Saturday, February 13, 2010
Egypt: More Details For H5N1 Confirmed Case #98
Saturday, February 13th, 2010 - 22:22
Caption: Increasing numbers of people suffering from bird flu
Dr Atta, Hisham Youssef, Undersecretary of the Ministry of Health Menoufia, Hit Ayman Abdel Hadi Abu Bakr (32 years), Agricultural Engineer Agricultural Management Ashmoon bird flu after confirming that samples taken from him and be positive was mentioned income Echmoun Fever Hospital on suspicion of being infected with swine flu and after sampling for analysis labs Central Ministry of Health and cons, which proved to be positive for the pigs and birds.
On the other hand moved the bodies concerned to the said house, wearing protective clothing have been executed 7 birds at home, and cleaned and houses next to it.
On the other hand confirmed the samples from each of the expectations other than Abdul-Rauf (50 years) Administrative comb primary school Kafr Samir Ramadan housewife (24 years) without action from the village of Kafr comb Menof detainees and Fever Hospital Menouf positive for swine flu after confirming that samples for analysis taken of them positive.
Commonground's Map of Menoufia, Egypt Outbreaks
Blue marker in the cluster: Confirmed 12/5/09
Green marker in Shibin El Kom was a SW death on January 21st.
Green marker in the cluster is a list of 9 Swine Flu deaths from January 4 – 20.
The Yellow marker in Berket El Sab is 3 outbreaks of H5N1 Poultry from December 21st – January 27th.
Go to the link, check out the definitions of the colored postmarks, click on each one to get the information.
Also, note the scale on the map below.
Egypt - Human Bird Flu Death - Menoufia - #99
Saturday, February 13th, 2010 -
The Ministry of Health on Saturday by the death of a bird flu infected a woman at the age of 29 years of Monofia, and the Fever Hospital Shebin Following the failure in the functions of breathing.
This is is a case of human infection by No. 99 of bird flu, bringing the total number of deaths in Egypt, 30 cases of the onset of the disease in 2006 so far and this case is the third event of the death in 2010.
Eurosurveillance: Avian influenza A(H5N1) in humans: lessons from Egypt
Highly pathogenic avian influenza A(H5N1) has ravaged the Egyptian poultry population. Ninety human cases, including 27 fatalities have been recorded by 30 December, 2009. However, epidemiological information on the infection in humans in Egypt is scarce. We analysed the first three years of highly pathogenic avian influenza A(H5N1) in Egypt between 20 March 2006 and 31 August 2009 and found that more cases occurred in females than males, especially in 2006 and 2007. Women in the age group 20-39 years had the greatest tendency to be infected. It took an average of one day and 18 hours to seek medical assistance in patients who recovered and of six days in fatal cases. Children sought treatment much earlier than adults. On average, patients died 11 days after the onset of symptoms. Exposure to infected poultry remained the most important risk factor.
Click on Chart
Introduction
On 17 February 2006, highly pathogenic avian influenza A(H5N1) was first reported in the poultry population in Egypt [1]. Since that time, the infection had affected at least 21 governorates forcing over 1.5 million individuals to loose their source of livelihood [1]. Overall, 370 backyard poultry flocks, 850 farms, and four zoos have been affected, and more than 36 million birds (mainly chickens) have died or have been culled in Egypt at an enormous cost to the country [1]. Currently, the virus is endemic in the Egyptian poultry population.
The first human case of avian influenza A(H5N1) in Egypt occurred on 17 March 2006 [2], and to date (30 December 2009), the statistics of human infection and fatalities continue to rise. Specifically, 90 human cases (approximately one fifth of the total global count), including 27 fatalities (approximately one eleventh of the global count) have been recorded in Egypt as of 30 December 2009 [2]. These numbers rank Egypt third in the list of recorded human cases and fatalities in the world, after Indonesia and Vietnam, and remain by far the highest in Africa. The World Health Organization (WHO) had previously stated that “countries around the world had improved their defenses against bird flu, but the situation remained critical in Egypt and Indonesia where the risk of the H5N1 virus mutating into a major human threat remains high” [3].
Worrisome with the situation in Egypt is the frequency with which women and young people are being infected and the very current trend of rising infections in children: in 2009 alone, 79% of all infected individuals were under 10 years old. Between January and December 2009, 17 of the 34 recorded cases involved children between 12 and 30 months-old. Similarly, at the time of this report, human cases of 2009 pandemic influenza A(H1N1) had also been confirmed in the Egyptian population, which raises the possibility of co-infection and the emergence of reassortant viruses.
While the situation in Egypt remains critical, empirical evaluation of its peculiarities seem to be lacking, except for a very recent report by Dudley [4]. Assessment of the scientific literature and epidemiological data returned little or no concrete evidence from Egypt. However, the country has provided adequate records to international organisations like the WHO and the World Organization for Animal Health (OIE) and these reports have improved significantly since the first submission in terms of spatial and temporal data, and clinical records of affected persons.
In this study, we analysed the records on avian influenza A(H5N1) in Egypt between 20 March 2006 and 31 August 2009 and explain the epidemiological significance of our findings.
Materials and Method
The Egyptian government reports to the WHO, available on the WHO website [2], were the primary source of data for these analyses. We considered all laboratory-confirmed human cases of avian influenza A(H5N1) reported to the WHO from Egypt between 20 March 2006 and 31 August 2009. All positive samples reported and used in these analyses had earlier been confirmed by microneutralisation assay on serum or by PCR on respiratory tract specimens as reported [5]. Similar confirmatory tests were done in the Egyptian national reference laboratory and at the WHO reference laboratories for diagnosis of influenza A(H5) infection, including the United States Naval Medical Research Unit 3 in Cairo, Egypt [4].
The parameters included in our analysis were: date of exposure, date of onset, course of symptoms, and time from hospitalisation until death/recovery, as listed in the WHO situation reports on avian influenza [6].
In the absence of complete information, reports were based on approximate dates and times from the reports. However, in cases of ambiguity arising from the records, such data were excluded from the calculations. In total, 85 confirmed cases were reported during the study period, of which 27 were fatal. After the exclusion of ambiguous data, only 63 of the 85 reported cases and 20 of the 27 fatal cases were evaluated for symptoms and hospitalization; and 44 of the 58 cases who recovered or were stable were analysed for symptoms and recovery. Analyses were performed using StatGraphics v2.0. Distributions were compared using chi-square test, and medians were compared using Fisher’s exact test.
