1
CY014227 A/Indonesia/CDC292N/2005 NA (6) 1331 2005 H5N1
ISDN137801 A/Indonesia/CDC292t/05 NA (6) 1331 2005 H5N1
CY014228 A/Indonesia/CDC292T/2005 NA (6) 1331 2005 H5N1

[wetDirt]

How many other changes in NA are there between Indo and Egypt? Is this a SNP or is it a chunk of a dozen?


*wanders off visualizing long-range migratory flying cats... Bar-headed geese adopting kittens and flying them over the Himalayas to Egypt...*

*mrrrooooooowww* *whump*

[HenryN]

Originally Posted by wetDirt

How many other changes in NA are there between Indo and Egypt? Is this a SNP or is it a chunk of a dozen?


*wanders off visualizing long-range migratory flying cats... Bar-headed geese adopting kittens and flying them over the Himalayas to Egypt...*

*mrrrooooooowww* *whump*

The above travel log is of a SNP, but it is a SNP with a very specific distribution.

[scottmcpherson]

I enjoy Wetdirt's sense of humor. More is needed.

[Theresa42]

I don't see an English version of this yet....

Google-translated from Arabic:

Cure Egyptian girl was infected with avian influenza
2007-03-22

Cairo, March 22 / Xinhua / Egyptian same girl was infected with avian influenza disease, after it had received the necessary treatment Manshiet Bakry Hospital in Egypt / Cairo /, according to the agency / Middle East News / Egyptian official.

He said Dr. Yusri Rajab director of the hospital today / Thursday / girl princess Abdul Latif Nayel, aged 10 years of Aswan Governorate, left the hospital after medical tests proved its recovery from the disease of avian flu.

The Egyptian Ministry of Health had announced in the 14th of this month, injuring girl bird influenza, the situation becomes human No. 25 among 26 cases of the disease in Egypt since he appeared in February 2006.

http://www.arabic.xinhuanet.com/arab...ent_404840.htm

[Theresa42]

Google-translated from Arabic:

Exit [patient number] 25 of the hospital after recover from bird flu
March 23, 2007

Emerging yesterday from the hospital Manshiet Bakry girl princess Abdulatif Nayel 10 years of Aswan Governorate after the recent air analysis laboratory to recover fully from the disease as avian influenza results were negative and the injury of 25 of the total casualties of the current 26 injured since the emergence of the disease in February in Egypt last year.

He said Dr. Yusri Rajab Manshiet Bakry Hospital Director: that the latter is the No. 26 of the child Mohammed Youssef Mahmoud, two and a half year of the Aswan Governorate, which is also still receiving treatment at the hospital so far Manshiet Bakry and expected his release after completion of his recovery during the next week.

The princess confirmed that the child she was diagnosed with the disease on March 14 due to the current Mkhalttha household infected birds were transferred from the hospital pathogenesis of Aswan, which entered suffering from a high temperature with pain in the muscles, indicating that the child was transferred later to a hospital Manshiet Bakry was given treatment The property was Altamiflo work epidemiological investigation of all family members and the results were negative.

He pointed to Dr. Yusri said the hospital had received nine children of the total casualties of the 26 cases of avian flu died, including 13 cases and the remaining cases recovered, indicating that the total number of children were ill and left all of the hospital except in the case and confirmed that the 26 early detection of infected cases and give appropriate property Altamiflo of in a timely manner helped to cure such cases, pointing out that the hospital Manshiet Bakry Section specializing in the treatment of children who are exposed to avian influenza infection and are receiving all the cases, which is fitted with a special quality of the equipment and machinery and equipment suitable for the treatment of children in situations of chest diseases.

He added that given the child's mother, which was accompanied during treatment instructions and health guidance must be followed, a speed no reported casualties among the birds of Veterinary Medicine and Educational birds inside houses and not mixing with children and vaccinating all birds against avian influenza, which are free of charge through the veterinary medicine at the that any of the family members to high temperature and the appearance of symptoms to go immediately to the nearest hospital or center.

http://www.almasry-alyoum.com/articl...leID=52207&r=t

[HenryN]

The HA and NA sequences from Aswan were virtually identical, so recovery of both was expected.

[Anne]

3-year-old girl becomes Egypt's 27th case with deadly bird flu strain


The Associated Press

27 mars

http://www.iht.com/articles/ap/2007/...t-Bird-Flu.php

CAIRO, Egypt: A three-year-old girl has contracted the potentially deadly strain of bird flu, bringing the total number of Egyptians to be diagnosed with the disease to 27 since it appeared in the country last year.
Health ministry spokesman Abdel Rahman Shahine said the girl — identified as Hajer Mohammed Awadallah from the southern city of Aswan — was admitted to a local hospital with a fever and cold symptoms.
She tested positive for the H5N1 bird flu strain on Sunday, he added.
"She is receiving medical treatment at Aswan children hospital," Shahine said, adding that her condition was table and that she was being treated with Tamiflu, the drug of choice for bird flu in humans.
Shahine added that the little girl contradicted the virus from domestic birds her family raises at

[HenryN]

It is likely that the sequence of this case will match the two earlier cases from Aswan.

[Theresa42]

New Egypt thread:

http://www.flutrackers.com/forum/showthread.php?t=20410