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  • Concerns arise over symptomless Egypt bird flu cases

    INTERVIEW-Concerns arise over symptomless Egypt bird flu cases
    08 Apr 2009 11:13:26 GMT
    Source: Reuters

    * WHO concerned about possible bird flu human carriers * U.N. body to test if cases exist * Worries about mutation of the pathogenic virus

    By Cynthia Johnston CAIRO, April 8 (Reuters) - The World Health Organisation is concerned some Egyptians may carry the highly pathogenic bird flu virus without showing symptoms, which could give it more of a chance to mutate to a strain that spreads easily among humans. Whether such cases exist still has to be put to the test and will be the focus of a planned Egyptian government study backed by the global health body, said John Jabbour, a Cairo-based emerging diseases specialist at WHO. "This is a concern only, now. It is a question to be asked," Jabbour told Reuters.

    He said a change in the pattern of human bird flu infections this year in Egypt had raised concerns about the existence of so-called sub clinical cases. The most populous Arab country, which has been hit harder by bird flu than any other country outside of Asia, has seen a surge in infections this year. While the H5N1 virus only rarely infects people, experts fear it could mutate into a form that humans could easily pass to one another, sparking a pandemic that could kill millions.

    The emergence of symptomless human carriers of the virus would be a worrisome development because it could allow the virus, undetected and untreated, more time to mutate inside the human body, Jabbour said. "If there is any sub clinical case in Egypt, the aim is to treat immediately to stop the reproduction of the virus. Because whether (through) mutation or reassortment, this will lead to the pandemic strain," he said.

    Of the 11 Egyptians infected with bird flu this year, all but two have been children under age three while adult cases have all but dried up. All have survived. That is starkly different from the same period a year ago, when seven people -- mostly adults and older children -- contracted the virus and three died.

    'SOMETHING STRANGE HAPPENING' Jabbour said the rise in infections in children without similar cases among adults had triggered questions as to whether adults were being infected with the virus but not falling ill. "There is something strange happening in Egypt. Why in children now and not in adults?" he said. "We need to see if there are sub clinical cases in the community."

    Jabbour said there had been no known instances of sub clinical bird flu cases in humans in other countries where the disease was present. Some birds, like ducks, are known to carry and spread the virus without showing symptoms, he said.

    The Egyptian study, which Jabbour said should begin in the coming months, would test the blood of people who may have been in contact with infected birds but had not become sick.

    Since 2003 the avian influenza virus has infected more than 400 people in 15 countries and killed 256 of them. It has killed or forced the culling of more than 300 million birds across Asia, the Middle East, Africa and Europe. Some 23 Egyptians have died after contracting the virus, most after contact with infected domestic birds in the country where roughly 5 million households depend on domestically raised poultry as a major source of food and income.

    But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt. He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other. "There is no change in the virus at all in the virus strain in Egypt.

    It is the same since the beginning of the outbreak. There is no mutation, nothing," he said. (Writing by Cynthia Johnston)

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  • #2
    Re: Concerns arise over symptomless Egypt bird flu cases

    Originally posted by niman View Post
    INTERVIEW-Concerns arise over symptomless Egypt bird flu cases
    08 Apr 2009 11:13:26 GMT
    Source: Reuters


    But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt. He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other. "There is no change in the virus at all in the virus strain in Egypt.

    It is the same since the beginning of the outbreak. There is no mutation, nothing," he said. (Writing by Cynthia Johnston)

    http://www.alertnet.org/thenews/newsdesk/L7467886.htm
    Toddler to toddler transmission confirmed (sick bird nonsense notwithstanding).

    Comment


    • #3
      Re: Concerns arise over symptomless Egypt bird flu cases

      Originally posted by niman View Post
      INTERVIEW-Concerns arise over symptomless Egypt bird flu cases
      08 Apr 2009 11:13:26 GMT
      Source: Reuters

      "There is no change in the virus at all in the virus strain in Egypt.

      It is the same since the beginning of the outbreak. There is no mutation, nothing," he said. (Writing by Cynthia Johnston)

      http://www.alertnet.org/thenews/newsdesk/L7467886.htm
      Beyond absurd. WHO has already selected TWO vaccine targets from Egypt, and NEITHER match the strain from 2009 linked to the mild cases.