Results
Demographic characteristics
In the period under analyses, 85 cases were evaluated, 32 of whom were male and 53 were female. Eighteen cases had been reported in 2006, 25 in 2007, eight in 2008 and 34 to date (31 August) in 2009, including a total of 27 human fatalities over the three and a half-year period.
The youngest cases were one year of age (two boys), and the oldest case was a 75 year-old woman. The median age of all confirmed cases was six years. The age of the cases (n=85) ranged from 12 months to 75 years, with a mean of 13 years and two months. The median age of all fatalities (n=27) was 25 years (range: four to 75 years) and the mean was 26 years and three months. The median age of the female cases (n=53) was 15 years, (range: 14 months to 75 years) and the mean was 16 years and 10 months, while the median age of the male cases (n=32) was four years (range: two months to 32 years) and the mean seven years and two months (Table, Figures 1 and 2).
Table. Human cases and fatalities associated with avian influenza A(H5N1) in Egypt, 20 March 2006–31 August 2009 (n=85)Pokhara: Bird Flu under control
Last Updated : 2010-02-12 12:21 PM
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Himalayan News Service
KATHMANDU: Dr Prabhakar Pathak, director general, Livestock Department, on Friday said the bird flu had been taken under control in Pokhara. He said the government had provided compensation to farmers for the killed fowls. The ministry provided Rs 100 per chicken, 50 paisa per egg and Rs 5 per kg of bran as relief. Pokhara and its neighbourhoods were on high alert since January 4.
Flu death rate drops again below epidemic threshold in U.S.
HOUSTON, Feb. 12 (Xinhua) -- The proportion of deaths attributed to pneumonia and influenza (P&I) in the United States dropped again below the epidemic threshold during the week ending Feb. 6, the federal Centers for Disease Control and Prevention ( CDC) said on Friday.
"During week five (Jan. 31 to Feb. 6), 7.3 percent of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 7.8 percent for week five," the CDC said on its web site.
Since last October, when the A/H1N1 pandemic peaked and as many as 48 states had widespread activity of the new virus, the proportion of deaths attributed to P&I based on the 122 Cities Report had been above the epidemic threshold for 11 weeks running.
As the A/H1N1 flu began to wane in December, the proportion of deaths linked to P&I based on the 122 Cities Report was dipping below the epidemic threshold in week 50 of 2009, but bouncing back in week 51. After that, it remained below the epidemic threshold for two more weeks, but bounced back again during the second week of 2010 and remained above the threshold for three more weeks.
The epidemic threshold is the point at which the observed proportion of deaths attributed to pneumonia or influenza is significantly higher than would be expected at that time of the year in the absence of substantial influenza-related mortality.
Latest statistics released by the CDC show that, from Aug. 30, 2009 to Feb. 6, 2010, there were 40,030 laboratory-confirmed influenza-associated hospitalizations and 1,937 laboratory- confirmed influenza-associated deaths, including 260 of young patients under age of 18, that have been reported to the federal agency.
But health officials believe the actual death toll have been much higher than the figures of laboratory-confirmed influenza- associated deaths.
Also on Friday, the CDC estimated 8,330 to 17,160 people had died between April 2009 and January 16, 2010 from the A/H1N1 virus, with a middle range of about 12,000, including 880 to 1,800 children.
According to the newly released CDC estimates, 41 million to 84 million people were infected with the A/H1N1 virus, while 183,000 to 378,000 people were hospitalized with the new virus during the same period.
"The estimates are actually much more accurate than the confirmed numbers," the CDC director Dr. Thomas Frieden said earlier. "The number of confirmed deaths is really just a small proportion of the number of total deaths," he explained.
On the whole, the CDC reported on Friday that the A/H1N1 flu infections continue to be on the wane nationally and there had been no states reporting widespread activity across the country for the first five months of 2010.
The proportion of outpatient visits for influenza-like illness (ILI) was 2.1 percent during the week ending Feb. 6, which remained below the national baseline of 2.3 percent since the beginning of the new year.
Although the A/H1N1 flu infections are declining, federal and state health officials still urge the American parents to get their children fully vaccinated as soon as possible.
In Ohio, statistics released by the state health department show that among 331,000 Ohio children aged 6 months to 10, roughly 25 percent had gotten the first dose while only seven percent had gotten the second.
The second dose of A/H1N1 vaccine for the youngsters under 10, recommended by the CDC, would achieve maximum protection against the new virus.
Experts said that parents are aware of the need to get kids fully vaccinated at the height of influenza breakouts but their attention drops when things normalized.
Ohio state health officials stress that vaccination is still important because another wave or two of flu are possible this winter or spring.
"I know flu is not on people's minds right now, but we really need to get these children vaccinations," said Dr. Mary Diorio, assistant state epidemiologist.
"We're still seeing (regional, local and sporadic) activity across the country. It's certainly not at the levels of late October, early November, but activity is still going on, and we have many weeks left in our flu season," CDC spokesman Tom Skinner warned the general public last week, saying "it would be too early to say the virus has disappeared."
57 Million Americans Sickened by H1N1 Flu: CDC
- FRIDAY, Feb. 12 (HealthDay News) -- With the H1N1 swine flu pandemic apparently winding down, federal health officials said Friday that about 57 million Americans have suffered through the illness since last April, and the total could range as high as 84 million.
In addition, the U.S. Centers for Disease Control and Prevention (CDC) estimates that as many as 378,000 people were hospitalized due to H1N1 flu and up to 17,160 Americans may have died from the virus.
The death toll so far remains less than half that seen in flu seasons before the advent of the new H1N1 strain. According to the CDC, in prior years some 36,000 Americans died from influenza during a typical season. Hospitalizations were much higher with H1N1, however; in prior seasons, a little more than 200,000 people are typically hospitalized, the agency said.
The data "provide the first assessment of the number of cases, hospitalizations and deaths from H1N1 for the period of April 2009 through Jan. 16, 2010," noted Dr. Pascal James Imperato, dean and distinguished service professor at the School of Public Health at State University of New York Downstate Medical Center in New York City.
"An extremely important finding is that, using mid-level range data, the majority of hospitalizations (150,000) and deaths (8,980) occurred among those 18 to 64 years of age and not among those younger than 18 years of age. In the latter group there were 82,000 hospitalizations and 1,230 deaths," he said.
