Egypt Human Cases Feb 25th - April 19th 2008

[HenryN]

Egyptian girl tests positive for bird flu-MENA

Mon 25 Feb 2008, 22:52 GMT

[-] Text [+]

CAIRO, Feb 25 (Reuters) - A 4-year-old Egyptian girl tested positive for bird flu on Monday, the 44th confirmed human case in the Arab world's most populous country, state news agency MENA said.
Ministry of Health spokesman Abdel Rahman Shaheen said the girl had been treated with the antiviral drug tamiflu and had been transferred from Minya province to a hospital in Cairo, the agency said.
The girl is suffering from a high fever and is having trouble breathing because she has inflammation of one of her lungs.
Four Egyptian women died from bird flu in December. Their deaths broke a 5-month pause in human cases in Egypt and brought to 19 the number of Egyptians who have died of the H5N1 bird flu virus since it emerged in Egypt in early 2006.
It is the third winter the virus has struck after lying low during Egypt's hot summers, when it is much less likely to spread from one carrier to another.
Around 5 million households in Egypt depend on poultry as a main source of food and income, and the government has said this makes it unlikely the disease can be eradicated despite a large-scale poultry vaccination programme.
WHO officials have said the bird flu virus was now considered endemic in Egypt.
Deaths from bird flu total more than 230 worldwide since 2003 and have been reported in several African and Asian countries, as well as in Turkey and Azerbaijan. Egypt has been the hardest-hit country outside of Asia.
Health experts fear the virus could mutate into a form that spreads easily from one person to another, possibly triggering a pandemic that could kill millions. (Writing by Aziz El-Kaissouni) (aziz.el-kaissouni@reuters.com; +20 2 2578 3290/1; Reuters Messaging: aziz.el-kaissouni.reuters.com@reuters.net))

http://africa.reuters.com/wire/news/usnL25644939.html

[HenryN]

Re: Egyptian girl tests positive for bird flu-MENA

Commentary

http://www.recombinomics.com/News/02250805/H5N1_Minya_Child.html

[Sally Furniss]

Re: Egyptian girl tests positive for bird flu-MENA

H5N1 Confirmed in Child in Minya Egypt

Recombinomics Commentary 23:55
February 25, 2008

A 4-year-old Egyptian girl tested positive for bird flu on Monday

Ministry of Health spokesman Abdel Rahman Shaheen said the girl had been treated with the antiviral drug tamiflu and had been transferred from Minya province to a hospital in Cairo, the agency said.

The girl is suffering from a high fever and is having trouble breathing because she has inflammation of one of her lungs.

The above comments describe a new confirmed H5N1 case in Egypt. The had been five confirmed cases early in the season, but this is the first case this month, which parallels last year when cases in the south began to be reported in March and April. Last season the early cases were fatal, but the cases later in the season were mild and largely from central or southern Egypt, including Minya

The above description suggests this case, from central Egypt, has already developed pneumonia, raising concerns that the upping cases will be more severe than cases a year ago. Although the H5N1 sequences from the human cases have not been released, the poultry sequences raise significant concerns.

The H5N1 in Egypt is evolving rapidly and appending new polymorphisms onto the genetic backgrounds from last season. Sequences with the receptor binding domain changes V223I and M230I, which were in the Gharbiya cluster, were in circulation this season, but there were many changes added onto this background, including the consensus polybasic cleavage site, RERRRKKR, instead of the Qinghai cleavage site of GERRRKKR.

The acquisition of the original site, first reported in 1996 in the Guangdong goose, may signal a more virulent strain, since the sequences almost certainly have retained the human PB2 polymorphism, E627K. Thus, the combining of the traditional polybasic cleavage site with the human receptor binding domain change M230I and the human E627K could generate a more lethal and transmissible H5N1.

Media Links

Recombinomics Presentations

Recombinomics Publications

Recombinomics Paper at Nature Precedings

[HenryN]

Re: Egyptian girl tests positive for bird flu-MENA

Commentary

http://www.recombinomics.com/News/02260801/H5N1_Gharbiya_Reversion.html

[AlaskaDenise]

Re: Egyptian girl tests positive for bird flu-MENA

Commentary

http://www.recombinomics.com/News/02...Reversion.html

Commentary

H5N1 Cleavage Site Reversion in Gharbiya Sequences in Egypt

Recombinomics Commentary 00:55
February 26, 2008

Poultry H5N1 HA sequences from Egypt have been recently released by NAMRU-3. Included in the released sequences was a series that contained the two receptor binding domain changes present in the Gharbiya cluster, V223I and M230I. However, this series has a number of additional polymorphisms that had been previously limited to east Asia. Moreover, many of these changes are non synonymous, raising concerns that the rapid evolution is being driven by mismatched vaccines. Although the vaccination campaign has been extensive, reports of H5N1 in poultry have been high.