      Comment


      • #4
        Re: Concerns arise over symptomless Egypt bird flu cases

        Originally posted by niman View Post
        Beyond absurd. WHO has already selected TWO vaccine targets from Egypt, and NEITHER match the strain from 2009 linked to the mild cases.

        http://www.who.int/csr/disease/avian...irusUpdate.pdf
        The selected targets are
        A/Egypt/2321-NAMRU3/2007 and
        A/Egypt/3300-NAMRU3/2008

        which are distinct form the 2009 mild cases
        A/Egypt/0585-NAMRU3/2009
        A/Egypt/0001-NAMRU3/2009

        but NAMRU-3 has not released ANY late 2008 / early 2009 sequences (poultry or patients)

        Comment


        • #5
          Re: Concerns arise over symptomless Egypt bird flu cases

          I have felt for a long time that some of the suspected cases in Egypt were possibly actual cases of H5N1.

          Children with "light" cases of bird flu in Egypt is nothing new. It begs the question of how many other cases, that were undiagnosed, may have escaped detection.

          As I read this from above:

          "...But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt. He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other..."


          ......apparently poultry is the contagion.

          Comment


          • #6
            Re: Concerns arise over symptomless Egypt bird flu cases

            Originally posted by Florida1 View Post
            I have felt for a long time that some of the suspected cases in Egypt were possibly actual cases of H5N1.

            Children with "light" cases of bird flu in Egypt is nothing new. It begs the question of how many other cases, that were undiagnosed, may have escaped detection.

            As I read this from above:

            "...But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt. He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other..."


            ......apparently poultry is the contagion.
            Please. "Beliefs" are NOT science. The 4 day gap in disease onset dates DEFINES H2H.

            Comment


            • #7
              Re: Concerns arise over symptomless Egypt bird flu cases

              We can argue about cases #61 and # 62 all day long but the larger picture is also very important.

              "There is something strange happening in Egypt. Why in children now and not in adults?" he said. "We need to see if there are sub clinical cases in the community."

              And while they are checking Egypt, they can look at Indonesia and China as well.

              Comment


              • #8
                Re: Concerns arise over symptomless Egypt bird flu cases

                Originally posted by Florida1 View Post
                I have felt for a long time that some of the suspected cases in Egypt were possibly actual cases of H5N1.

                Children with "light" cases of bird flu in Egypt is nothing new. It begs the question of how many other cases, that were undiagnosed, may have escaped detection.

                As I read this from above:

                "...But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt. He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other..."


                ......apparently poultry is the contagion.
                The same agency that "believes" the OBVIOUS H2H is not H2H also failed to note that the two H5N1 CONFIRMED toddlers were NEIGHBORS and COUSINS, in the official update.

                The "belief" is well beyond propaganda.

                Comment


                • #9
                  Re: Concerns arise over symptomless Egypt bird flu cases

                  Originally posted by Florida1 View Post
                  We can argue about cases #61 and # 62 all day long but the larger picture is also very important.

                  "There is something strange happening in Egypt. Why in children now and not in adults?" he said. "We need to see if there are sub clinical cases in the community."

                  And while they are checking Egypt, they can look at Indonesia and China as well.
                  The larger picture is who is in charge of the "investigation".

                  The fairy tale is now official:



                  Case number 62

                  The Ministry of Health and Population of Egypt reported a new confirmed human case of avian influenza on 6 April 2009. The new case is a two-year-old male from the Kom Hamada district, El Behira governorate. His symptoms began on 31 March and he was hospitalized at Damanhour Fever Hospital on 1 April. The child received treatment with Tamiflu on the same day of hospitalization. Infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory on 2 April.
                  Investigations into the source of infection indicate a history of close contact with dead and sick poultry prior to becoming ill. The child is in a stable condition.
                  Case number 61

                  The Ministry of Health and Population of Egypt reported a new confirmed human case of avian influenza on 6 April 2009. The new case is a two-year-old male from the Kom Hamada district, El Behira governorate. His symptoms began on 27 March and he was hospitalized at Naaora Fever Hospital on 30 March. The child received treatment with Tamiflu on the same day of hospitalization. Infection with H5N1 avian influenza was confirmed by the Egyptian Central Public Health Laboratory on 1 April.
                  Investigations into the source of infection indicate a history of close contact with dead and sick poultry prior to becoming ill. The child is in a stable condition.