Again, those statistics vary from prior years. According to the CDC, most deaths associated with the more typical seasonal flu occur among those 65 and older.
But it's very hard to compare seasonal and H1N1 pandemic flu, said CDC spokesman Richard Quartarone.
"Probably the biggest difference in what we see with H1N1 is it's being spread and causing disease in people under 65," he said. "This strain spreads very quickly among people under 18. There is a lot of disease, a lot of severe illness and death among people between 18 and 64, many of whom have some sort of chronic health condition."
With seasonal flu 90 percent of the deaths are among people over 65, Quartarone said. "While it is the opposite with the H1N1 strain," he said.
The probable explanation for most H1N1-linked hospitalizations and deaths among the 18- to 64-year age group is that the majority of these people likely had underlying medical conditions, such as asthma, cardiac problems and diabetes, Imperato said. These conditions would place them at a higher risk for being hospitalized and of dying if they became infected, he said.
Imperato also noted that "more older people died than children in this epidemic. Yet, older people were not initially included in the priority groups for immunization."
According to the CDC, flu activity has now subsided across the country but most of the flu still circulating is the H1N1 strain. Although flu activity has dropped precipitously, cases of both H1N1 and seasonal flu can still rise and fall, which is what the agency expects to see over the next several months.
The latest data from the CDC finds no states reporting widespread influenza activity and only six reporting regional activity.
"H1N1 flu activity seems to have leveled off, but the virus does continue to circulate causing illness, hospitalizations and deaths," Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, said during a teleconference last week.
And Schuchat warned against any false sense of security. "We are remaining vigilant here and we do not think people should become complacent," she said. "None of us know whether we are going to have bursts of disease or clusters or just ongoing transmission as we have been seeing the past few weeks," she said.
The CDC estimates for H1N1 flu between April 2009 and Jan. 16, 2010 include:
- About 19 million cases and 82,000 hospitalizations and 1,230 deaths among those younger than 18.
- About 33 million cases, 150,000 hospitalizations and 8,980 deaths for those 18 to 64.
- About 5 million cases, 25,000 hospitalizations and 1,480 deaths for those 65 and older.
- The total estimated range of cases is between 41 million and 84 million (mid-range 57 million).
- The total estimated range of hospitalizations is from 183,000 to 378,000.
- The total estimated range of deaths is from 8,330 to 17,160.
WHO experts to determine if worst of flu pandemic is over
GENEVA (AFP) - The World Health Organisation said Thursday that its emergency panel of swine flu experts would meet this month to formally determine whether the pandemic has passed its peak.
"WHO will be asking the emergency committee to convene later this month to review the situation and provide the WHO with guidance on whether we are entering a post peak period," said Keiji Fukuda, Special Adviser to the WHO Director-General on Pandemic Influenza.
"What we are hoping for is that the worst is behind us," Fukuda said during a telephone news briefing.
The A(H1N1) flu pandemic was generally tailing off in most parts of the world and appeared to be entering a transitional period, according to the UN health agency.
However, Fukuda cautioned that there could be no abrupt end to the pandemic alert triggered last year.
"We may be seeing a general decline in pandemic activity but the pandemic itself has not yet run its full course," he added
Swine flu would continue at various levels around the world in the immediate future, and some areas should expect a localised upsurge, Fukuda said.
There were signs that swine flu was taking hold in West Africa.
"We're now seeing the first evidence of community transmission in Senegal," said Fukuda.
"I expect that if there are a number of severe cases like in other countries this will cause some stress on clinical facilities."
More than 15,000 people have died worldwide from the new A(H1N1) strain since it was uncovered in Mexico and the United States in April 2008, according to the WHO.
It has swept around the world, reaching at least 211 countries and territories.
The emergency committee of specialists, which will probably meet in the last week of February, provides WHO Director General Margaret Chan with definitive scientific guidance on severe health threats.
Fukuda said its stance would help public authorities around the world adjust their planning for the disease, as it appeared to be gradually shifting towards a pattern more akin to seasonal flu.
Several countries have been running down their special pandemic flu precautions in recent weeks.
Britain's public swine flu hotline, launched seven months ago amid the rapid global spread of the virus, was switched off on Thursday after a steady fall in the number of cases reported.
Algeria last week joined a number of countries seeking a sharp cut in their order of swine flu vaccines.
Critics have accused the WHO of over estimating the danger of the A(H1N1) strain, particularly in recent months as its symptoms generally turned out to be milder than feared and the disease petered out as it spread across the earth.
Current situation Influenza (H1N1) in Malaysia 2010 For Epid Week 05/2010 (31 Januari - 06 Februari 2010)
Number of cases of influenza A (H1N1) reported in epid week 5 / 2010 has increased by 25% compared with the last two weeks. Inclusion in the number of cluster cases also increased from 4 in the epid week 4 / 2010 to 8 weeks on the incident cluster 5 / 2010.
Inclusion in the creation of clusters have been reported during the last week, is in SK Padang Negara, Kuala Terengganu; SK Indera Shahbandar, Kuala Lipis; MRSM Kuala Terengganu; PLKN Merang Suria Holiday Camp, setiu; SMK Mengabang Telipot Complex, Kuala Terengganu; LKTP SK Rattan, Dungun; BC Mahmaud, Samarinda and Beaconhouse Sri Inai School, Petaling Jaya. Number of students / trainees who are involved for each cluster is between 3 to 21 people. Five of the eight incidents cluster are positive for influenza (H1N1). Preventive measures and control the spread of infection in each school / PLKN has been implemented.
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Friday, February 12, 2010
WHO: Avian influenza – situation in Indonesia
The Ministry of Health of Indonesia has announced a new case of human infection of H5N1 avian influenza. A 25-year-old female from South Jakarta District, DKI Jakarta Province died on 25 January 2010. Laboratory tests were positive for H5N1 virus infection. The case was possibly infected from direct contact with poultry.
Of the 163 cases confirmed to date in Indonesia, 135 have been fatal.
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO
Click on Chart
http://www.who.int/csr/disease/avian_influenza/country/cases_table_2010_02_12/en/index.html
Thursday, February 11, 2010
Vietnam: Ensure the health of people in the Lunar New Year
To actively in preventing anti-disease and well-organized emergency work directly, examinations and treatment available for people in those days Tet, the Department of Health has set up plans for preparedness for the situation situation occurs.
