Published Date: 2007-12-27 23:50:00
Subject: PRO/MBDS> Avian influenza, human: Pakistan, Egypt
Archive Number: 20071227.4155
AVIAN INFLUENZA, HUMAN: PAKISTAN, EGYPT
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
[In response to a query from a subscriber, the below posting from the
general ProMED-mail list is being reproduced here to keep the MBDS
region up to date on avian influenza occurrences outside of the MBDS
region. There has been a lot of press coverage on possible human to
human transmission in Pakistan, which at present has not been
confirmed by WHO (see report  below). - Mod.MPP]
In this update:
 Pakistan, one case confirmed, WHO
 Egypt, 2 cases confirmed
 Pakistan, one case confirmed
Date: Thu 27 Dec 2007
Source: World Health Organisation (WHO), CSR, Disease Outbreak News [edited]
Pakistan: Avian influenza situation - WHO Update
The 1st case of human infection with H5N1 avian influenza has been
confirmed in Pakistan. Laboratory tests conducted by the WHO H5
Reference Laboratory in Cairo, Egypt and WHO Collaborating Center for
Reference and Research on Influenza, in London, United Kingdom, have
confirmed the presence of avian influenza virus strain A(H5N1) in
samples collected from one case in an affected family. Additional
laboratory analysis, including gene sequencing, is ongoing.
At the request of the Pakistan government, a WHO team traveled to
Pakistan to participate with national authorities in the ongoing
investigations of several suspected cases of human H5N1 infections.
The following conclusions have been made accordingly:
- The preliminary risk assessment found no evidence of sustained or
community human to human transmission.
- All identified close contacts including the other members of the
affected family and involved health care workers remain asymptomatic
and have been removed from close medical observation.
The Ministry of Health in Pakistan has taken timely steps to
investigate and contain this event including case isolation, contact
tracing and monitoring, detailed epidemiological investigations,
increasing the availability of personal protective equipment,
dedicating hospital facilities for any new suspected cases, and other
infection control measures. In addition, agricultural authorities,
including the Ministry of Food, Agriculture and Livestock and FAO,
have been active technical partners for the effective control of this
ProMED-mail Rapporteur Marianne Hopp
[This report is the first confirmation by a WHO reference laboratory
of a case of H5N1 avian influenza virus infection in Pakistan.
Samples from one member in an affected family have tested H5N1
virus-positive. The particular member of the affected family is not
identified. Other members of the affected family and their contacts
remain asymptomatic and test results are not stated. More precise in
formation is awaited, but occurrence of human-to-human transmission
has been discounted. - Mod.CP]
[For a map of Pakistan, see
For the interactive HealthMap/ProMED map of Pakistan with links to
other outbreaks reported on ProMED-mail in the surrounding areas, see
<http://healthmap.org/promed?v=30,69.4,5>. - Mod.MPP]
 Egypt, 2 cases confirmed
Date: 27 Dec 2007
Two Egyptians test positive for bird flu - ministry
Two Egyptians have tested positive for the deadly H5N1 bird flu
virus, a day after an Egyptian woman died of the disease, Egypt's
health ministry said on Thursday [27 Dec 2007].
"There are 2 cases today, one in Damietta and one in Menoufia...
Today lab results confirmed that they are infected with bird flu,"
Amr Kandeel, head of communicable disease control at the health
ministry, told Reuters.
The 2 new cases, both of whom are currently receiving treatment in
hospital, bring the total number of human bird flu cases in Egypt to
41, Kandeel added.
State news agency MENA said the Menoufia case was a 22-year-old, but
gave no details for the 2nd case.
On Wednesday, a 25-year-old [female] died of bird flu in Beni Suef
province, south of Cairo, on the same day she was diagnosed as being
infected with the highly pathogenic virus.
She was the 16th fatality from bird flu in Egypt.
The H5N1 virus which causes bird flu tends to lie dormant during the
summer and Egyptian officials had hoped that after 2 years of
outbreaks it would not re-occur this winter.
But John Jabbour, an official at the World Health Organisation, said
the new cases were not surprising.
"The agent is there... Since July  we've had no human cases and
many things calmed down, so people returned to dealing with live
birds as usual. Since the virus is there, we expect to have human
cases. It's not a surprise at all," Jabbour said.
MENA reported Thursday [27 Dec 2007] that veterinary authorities in
Sharkia province had culled 12 000 chickens after tests found the
flock had been infected with bird flu.
Most of those who have fallen ill in Egypt were reported to have had
contact with sick or dead household birds, primarily in northern
Egypt where the weather is cooler than in the south.
The government still finds it hard to enforce restrictions on the
movement and sale of live poultry.
The death toll is the highest for any country outside Asia and could
reflect the high population density in agricultural parts of Egypt.
Experts fear the bird flu virus might mutate or combine with the
highly contagious seasonal influenza virus and spark a deadly
pandemic which could circle the globe and kill millions.
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.
[Reported by: Aziz El-Kaissouni]
ProMED-mail Rapporteur Mary Marshall
[According to the most recent data available on the WHO website, as
of 27 Dec 2007 there have been 39 cases and 16 deaths due to H5N1
infection in Egypt of which 21 cases and 6 deaths were confirmed
during 2007. If these 2 additional cases are confirmed by a
reference laboratory they will bring the total number of confirmed
cases in Egypt to 41.
For a map of Egypt with directorates, see
<http://www.lib.utexas.edu/maps/africa/egypt_admn97.jpg>. For the
interactive HealthMap/ProMED map of Egypt with links to other
ProMED-mail reports in the surrounding area, see
<http://healthmap.org/promed?v=26.5,29.9,5>. - Mod.MPP]
For other general ProMED-mail postings on these human cases, see the
below reports available at <http://www.promedmail.org>. - Mod.MPP]