One of the non synonymous changes converts the signature Qinghai polybasic cleavage site of GERRRKKR into the original cleavage site of RERRRKKR, which was first reported in a Guangdong goose in 1996, and subsequently became widespread in eastern Asia in highly pathogenic H5N1. Although various human clade 2 isolates have signature changes such as RESRRKKR for clade 2.1 in Indonesia and RERRRKR for clade 2.3 (Fujian strain) in China and now moving into southeast Asia, the conversion of the Qingai cleavage site to the original motif has not been reported in public sequences.

However, the largest cluster in Indonesia, the Karo cluster in 2006, has the original cleavage site, which is now on Gharbiya-like sequences in Egypt. It is not clear if the Tamiflu resistance marker, N294S, is on the avian or human sequences this season, because no NA sequences have been released.

The acquisition of the original consensus cleavage is indicative of multiple changes in the recently released HA sequences. The recent confirmation of in a child in Minya who has a least one lung infection, in contrast to the mild cases last season, is cause for concern.

Sequences with traditional RERRRKKR cleavage site

A/chicken/Egypt/9390NAMRU3-CLEVB157/2007
A/chicken/Egypt/9392NAMRU3-CLEVB167/2007
A/chicken/Egypt/9391NAMRU3-CLEVB158/2007
A/chicken/Egypt/9387NAMRU3-CLEVB148/2007
A/chicken/Egypt/9385NAMRU3-CLEVB125/2007
A/chicken/Egypt/9386NAMRU3-CLEVB/136/2007
A/chicken/Egypt/3051NAMRU3-CLEVB78/2007


.

[sharon sanders]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Previous Egypt Human Cases thread:

http://www.flutrackers.com/forum/showthread.php?t=48404

[sharon sanders]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

machine translation

Ministry of Health announces infection No. 44 avian influenza girl Minya 2/25/2008 11:55:00 PM

<!-- Image --><table style="text-align: left; direction: ltr;" align="right" border="0" cellpadding="0" cellspacing="0" width="180"><tbody><tr><td><script type="text/javascript"> <!-- function pop() { var generator=window.open('','name','height=500,width= 500,status=1,scrollbars=1'); generator.document.write('<html><head><title>Masra wy - وزارة الصحة تعلن الإصابة رقم 44 بأنفلونزا الطيور لطفلة من المنيا </title>'); generator.document.write('<link rel="stylesheet" href="/style/news.css">'); generator.document.write('</head><body>'); generator.document.write('

'); generator.document.write('

'); generator.document.write('

الإصابة البشرية رقم 44 بمرض أنفلونزا الطيور

'); generator.document.write('

أغلق النافذة

'); generator.document.write('</body></html>'); generator.document.close(); } //--> </script></td></tr><tr><td>

اضغط هنا لتكبير الصورة

Click to enlarge

</td></tr><tr><td class="phototitle" align="center" height="18">

الإصابة البشرية رقم 44 بمرض أنفلونزا الطيور

No. 44 human infection of avian influenza illn </td></tr></tbody></table>

وي-

CAIRO - Editor TOM - Monday confirmed human infection No. 44 contracted avian influenza in Egypt for 4-year-old girl from the village of Sheikh Massoud Center enemy Minya governorate.


The Middle East News Agency quoted Dr. Abdul Rahman Al Shaheen Media adviser and spokesman, Ministry of Health and Population Monday night that the patient was transferred after all tests and analyses necessary and giving real estate "Altamflo" enemy Central Hospital to a hospital Adviser Bakry Cairo.




He explained that the condition of medium and suffering from high temperature and shortness of breath and pneumonia in one lung, and is currently condition and follow-up care necessary Adviser Bakry Hospital in Cairo.

غت مليا

The People's Assembly's discussions revealed that Egypt's losses from the spread of bird flu has reached two billion pounds.

ورة مباشرة وملايين آخرين بصورة غي


ر مباشرة.

The deputies emphasized in their discussions accuracy of the statement by Minister of Agriculture Amin Abaza on government inaction in the face of disease, which led to the spread and increase in the number of injuries which now threatens the future of poultry industry in Egypt, which investments amount to 25 billion pounds, benefiting 3 million Egyptian directly and 10 million others are indirectly.

http://www.masrawy.com/news/egypt/default.aspx

[Theresa42]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Report of a suspected case in Sohag who died last Friday. It's not clear whether or not the woman was tested. Sounds like she may have been tested at the first hospital she was in (Tahta Hosp) but then not tested in Sohag Fevers Hosp? No mention of any test results.