Implementing the guidance of the PPC on ensuring the health of people happy in the spring during Tet Canh Dan. Department of Health has implemented and guide attached units in the local positive review-prevention against diseases usually occur in Lunar New Year as gastrointestinal disease, food poisoning and diseases and epidemics spread through the respiratory tract, influenza A (H1N1) ... Same time, requests the head of the unit performed well the plan member, welcome and make sure the number of emergency medicine, materials, chemicals, medical equipment available to meet the situation occurred in patients hospital, as well as the online information for the hospital when the need arises. Hospitals, health centers and district provincial quickly deploy all measures to prevent and stamp out anti-progress when detected or suspected cases of influenza infected A (H1N1) and other diseases if they occur. To monitor the work of implementing the plan, the Department of Health held unscheduled inspection at health facilities when necessary.
Individual members working in the emergency's Eve festivities and fireworks celebrate Xuan Canh Dan was held in the Square 17-3 (TP. Pleiku), Dang Duc Chau Deputy Director of the Department of Health said the Department has building plans and proposed Provincial Hospital and Medical Center City. Pleiku each unit formed an emergency team consists of an ambulance with a full range of equipment and materials for the medical staff of health-doctors experienced in-seat service and transfer patients to hospitals when necessary. Provincial Hospital added an ambulance vehicle 115 with other health team members in sufficient Square 17-3 occur during the festival. Until now, all details have been deployed, both Eve and the days thereafter.
The Tet holiday is the time emergency patients continued to rise in almost all over the local, so the health facilities in the province has been actively stockpiling enough units of blood necessary for the record, emergency . Doctor Bach Anh Hung-Deputy Director Provincial Hospital said: For number of emergency room will increase high on this occasion, in addition to 100 units of blood has, recently, the unit has received nearly 400 quality units of blood units from the school, including: Medical School, Intermediate School Forest Highlands and College Teachers' Gia Lai. Number of units of blood have been provided will ensure the emergency occurs in a hospital in the days of Tet.
Health sector has bulk implementation to ensure response to every situation occur. However, to avoid the incident happening in the days fun Xuan Tet, one should remain aware of the people to detect and report diseases and the observance of traffic rules well in on spring.
Flu pandemic: what lies ahead
Thursday 11 February 2010 Pandemic is heading for ‘post-peak’ period, WHO says amid lingering concerns over unpredictable future | |||
| The 2009 pandemic is waning in most parts of the world, but recently Senegal has reported the first 14 cases of ‘swine flu’ to be associated with community transmission of the virus in West Africa, the World Health Organization (WHO) said today. “There is a scientific judgment that the worst on a global level may be over,” said Keiji Fukuda, Special Adviser on Pandemic Influenza to the Director-General, at a news conference. “‘However it’s also very clear that the virus has not disappeared. We can anticipate significant local upsurges.” This pattern of activity for the new virus is different from patterns documented a few months ago, explained Fukuda, and could mean that the pandemic has entered a period of transition into “regular” flu activity dubbed the ‘post-peak’ period in the WHO pandemic guidance document. But a formal assessment of this will be made later this month in the 7th meeting of an advisory body, the International Health Regulations (IHR) Emergency Committee. In a different meeting to be held on 18 February, the WHO will decide which virus strains to recommend for companies making the vaccine that will be distributed in the northern hemisphere in the next flu season. Seasonal flu viruses have not disappeared, said Fukuda, but the swine-origin H1N1 strain is now dominating. “I don’t want to second guess what the expert advisers will recommend; but it is fair to point out that the current pandemic virus is by far the most common being isolated.” Juergen Richt, from Kansas State University in the USA, is worried about the far-reaching spread of this highly transmissible virus. As it becomse the dominant strain, it is more likely to circulate in the same areas that harbour the H5N1 bird-flu strain. If this happens, “it could be big trouble”, he says. Although the swine-flu virus has not been found to infect chickens, where the H5N1 strain is commonly found, both viruses could infect humans at the same time — a window of opportunity to re-assort. Because the new H1N1 virus spreads more easily than the seasonal H1N1 and H3N2 strains, Richt believes that the chances of the two virus subtypes swapping genetic material in this way are higher than they were before the pandemic strain emerged. A transformation of the H5N1 virus “could be only a couple of mutations away”, says Richt. Swapping genes with the new H1N1 virus might allow it to transmit more efficiently, creating a very different pandemic scenario. Fukuda said today that all the pandemic-H1N1 strains analysed so far look very similar, so this virus subtype appears to be very stable. But in a world of fickle flu viruses the H5N1 strain appears especially unstable. According to results from an influenza-A genome-mapping project published this month in PLoS ONE, H5N1 viruses appear to swap genetic material with other virus subtypes often, but fail to accumulate enough mutations to allow efficient spread between people. The authors say that this suggests a low pandemic risk for this strain “in its current form”. Raul Rabadan from Columbia University in New York, USA, cautions that “although we are learning more about these viruses, we still do not have a complete understanding of all factors that could contribute to the efficient propagation of influenza viruses in humans.” “Viruses are so flexible”, says Richt. One never knows what might be around the corner, he points out, so keeping surveillance efforts going is essential. |
Egypt: H5N1 Human & Poultry + H1N1 Deaths in Menoufiya
Confirmed #96
29 yo
From: Sadat Center. Elsadat District.
Onset: 1/27
Adm: 2/3
Notes: Upon admission, suffering from double pneumonia, high fever, difficulty breathing. Exposed to poultry suspected of being infected with bird flu. 2/8: Critical Condition.
Suspected
17 yo Jalal Ibrahim Abdel Razek
From: Menouf city
Onset:
Adm:
Notes: Reported 2/9. “Said Dr.. Hesham Atta and Undersecretary of the Ministry of Health Menoufia Fever Hospital Menouf Echmoun detained and 3 cases of bird flu Menouf City and two are positive swine flu Pudong Ashmun…..
Sampling of infected cases to be analyzed and sent to the central laboratories, which had proved positive.”