                  Comment


                  • #10
                    Re: Concerns arise over symptomless Egypt bird flu cases

                    Originally posted by Florida1 View Post
                    We can argue about cases #61 and # 62 all day long but the larger picture is also very important.

                    "There is something strange happening in Egypt. Why in children now and not in adults?" he said. "We need to see if there are sub clinical cases in the community."

                    And while they are checking Egypt, they can look at Indonesia and China as well.
                    Please. CLINICAL cases without a poultry connection are NOT tested for H5N1 in Egypt (or elsewhere).

                    Comment


                    • #11
                      Re: Concerns arise over symptomless Egypt bird flu cases

                      I see you are really into pleasing me lately!

                      Comment


                      • #12
                        Re: Concerns arise over symptomless Egypt bird flu cases

                        Originally posted by Florida1 View Post
                        I have felt for a long time that some of the suspected cases in Egypt were possibly actual cases of H5N1.

                        Children with "light" cases of bird flu in Egypt is nothing new. It begs the question of how many other cases, that were undiagnosed, may have escaped detection.

                        As I read this from above:

                        "...But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt. He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other..."


                        ......apparently poultry is the contagion.
                        The mild CONFIRMED H5N1 cases in EGYPT were noted in 2007



                        Mild H5N1 in Aswan Egypt
                        Recombinomics Commentary
                        March 26, 2007


                        The case is a female child, three years old. The illness started on the 22nd of March and admitted to the hospital on the 24th where they put her on tamiflu. The samples were taken on the 24th and confirmed positive for H5N1 on 25 March 2007. The patient had a history of contact with backyard poultry. The patient is still in a good health condition and is not epidemiologically linked to the previous two human cases in Aswan.

                        The above comments (emphasis added) from the WHO Eastern Mediterranean Regional Office supports media reports indicating the three confirmed H5N1 cases in Aswan were mild. Media reports indicate the two earlier cases (10F and 2M) were briefly hospitalized and have been discharged. The above comments indicate the most recent case “is still in a good health condition.” These comments support media reports indicating that the patients had a high fever and “cold” symptoms. None of the reports indicated the patients developed pneumonia, and the short hospital stay supports a mild presentation.............................

                        Comment


                        • #13
                          Re: Concerns arise over symptomless Egypt bird flu cases

                          Originally posted by Florida1 View Post
                          I have felt for a long time that some of the suspected cases in Egypt were possibly actual cases of H5N1.

                          Children with "light" cases of bird flu in Egypt is nothing new. It begs the question of how many other cases, that were undiagnosed, may have escaped detection.

                          As I read this from above:

                          "...But Jabbour said there was still no evidence of the disease being passed from person to person in Egypt. He added that two toddlers from the northern province of Beheira infected within days of one another in March were cousins. But he said the boys were believed to have contracted the virus from the same sick birds, not from each other..."


                          ......apparently poultry is the contagion.
                          Similary. in 2007 the cases that "were not epidemiologically linked" had H5N1 sequences that were virtually IDENTICAL.

                          Third H5N1 Infected Child in Aswan Egypt
                          Recombinomics Commentary
                          March 25, 2007


                          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.

                          The above comments are remarkably similar to the two other recent confirmed H5N1 infections in children (10F and 2M) in Aswan. The sequence of the H5N1 from today's confirmed case (3F) has not been generated, but the HA and NA sequences from the two prior Aswan cases were virtually identical.

                          Comment


                          • #14
                            Re: Concerns arise over symptomless Egypt bird flu cases

                            Commentary

                            Comment


                            • #15
                              Re: Concerns arise over symptomless Egypt bird flu cases

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

                              8 April 2009 --

                              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.
                              -
                              <cite cite="http://www.who.int/csr/don/2009_04_08a/en/index.html">WHO | Avian influenza - situation in Egypt - update 10</cite>

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