It also sounds like there are (at least) a couple of other suspected cases also in hospital in Sohag.

Hat-tip to pugmom for finding this article!

Machine-translated from Arabic:

Youssef: The bird flu came to Tahta
Feb 23, 2008

He wrote: Al Desouki's successor

Mohamed Youssef (the parliamentary bloc member of the Muslim brothers about Tahta constituency in Sohag Governate) stood recently with the visit of two conditions that suspects in they injured it by the bird flu disease, and that for the reassurance of them and on the analyses that were held for them.

And the deputy explained that under the permanent declaration of the Ministry of Health that the situation is stable and the matter under the control the fatal epidemic spread so that it invades Tahta city the overpopulated city is few the capabilities and many the randomness.

And the deputy confirmed that one of the conditions [suspected cases] were dead yesterday Friday [Feb 22] and calls Amaal Salah Qubaisy Al Sayed (34 years) is married and have a new child four months.

And the deputy explained what happened a saying "our knowledge that the Mrs. was complaining of a coldness in the body and with its going to Dr. Khalafallah Fathi Abdul Aal (a doctor in the hospital of Tahta fevers) on Tuesday 19/2/2008 the case diagnosis took place that it is a cold, and he reassured us by the non presence of dead birds then came the patient for it once again on Thursday at 10 an evening 21/2/2008 AD and the condition was complaining of a narrowness by the soul [congested chest]".

And Youssef added a saying "the doctor carried out immediately the direction by the patient himself to the central hospital of Tahta for a work that he radiated [X-ray] and analyses of a suspicion of the bird flu, and the doctor was not content with that, but for the reassurance more carried out its transfer of the doubt [of the suspected case] carried out its transfer to Tahta fevers that in front of it, and it was confirmed that it is the bird flu to a blood money from the common diagnosis from the doctors".

And the block member pointed out that the doctor has addressed all authorities from the police station, the veterinary medicine and the environment and the Health Department and the Fever Hospital Suhaj, and the doctor was not content with that, but went himself to Suhaj fevers with accompanying the patient by Tahta ambulance for their acceptance at in the morning, explaining that it has worked a report its referral to the Minister of Health and the concerned authorities took place until the horrible news came with the death of Mrs. on Friday 22/2/2008 at after the afternoon four and she translated from Suhaj fevers to the general hospital of Suhaj to the non presence of a system is an artificial respiration as said by the hospital of Suhaj fevers!!

And the deputy denounced the neglect that happened in the non taking of the sample the hospital of the fevers Suhaj from the patient and she at it at 2 in the morning at 4 after the afternoon!!

http://www.nowabikhwan.com/index.aspx?ctrl=press&ID=c8a84d72-3ed8-49f0-9f6e-197601281b54

[Theresa42]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Hat-tip, mojo!

Egypt confirms 44th human bird flu case
2008-02-26

CAIRO, Feb. 25 (Xinhua) -- The Egyptian Ministry of Health confirmed Monday that a four-year-old girl was infected with bird flu virus in Egypt, bringing the number of human infection case to 44 in the populous Arab country.

The latest case was detected in El Minya governorate, Upper Egypt, some 220 km south of the Egyptian capital of Cairo, Health Ministry spokesman Abdel Rahman Shaheen was quoted by the official MENA news agency as saying.

The girl was hospitalized for fever on Monday and later moved to Manshiat al-Bakri hospital in Cairo, said the report.

The Egyptian government has exerted more efforts to prevent further spread of bird flu since the fatal virus caused four human deaths in less than a week in late December, 2007.

Among the 44 human cases, Egypt has reported 19 deaths since it detected the first H5N1 virus in dead poultry in February 2006 and the first human case in March of the same year.

http://news.xinhuanet.com/english/2008-02/26/content_7671211.htm

[HenryN]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Report of a suspected case in Sohag who died last Friday. It's not clear whether or not the woman was tested. Sounds like she may have been tested at the first hospital she was in (Tahta Hosp) but then not tested in Sohag Fevers Hosp? No mention of any test results.

It also sounds like there are (at least) a couple of other suspected cases also in hospital in Sohag.

Hat-tip to pugmom for finding this article!