Confirmed #98
32 yo
From: Monufia
Adm: yes
Notes:
Swine Flu Deaths
1/20 - Death #238
1/16 - Death #219
1/13 - Death #208
1/12 - Death #201
1/11 - Death #199
1/9 - Death #182
1/8 - Death #176
1/5 - Death #162
1/4 - Death #152
H5N1 Poultry Since January 16th - SAIDR Site
Date of result: 27 January 2010
Date of sampling: 26 January 2010
Governorate: Menoufiya
District: Berket El Sab’
Village: Hourin
Type of rearing: Household
Species: Chicken
Number of birds: 15
Vaccination status: Unvaccinated
Purpose of sampling: Notification
Date of result: 25 January 2010
Date of sampling: 24 January 2010
Governorate: Menoufiya
District: Menouf
Village: Sedoud
Type of rearing: Household
Species: Chicken
Number of birds: 10
Vaccination status: Unvaccinated
Purpose of sampling: Notification
MALR/GOVS on 19 January 2010 announced 17 household cases in 8 governorates (marked below with an asterisk * ). GOVS said the volume of cases was a result of the strengthening of passive surveillance in veterinary clinics. Veterinarians in the clinics were trained in a new HPAI case definition and use of a rapid field test. The veterinarians were given tasks for early detection of cases in the village, i.e., regular checks on the clinical status of birds in surrounding villages and testing for sick chickens in consistency with the case definition by using the rapid field test. In the cases announced January 19 (*), all samples taken by rapid field test were sent to the laboratory for confirmation by PCR technique regardless of the result of the rapid field test. The PDS team is responsible also for active surveillance in high-risk areas within household and following rumors on dead or sick poultry.
Date of result: 16 January 10
Date of sampling: 15 January 10
Governorate: Menoufiya
District: Ashmoun
Village: Tahway
Type of rearing: Household
Species: Mixed (Ducks, turkey, chicken)
Number of birds: 8
Vaccination status: Not vaccinated
Purpose of sampling: PDS
Comment: Source of infection: Young grower Peking ducks bought from live bird market
Date of result: 16 January 10
Date of sampling: 15 January 10
Governorate: Menoufiya
District: Ashmoun
Village: El Helwasy
Type of rearing: Household
Species: Ducks
Number of birds:
Vaccination status: Not vaccinated
Purpose of sampling: PDS
Comment: Source of infection: Young grower ducks bought from a nursery farm via peddlers. The village had a confirmed outbreak the detected by PDS program on 10 September 2009; the team re-visited the village following a rumor of high mortality among ducks.
Egypt: H5N1 Confirmed Human & Poultry + H1N1 Deaths in Dakahliya
Confirmed #92
1.5 yo
Onset: 1/7
Adm: 1/12
Confirmed #95 (WHO Update/not numbered)
40 yo
From: Banha District
Onset: 1/31
Adm: 2/2
Notes: Stable condition. Rptd on 2/8 (WHO).
Dakahlia – Swine Flu Deaths
#264 – 2/9/10
#263 – 2/9/10
H5N1 Poultry since January 15th – SAIDR site
Date of result: 31 January 2010
Date of sampling: 30 January 2010
Governorate: Dakahliya
District: Mit Ghamr
Village: Kafr El Naeim
Type of rearing: Household
Species: Mixed (chicken, ducks)
Number of birds: 70
Vaccination status: Not reported
Purpose of sampling: PDS
Date of result: 28 January 2010
Date of sampling: 27 January 2010
Governorate: Dakahliya
District: Talkha
Village: Mit Nabet
Type of rearing: Farm
Species: Chicken (broiler breeder)
Number of birds: 9,000
Vaccination status: Yes
Purpose of sampling: SAIDR active Surveillance
Date of result: 28 January 2010
Date of sampling: 27 January 2010
Governorate: Dakahliya
District: Mit Ghamr
Village: Kafr El Nasr
Type of rearing: Household
Species: Mixed (chicken, ducks)
Number of birds: 57
Vaccination status: Not reported
Purpose of sampling: PDS
Comment: Source of infection: Chicken bought from live bird market and slaughtered at the same day.
The viscera of the slaughtered chickens provided as feed for the kept poultry, and then the mortality started one day later.
Date of result: 27 January 2010
Date of sampling: 26 January 2010
Governorate: Dakahliya
District: Mansoura
Village: Mit El Akrad
Type of rearing: Household
Species: Mixed (chicken, ducks)
Number of birds: 92
Vaccination status: Unvaccinated
Purpose of sampling: PDS
Comment: Source of infection unknown. The village is surrounded by three water canals where hundreds of dead chickens and ducks were thrown.
Date of result: 22 January 2010
Date of sampling: 22 January 2010
Governorate: Dakahliya
District: Mit Ghamr
Village: El Bahayta
Type of rearing: Household
Species: Mixed (chicken, ducks)
Number of birds: 34
Vaccination status: Unvaccinated
Purpose of sampling: Notification
Date of result: 20 January 2010
Date of sampling: 20 January 2010
Governorate: Dakahliya
District: Tomay El Amdid
City: Tomay El Amdid
Type of rearing: Household
Species: Duck
Number of birds: 10
Vaccination status: Unvaccinated
Purpose of sampling: Notification
Date of result: 15 January 10
Date of sampling: 14 January 10
Governorate: Dakahlia
District: Mit Ghamr
Village: Tafahna El Ashraf
Type of rearing: Household
Species: Mixed (Ducks, geese, chicken)
Number of birds: 8
Vaccination status: Not vaccinated
Purpose of sampling: PDS
Comment: Source of infection: unknown
The flock was composed of adult Sudanese ducks, young Sudanese ducks, geese and chickens, all the species were in apparently healthy condition except young Sudanese ducks which developed nervous signs while the chickens were having only diarrhea.
This HPAI outbreak was detected at an early stage and was limited to one household.
Date of result: 15 January 10
Date of sampling: 14 January 10
Governorate: Dakahlia
District: Mit Ghamr
Village: Saharagt El Kobra (village Mit Nagy)
Type of rearing: Farm
Species: Chicken (Broiler)
Number of birds: 500
Vaccination status: Not vaccinated
Purpose of sampling: Notification
Egypt - New Case H5N1 Monofia Province - #98
محافظة = Province
محافظة المنوفية = Monofia
Health announces deaths were the "pigs" and the injury of the "flu"
Thursday, February 11th, 2010 - 23:03
The Ministry of Health reported two new deaths with HIV "er HP 1 The 1" world-renowned swine flu, bringing the number of deaths in Egypt since the emergence of the disease and so far 267 deaths.
The ministry of health, said in a statement today that the case No. 266 of a woman from the province of Dakahlia, 22 years old, and case No. 267 of a girl at the age of 10 months of Beni Suef.
As announced by the Ministry of Health has announced new cases of bird flu, to reach human cases to 98 cases.
