WHO update shows ongoing H5N1 activity in Egypt

Egypt's health ministry has reported 17 more H5N1 avian influenza infections to the World Health Organization (WHO), indicating continuing disease activity that began in November, according to a Mar 21 update from the WHO's Eastern Mediterranean regional office.

The cases were reported through Mar 17, raising the total reported to the WHO so far this year to 116 cases, 36 of them fatal. The new infections appear to have not been included in the WHO's previous update on Mar 14.

Since Mar 17, Egypt has reported cases in additional patients, according to statements from Egypt's health ministry and governorate health departments translated and posted by FluTrackers, an infectious disease news message board. They include a 4-year-old child from Sharqia governorate whose infection was reported on Mar 22 and a 30-year-old woman from Asyut governorate whose illness was reported today.

Difficulty tracking cases

It has been difficult to closely gauge the number of lab-confirmed H5N1 cases coming out of Egypt in recent months. FluTrackers' list of infections reported so far this year by official sources has reached 105.

Few details were available about the latest 17 cases reported to WHO, other than the genders and locations. The WHO said 11 case-patients are female and 6 are male and that they hail from 8 different governorates: Sharqia, Beheira, Giza, Qalyubia, Menya, Qena, Dakahlia and Kafr El-Shaikh.

On Mar 16, the United Nations Food and Agriculture Organization (FAO) announced 17 recent human H5N1 cases from Egypt. It's not known if they are the same ones as in the WHO's latest report, but affected governorates mentioned in both statements are almost identical. FluTrackers had said about 8 of the cases in the FAO report were previously known.

Egypt's government invited global health groups, including the WHO and the US Naval Medical Unit 3, to conduct a mission from Mar 8 to Mar 12 to investigate the current situation and assess the future risks. The group presented its recommendations to Egypt's health ministry at the end of their visit, according to the WHO.

Unprecedented H5N1 levels

In a Mar 3 update on flu at the human-animal interface, the WHO said the level of H5N1 disease in Egypt over the past few months is unprecedented, but initial lab investigations haven't detected any major genetic changes in H5N1 viruses from people or birds.

The agency said the increase probably relates to a constellation of factors, including increased H5N1 circulation in poultry, lower public awareness of the risk, and possible seasonal factors due to cold weather.

See also:

Mar 21 WHO statement

Mar 24 FluTrackers thread on Asyut governorate case

FluTrackers Egypt H5N1 case list

Mar 3 WHO report

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