Machine-translated from Arabic:

Youssef: The bird flu came to Tahta
Feb 23, 2008



And Youssef added a saying "the doctor carried out immediately the direction by the patient himself to the central hospital of Tahta for a work that he radiated [X-ray] and analyses of a suspicion of the bird flu, and the doctor was not content with that, but for the reassurance more carried out its transfer of the doubt [of the suspected case] carried out its transfer to Tahta fevers that in front of it, and it was confirmed that it is the bird flu to a blood money from the common diagnosis from the doctors".

http://www.nowabikhwan.com/index.asp...e-197601281b54

Does the above indicate that the x-ray confirmed pneumonia, but the transfer was to get a lab test to confirm (but no sample was collected prior to death)?

[Theresa42]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Does the above indicate that the x-ray confirmed pneumonia, but the transfer was to get a lab test to confirm (but no sample was collected prior to death)?

Hard to tell. Could be that.

Or it could be that she was also tested at the first hospital in addition to the X-rays -- "and analyses", analyses meaning tests? -- but was just transferred to the Fevers Hospital because her condition was so bad. The other suspected cases in the Tahta Hospital seem to have been tested.

If the woman who died was tested at the first hospital, they haven't reported on any results from those tests yet though. ??

She definitely wasn't tested at the second hospital -- Sohag Fevers Hospital.

[HenryN]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Hard to tell. Could be that.

Or it could be that she was also tested at the first hospital in addition to the X-rays -- "and analyses", analyses meaning tests? -- but was just transferred to the Fevers Hospital because her condition was so bad. The other suspected cases in the Tahta Hospital seem to have been tested.

If the woman who died was tested at the first hospital, they haven't reported on any results from those tests yet though. ??

She definitely wasn't tested at the second hospital -- Sohag Fevers Hospital.

And Sohag didn't have a respirator available (in addition to not collecting a sample)?

[Theresa42]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

And Sohag didn't have a respirator available (in addition to not collecting a sample)?

Sounded like that don't have a respirator at all!

(This is, I believe, a report from the Muslim Brotherhood and they are very anti-government. Worth bearing in mind.)

[HenryN]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Commentary

http://www.recombinomics.com/News/02260802/H5N1_Sohag_Fatality.html

[AlaskaDenise]

Re: Egypt Human Cases Feb 25th +, Girl tests positive for bird flu

Commentary

http://www.recombinomics.com/News/02..._Fatality.html

Commentary

Suspect H5N1 Fatality in Sohag Egypt

Recombinomics Commentary 07:51
February 26, 2008

And the deputy confirmed that one of the conditions [suspected cases] were dead yesterday Friday [Feb 22] and calls Amaal Salah Qubaisy Al Sayed (34 years) is married and have a new child four months.

And Youssef added a saying "the doctor carried out immediately the direction by the patient himself to the central hospital of Tahta for a work that he radiated [X-ray] and analyses of a suspicion of the bird flu, and the doctor was not content with that, but for the reassurance more carried out its transfer of the doubt [of the suspected case] carried out its transfer to Tahta fevers that in front of it, and it was confirmed that it is the bird flu to a blood money from the common diagnosis from the doctors".

the doctor was not content with that, but went himself to Suhaj fevers with accompanying the patient by Tahta ambulance for their acceptance at in the morning, explaining that it has worked a report its referral to the Minister of Health and the concerned authorities took place until the horrible news came with the death of Mrs. on Friday 22/2/2008 at after the afternoon four and she translated from Suhaj fevers to the general hospital of Suhaj

And the deputy denounced the neglect that happened in the non taking of the sample the hospital of the fevers Suhaj from the patient and she at it at 2 in the morning at 4 after the afternoon!!

The above translation describes a fatal suspect H5N1 case in Sohag. The patient did not improve last week and after x-rays raised additional concerns of an H5N1 infection, she was transferred to from Tahta to Sohag, but died shortly after transfer and a sample for testing was not collected.

This case is in addition to the H5N1 confirmed case (4F) in Minyah. That case also had x-ray confirmed pneumonia and is hospitalized in Cairo.

The confirmed and suspect cases may be signaling a new wave of H5N1 infections in Egypt. Last year there was a spike in cases in March and April, but those cases were mild. Only one in 17 H5N1 confirmed cases died, in marked contrast to cases at the beginning of last season or this season when 11 of 12 confirmed patients died.

Recently release poultry sequences include Gharbiya-like sequences with receptor binding domain changes, V223I and M230I, as well as reversion to the original poly-basic cleavage site RERRRKKR.

Release of human HA and NA sequences, as well as poultry NA sequences from this season would be useful. In late 2007 four of the five confirmed patients died, yet no sequence data has been made public by NAMRU-3 or the CDC.


.