A statement by the Ministry of Health that the incidence of the new man in Al-Echmoun at the age of 32 years, was admitted to hospital and given Tamiflu .. He pointed out that his injury was the result of mixing with infected birds.
Original:
أعلنت وزارة الصحة عن حالتى وفاة جديدتين بفيروس "إيه إتش 1 إن 1" المعروف عالميا بأنفلونزا الخنازير، ليرتفع عدد حالات الوفاة فى مصر منذ ظهور المرض وحتى الآن إلى 267 حالة وفاة.
وأوضحت وزارة الصحة، فى بيان لها اليوم، أن الحالة رقم 266 لسيدة من محافظة الدقهلية تبلغ من العمر 22 عاما، والحالة رقم 267 لطفلة تبلغ من العمر 10 أشهر من محافظة بنى سويف.
كما أعلنت وزارة الصحة اليوم عن إصابة جديدة بمرض أنفلونزا الطيور، لتصل حالات الإصابة البشرية إلى 98 حالة.
وأوضح بيان لوزارة الصحة أن الإصابة الجديدة لرجل من أشمون في محافظة المنوفية يبلغ من العمر 32 عاما، تم دخوله المستشفى وإعطاؤه عقار التاميفلو .. مشيرا إلى أن إصابته جاءت نتيجة مخالطته لطيور مصابة.
Authorities spray cars in attempt to halt flu
AUTHORITIES in Kandal province have launched a campaign to contain a recent outbreak of the H5N1 influenza virus – commonly known as bird flu – that led to large-scale culls of chickens and ducks in neighbouring Takeo province last week.
Ing Sokmoy, chief of the Office of Domesticated Animals at the Kandal provincial Department of Agriculture, said on Wednesday that the campaign, which began this week, was designed to prevent the virus from spreading during Chinese New Year, which begins on February 14.
As part of the campaign, officials have been spraying vehicles travelling along National Road 1 to Phnom Penh with liquid TH4, an antibacterial agent. H5N1 is nonbacterial.
“We always have these kinds of campaigns to avoid virus infection,” she said. “Even though our province has no reports of bird flu, we want people to be cautious that bird flu has been found in Takeo province recently and make them aware about sanitation.”
She added that TH4 would be sprayed on the wheels of all cars and trucks importing goods to Phnom Penh through Kandal.
Ing Sokmoy did not say when the campaign was set to finish, but emphasised that it will continue for as long as officials deem it necessary.
On February 3, officials started to cull poultry in Takeo’s Pralay Meas village after more than 19,000 ducks died and some bird flu tests came back positive. Nhib Sron, director of the Takeo provincial Department of Agriculture, said sales of poultry have been banned for 30 days within 5 kilometres of the affected village in Koh Andeth district.
Cambodia to Check Poultry Shipped to Capital for Bird Flu Infection
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Nepal: 11,000 fowls killed in single day
Nepal reports outbreak of bird flu
Kathmandu, February 04, 2010
Nepal has reported an outbreak of bird flu in the country, a media report said on Thursday.
2010-02-10
POKHARA: In a bid to prevent further spread of bird flu, 11,000 birds, including 9,817 chickens, 379 ducks and 43 pigeons, were killed in Pokhara today.
According to the Bird Flu Prevention Desk at the District Livestock Office, the government will provide compensation for the killed fowls.
Dr Amar Shah said a rapid response team had destroyed 37 kilograms of chicken, 1,370 eggs and 1,183 kg of poultry feed in the affected area. The official said they were checking whether anybody had hidden their fowls. Clearing cages and spreading pesticides are said to start soon. Dr Shah warned all to stay alert since the dangerous disease had spread over a wider geography. There has, however, been no human casualty so far in the region. The symptoms of a bird flu infection are difficulty in respiration, headache, burning sensation in the throat and high fever.
Meanwhile, Western Regional Hospital (WRH) in Pokhara is prepared to treat patients in
case of a bird flu outbreak among humans. Dr Ashok Chaurasiya, director, WRH, said the health facility was capable of tackling the dangerous disease.
Butchers in the area said consumers of poultry products had not decreased significantly in number in Gharipatan despite its declaration as an avian-flu affected zone. Per kg price of chicken however fell Rs 100 to 230 a week after the news of the outbreak.
According to entrepreneurs, about 8,000 birds are consumed in Pokhara daily. An estimated Rs 150 million has been invested in poultry farming in Pokhara.
Wednesday, February 10, 2010
Vietnam destroyed thousands of poultry as bird flu precaution translated recurrence
February 10, 2010
According to the Agriculture of Vietnam, translated at risk of bird flu spreading in central and regional Cuu Long River Delta because poultry is transported, sold wholesale in large quantities Lunar New Year, serving wheels for worship in the tradition.
Authorities Vietnam today called for more vigilant of their service bird flu precautions appear in the upcoming New Year day. According to the information on the Agency under the Ministry of Agriculture Veterinary Vietnam, Ha Tinh province have destroyed over 14,000 poultry. Here, a hard disease was discovered today January 15 and nearly 3600 birds have carried the H5N1 virus.
In addition, Ha Tinh, but in other diseases are also found in five other provinces, including Quang Tri, Kon Tum and the central Vietnam, Dien Bien in the northwestern and Soc Trang, Ca Mau in southern Vietnam.
AFP news Again, last week, Agriculture Minister Cao Duc Phat has asked all local authorities to increase measures to prevent the H5N1 virus, viruses causing avian influenza during the period prior to the Tet.
Today, English language newspaper Vietnam News quoted an official at the Ministry of Agriculture calling people alert to the risk of bird flu spreading services in central Vietnam and the Cuu Long river delta because poultry the transportation, wholesale large quantities in the Lunar New Year, for the wheels offering the tradition.
Vietnam weak return avian epidemic New Year season.
The President on Thursday, February 11 at 2553 BC 1:18:36 pm
A. FP image on January 27, 2553 Peach flowers bloom in the garden is one of the Red River Chan, Hanoi, Vietnam, people are preparing to celebrate the season homes New Year Festival. That is to begin officially owe on Sunday (February 14) this context the spread of bird flu. That is peace in several provinces AFS P - thousands of poultry have been left in Vietnam from the removal of government efforts to protect. The spread of bird flu in the New Year Festival Ywn to the few days before the birds are a popular food for the festival celebrating the New Year or New Year's tradition Ywn will begin in Sunday. And staff are being raised to stop the spread of disease in 6 provinces of the country. Province of cholera ตี๋ (Ha Tinh) in the Central Province have been affected most severely.
