Second Egyptian dies of bird flu; H5 virus found in mink

Mar 29, 2006 (CIDRAP News) – A second Egyptian has died of H5N1 avian influenza, and the virus may have infected a mink in Sweden, according to recent reports.

The Egyptian victim, Fatma Mahmoud Youssef Sabra, 30, lived in the Qaliubiya governorate north of Cairo, the Associated Press (AP) reported today. Egyptian authorities confirmed that she died of H5N1 infection, according to a World Health Organization (WHO) statement. The agency said she became ill on Mar 12 after slaughtering chickens at home; she was admitted to a hospital Mar 16 and died Mar 27.

The first human case in Egypt involved another 30-year-old woman from the same governorate, who died Mar 17.

As previously reported, tests by the Cairo-based US Naval Medical Research Unit 3 (NAMRU-3) confirmed three other human cases in Egypt, for five total cases to date. The WHO listed the patients as a 32-year-old man who worked on a farm where poultry were culled shortly before he fell ill on Mar 16, a 17-year-old boy from a poultry farm in the Nile Delta who fell ill Mar 18, and an 18-year-old girl from the Kafr-El-Sheikh governorate who fell ill after butchering sick poultry. She has been hospitalized since Mar 25, but the man and the teen-ager have recovered, WHO said.

The WHO has postponed adding these cases to its case count until confirmatory testing is completed, the agency said today. The current tally is 186 human cases, including 105 deaths.

Conflicting reports on the status of avian flu in Iraq have emerged in the past 3 days. A WHO spokeswoman told Reuters news service on Mar 27 that avian flu was under control in Iraq, in comments that appeared focused on the virus' spread in poultry.

Today Agence France-Presse (AFP) reported that birds in a district of Baghdad have tested positive for H5N1 flu, while a man elsewhere in the city has been hospitalized with signs and symptoms consistent with avian flu. Tests on birds from the Kamamaliya district were positive for H5N1, said Ibtisam Aziz, a spokeswoman for the Iraqi government's avian flu committee. The tests were conducted after a man who died earlier this week was suspected of having avian flu, AFP reported. A relative of the man had similar symptoms but has since recovered, Aziz said.

Reports did not say when test results for those three suspected human cases were expected.

Mink had H5 flu virus
In Europe this week, an H5 virus has been confirmed in a new species, a mink found in Sweden. There have been no confirmed reports of H5N1 avian flu in mink, according to a species list maintained by the US Geological Survey's National Wildlife Health Center.

The mink had an aggressive H5 virus and was euthanized, the National Veterinary Institute in Sweden said, as reported by Reuters Mar 27. The animal was found in the Blekinge region of southern Sweden, where several infected birds have been found.

The institute said the mink was thought to have contracted the virus by consuming infected wild birds, the suspected mode of transmission to felines as well.

Bird cases continue to spread
The H5N1 virus has now been confirmed in twomore European countries where it was suspected of killing wild birds, news services reported. A dead swan found last week in southwestern Czech Republic had the virus, and confirmatory tests are under way at the European Union reference lab in England, AFP reported today.

The English lab has confirmed H5N1 in a buzzard that was found in Denmark, south of Copenhagen, AFP reported in a separate story today. Denmark has now reported a dozen cases of the virus in birds.

In western India, the culling of a quarter-million chickens began today, following newly confirmed cases of H5N1 in several villages, AFP reported. Four hundred cullers began the culling, which was expected to last 5 days and span 1,500 square kilometers in two states, said Bijay Kumar, animal husbandry commissioner in Maharashtra state.

Meanwhile, concerns have arisen over the handling of samples from poultry in India. Spoiled samples have hampered efforts to identify new outbreaks, according to AFP. Only one lab in India is testing for H5N1, and it has been handling as many as 5,000 samples a week. However, conditions outside the lab in Bhopal are posing problems, said H.K. Pradhan, head of the High Security Animal Disease Laboratory in Madhya Pradesh, in an AFP interview.

"The samples are coming from far-off places and the cold chain is not maintained properly so the virus dies," Pradhan said. "In some areas ice is not readily available" to preserve poultry carcasses, he added. "The state authorities need to take more care."

In Israel, authorities in Jerusalem ordered culling of poultry at Kibbutz Ma'aleh Hahamisha today after H5N1 was found there yesterday, The Jerusalem Post reported online today. Israel earlier had culled 1.2 million poultry from 53 farms in 14 communities in only 9 days, the agriculture minister was quoted as saying.

See also

Mar 29 WHO update on situation in Egypt
http://www.who.int/csr/don/2006_03_29/en/index.html

US Geological Survey list of species affected by H5N1 avian flu
http://www.nwhc.usgs.gov/disease_information/avian_influenza/affected_species_chart.jsp

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