With more than 14,000 poultry have been left after removing the 3,600 found contaminated with bacteria. Ministry of Agriculture and Rural Development reported this issue. Through the Ministry's website. Mon cholera epidemic in ตี๋ d began on 15 January last is also found in poultry infected with the other 5 provinces late Mr. adhesives ° want (Cao Duc Phat) the Minister of Agriculture. Ordered local officials to the last week to increase monitoring measures. H5N1 virus guard during and after the New Year Festival Ywn. Vietnam News newspaper also claimed the government's word, ministry officials said another high risk that the avian flu to spread in central and southern areas. Mekong River plains in the New Year festival. Because many animals are moving into areas for cooking. Report of the World Health Organization.
Scientists develop new basis for H5N1 vaccine: WHO
GENEVA – Scientists have used bird flu virus samples from Egypt to develop a new basis for a vaccine against the toxic H5N1 strain that continues to circulate, the World Health Organization said on Thursday.
Avian influenza kills about half the people it infects, but unlike the quickly circulating H1N1 flu virus has not been shown to pass easily between humans to date.
The WHO said the candidate virus was developed at the U.S. Centers for Disease Control and Prevention in Atlanta "thanks to the ministry of health and population of Egypt, for providing virus specimens",
"This recombinant vaccine virus is available for distribution," it said in a statement on its website.
"Institutions, companies and others interested in pandemic vaccine development who wish to receive these candidate vaccine viruses should contact either the WHO Global Influenza Program . . . or the Centers for Disease Control and Prevention."
Pharmaceutical companies including Novartis are already working on vaccines against H5N1 bird flu, which has killed or forced the culling of more than 300 million birds since 2003 as it spread to 61 countries in Asia, the Middle East and Africa.
While eclipsed on the headlines by the highly contagious H1N1 strain, which proved deadly in its North American epicentre but has caused mild symptoms as it spread, the WHO stressed it was important to remember the risks posed by avian influenza.
The UN's Food and Agriculture Organization reported 250 outbreaks of H5N1 in birds in February alone — in Bangladesh, China, Egypt, India, Indonesia, Laos, Nepal and Vietnam.
Avian influenza has killed 261 people out of 424 infected since 2003. By contrast, the H1N1 strain, commonly known as swine flu and which has put the world on pandemic alert, has infected more than 13,000 people but killed just 95, according to WHO figures.
Its statement on Thursday said flu experts were continuing to monitor the evolution of avian influenza and other flu viruses and stressed the need for countries to keep providing samples of identified strains.
"Countries are encouraged to share with WHO their specimens and/or isolates, both from humans and animals, for their inclusion in the WHO H5N1 vaccine virus development and selection process, in addition to other activities of public health significance," it said.
Virus sharing is a sensitive topic for developing countries such as Indonesia, who have bristled at the idea of companies using their biological material to manufacture and patent vaccines that are then sold at unaffordable prices.
WHO Director-General Margaret Chan, who raised the United Nations agency's pandemic alert to 5 out of 6 in response to the fast spread of swine flu, is trying to broker an international agreement on the sharing of virus samples by January 2010.
She has called on countries to do all they can to ensure fresh samples of both H5N1 and the new H1N1 strains reach the pharmaceutical community so that their vaccines can offer immunity against the latest forms of the viruses.
The WHO's statement did not include new guidance on the H1N1 virus or vaccines to fight it. WHO officials have said they would offer recommendations "during the summer" about how many pandemic vaccines focused on that strain may needed, depending on whether it continues to cause mild effects as its spreads.
British scientists have produced a strain of H1N1 flu virus which could be used for largescale production of a vaccine, should it go ahead.
That strain is being made available to the pharmaceutical industry and other flu laboratories, Britain's Health Protection Agency said on Thursday, describing it as "a crucial step towards large scale production of a vaccine against swine flu".
Bird flu vaccine production still lags: Study
GENEVA – Drug companies would need four years to meet global demand for bird flu vaccines if a pandemic broke out today, but new technology could significantly boost production by 2014, a study said Tuesday.
Doses of vaccine tailored to the actual strain of pandemic influenza that emerges would not be available until four months after it is identified, it said.
Consulting firm Oliver Wyman gathered confidential data from drugmakers for the study which projected at least a doubling of production by 2014 mainly due to vaccines being made in cells in a lab dish instead of chicken eggs.
The study was carried out with the World Health Organization (WHO) and International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).
"The bottom line is that the capacity to make pandemic vaccines has tripled over the last two years ... this is mainly driven by improvements in production yields and also in dose-sparing technologies," Marie-Paule Kieny, director of the WHO initiative for vaccine research, told a news conference.
"We still don't have enough to cover the whole world in the early months of a pandemic, even though the situation has improved."
Currently, drug makers could make up to 2.5 billion doses of pandemic vaccines in one year, meaning it would take four years to meet global demand, the study said. In a best-case scenario, they could make 7.7 billion doses in 1.5 years.
RACE AGAINST THE CLOCK
Manufacturers hunting for the best vaccines to stop the deadly disease face a race against the clock if the H5N1 strain of influenza now circulating in birds mutates and starts spreading easily among humans, as many researchers fear.
At least 20 firms are working on pandemic vaccines, Kieny said. Western makers including Europe's biggest drugmaker GlaxoSmithKline, France's Sanofi-Aventis, Switzerland's Novartis and Baxter International of the United States accounted for most of the expanded capacity.
Production capacity was expected to increase to 5.1-14.7 billion doses by 2014, taking 12-28 months to meet global demand, the study said.
"The big increase between now and 2014 is due to the coming on to the market of vaccines made on cell cultures," Kieny said. "But this is still a projection."
Even by 2014, not all countries would have access to pandemic vaccine in the first six to nine months after the pandemic erupted, she added. There was concern that "developing countries will have little or no vaccines at the beginning."
The WHO, a United Nations agency, was making available a total of $12 million in grants to 11 developing countries to help them develop vaccine manufacturing capacity, she said.
Current demand for seasonal influenza vaccine is about 500 million doses a year, whereas drug makers currently have the capacity to make about 800 million doses, Kieny said.
Bird flu has killed 255 people out of 408 infected worldwide since 2003, according to the WHO. The toll includes a 23-year-old woman in Vietnam who died Saturday.
Egypt: New death from bird flu, a man of Helwan
The Ministry of Health on the status of new deaths from bird flu, bringing the total deaths in Egypt since the emergence of the disease in 2006 to 29 cases so far.
The ministry's statement that the new death to the old man "37 years" of Helwan, died Tuesday evening, a hospital was Abbasid impact of the failure in the functions of breathing.
The statement said that this case is the second case this year, and a total of bird flu infections in Egypt amounted to 97 cases since the onset of the disease.
Egypt: The death of a citizen suspected of being infected with swine flu in Fayoum
A native suspected of being infected with disease, swine flu today, Wednesday, was killed in a hospital intensive care Fayoum year.
Ahmed Mahmoud Zayed (52 years) from the village tribal status Nohor Snurs entered the hospital's intensive care yesterday, Tuesday, on suspicion of a disease of swine flu, was sent samples taken from the Central Laboratories Ministry of Health for analysis and the statement of passivity or be positive for the disease, but no results so far.
Indonesia: Bekasi Citizen Dies of H5N1 & Jakarta Citizen Confirmed H5N1
Click on Map. Note the Scale (lower left of map)
A BEKASI CITIZEN DIED FROM BIRD FLU
Jakarta, 10/2/2010 (Kominfo-Newsroom) - Ministry of Health of Indonesia reported, in the month
January 2010 there was one case of H5N1 (bird flu), ie a woman aged initials NL Residents 25 years old Bekasi, West Java, who died on January 25, 2010.
"The results of relevant laboratory stated positive of H5N1. Possible factors
risk is contact with poultry, "said Director General of Disease Control &
Environment, Kemkes RI, Tjandra Yoga, in his statement in Jakarta, Wednesday (10 / 2).
In addition, he said, in the routine surveillance activities of influenza like illness (ILI), is found a boy aged three years and two months initials AD, citizens of Jakarta, with complaints ILI light. Laboratory results showed the H5N1 positive person. Nevertheless,
he said, concerned has recovered and his health condition improved, and there is no
ILI symptoms again. (T.Jul / ysoel)
Original:
SEORANG WARGA BEKASI PENDERITA FLU BURUNG MENINGGAL DUNIA
Jakarta, 10/2/2010 (Kominfo-Newsroom) - Kementerian Kesehatan RI melaporkan, dalam bulan Januari 2010 terdapat satu kasus H5N1(flu burung), yakni seorang perempuan berinisial NL berusia 25 tahun warga Bekasi, Jawa Barat, yang meninggal dunia tanggal 25 Januari 2010.
“Hasil laboratorium menyatakan yang bersangkutan positif H5N1. Kemungkinan faktor resikonya adalah kontak dengan unggas,” kata Dirjen Pengendalian Penyakit dan Penyehatan Lingkungan, Kemkes RI, Tjandra Yoga, dalam keterangannya di Jakarta, Rabu (10/2).
Selain itu, katanya, dalam kegiatan surveilans rutin influenza like illness (ILI), ditemukan seorang anak laki-laki berusia tiga tahun dua bulan berinisial AD, warga Jakarta, dengan keluhan ILI ringan.
Hasil laboratorium menunjukkan yang bersangkutan positif H5N1. Meski demikian, katanya, yang bersangkutan telah pulih dan keadaan kesehatannya membaik, serta tidak ada gejala ILI lagi. (T.Jul/ysoel)
hat-tip Dutchy
Mexico: Possible case of mutation of A H1N1
They believe that the 275 mutation may have occurred for one patient, who was in the hospital of the IMSS
NUEVO LAREDO .- The mutation 222 and 275 of the influenza A virus H1N1, which caused health specialists again ignite the hot spots to the suspicion that this mutation is recorded in patients who are affected by the H1N1 strain A 2009.
222 is the mutation rate refers to patients with influenza A H1N1, which show no resistance to antiviral traditionally fight this disease.
The type 275 of the virus occurs in patients who are resistant to oseltamivir (brand name Tamiflu) and has already been reported in isolation in several countries.
Locally, although not confirmed officially, it is suspected that the 275 mutation has already been registered in a patient, who in the last quarter of 2009, was admitted to the Hospital de Zona No. 11 del IMSS.
Dr. Angel Contreras Gutierrez, the hospital epidemiologist, explained that this case occurred in less unresponsive to treatment, within the space of 12 hours on average is recorded in patients affected by influenza A H1N1.
"This patient was taken from its cultivation (sample) and sent to INDRE and there we said it was susceptible mycobacterial, while it was changed by one traditional medicine for injection and responded favorably, this medicine is used in very serious and delicate as it is also a control treatment, "he said.
Contreras Gutierrez said that while decreased considerably currently suspected influenza A H1N1, with this mutation of the virus, the first protocol of actions to be performed is a constant monitoring of each new suspected cases.
"Since we started the year until this week five, were two to a case which had been reported as suspicious of influenza A H1N1 in terms of seven days, but now they will have to make monitoring by which to enact if the patient shows resistance to drugs, "he said.
Of the suspected cases of human influenza, he said, the latest occurred last week in a child who spent time in Laredo, Texas.
The epidemiologist said that even with this new warning issued by the Ministry of Health by these mutations of the A H1N1, the IMSS is considered ready to face the new cases of this virus.
"To cope with the influenza virus, we have thousand 500 treatments of Tamiflu, but we also have the Senavivir, and what's new and effective Panavivir, this is an injectable solution that applies only to patients who are resistant to traditional medicine that are considered very serious cases.
"With these mutations, people should not be alarmed and should continue to expectation, fighting this disease now even with the implementation of the A H1N1 vaccine and following the hygiene measures to prevent universal," he said.
hat-tip Tonka
WHO: Avian influenza - situation in Egypt - update 29
The Ministry of Health of Egypt has announced a new case of human H5N1 avian influenza infection.
The case is a 37-year-old male from Helwan District, Helwan Governorate.
He developed symptoms on 31 January and was hospitalized on 6 February, where he received oseltamivir treatment.
He is in a critical condition.
The case was confirmed by the Egyptian Central Public Health Laboratories, a National Influenza Center of the WHO Global Influenza Surveillance Network (GISN).
Of the 97 laboratory confirmed cases of Avian influenza A(H5N1) reported in Egypt, 27 have been fatal.
hat-tip Ironorehopper