EGYPT PREPARING FOR AVIAN INFLUENZA

UNCLAS SECTION 01 OF 03 CAIRO 007552

SIPDIS

SENSITIVE

E.O. 12958: N/A
TAGS: TBIO ECON PREL SOCI WHO KSTH
SUBJECT: EGYPT PREPARING FOR AVIAN INFLUENZA

REF: A. STATE 153802

B. STATE 175585

C. STATE 180478

This message is sensitive but unclassified, please handle
accordingly.

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Summary
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1. (SBU) Government of Egypt officials share our concerns
regarding avian influenza (AI). The GOE's close co-operation
with Cairo's U.S. Naval Medical Research Unit (NAMRU-3) has
positioned it for effective surveillance of AI, though the
system has some limitations. However, the political will to
contain an outbreak absent a plan for compensation for
poultry destruction remains a question. Post is working with
the GOE to facilitate the travel of an appropriate GOE
official to the October 6 partnership meeting in Washington.
End summary.


2. (U) In separate meetings, ECPO Counselor met with
representatives from the Egyptian Ministry of Health and
Population (MOH) and the Ministry of Agriculture and Land
Reclamation (MOA) and addressed the USG's concerns regarding
AI as laid out in Ref A. ECPO Counselor was accompanied by
representatives from NAMRU-3 at the MOH and from the Foreign
Agricultural Service (FAS) at the MOA.


3. (SBU) In a separate meeting with Ministry of Foreign
Affairs (MFA) Environmental Counselor Omar Ali Abou Eiche,
EST officer delivered an invitation to the October 6
International Partnership on Avian and Pandemic Influenza
meeting in Washington to the MFA, per Ref B. The meeting
agenda and other information was separately delivered to the
MFA, the MOH, and the MOA per Ref C. The MFA informed the
Embassy that it had no objection to the core principles,
however, funding constraints would mean the MFA probably will
not be able to send a representative from Cairo to the
meeting. The MOA informed FAS that Agricultural Attache Dr.
Hussein Mansour from the Egyptian embassy in Washington would
attend the event. (Note: Subsequent to this discussion,
NAMRU-3 confirmed it can fund travel for a GOE representative
to the meeting. Post is working with the GOE to identify an
appropriate official and facilitate travel. End note.)

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AI Programs at the Ministry of Health
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4. (U) In the meeting at the MOH with Dr. Magda A. Rakha,
First Under Secretary (i.e., Deputy Minister) of Health, and
Dr. Nasr El-Sayed, Under Secretary for Preventive Affairs,
ECPO Counselor explained the USG's concerns regarding avian
influenza (AI),stressing its worldwide effect, the
possibility of a pandemic, and the need for transparency on
the part of all governments, both during the preventive
stages of action as well as in the event of an outbreak.
ECPO Counselor noted Egypt's already close cooperation with
NAMRU-3 to conduct surveillance of migratory birds and of
human outbreaks through the NAMRU-initiated health
surveillance system.


5. (U) Dr. Rakha stated that the GOE is taking the AI threat
seriously and noted that the Minister of Health, Dr. Tag El
Din, postponed a recent trip to Sudan in order to deal with
this issue. The Ministry had also recently been briefed on
the subject by the Canadian embassy.


6. (U) Dr. El-Sayed, who is the ministry's point of contact
for AI, said that there has been much activity in the last
month on AI. The Ministries of Health, Agriculture,
Environment and Defense, including MOH staff from the
pharmaceutical and virology departments, met on September 13
to form a National Committee and to discuss influenza
pandemic preparedness with representatives from the World
Health Organization (WHO) and NAMRU-3. The discussion
touched on epidemiology, transmissibility and treatment
options.


7. (U) The GOE is working with NAMRU-3 to strengthen its
laboratory capabilities. The GOE is now formulating a
National Plan to deal with AI, and they already have an
Emergency Plan in place to coordinate among concerned
agencies and the poultry industry should an outbreak occur.


8. (U) According to Dr. El-Sayed, Egypt will represent the
Middle East region at a proposed ministerial-level meeting in
Canada in mid-October. Also, the MOH received an invitation
September 17 from Search for Common Ground to a meeting in
December on AI. Invited to the meeting are representatives
from Egypt, Israel, the Palestinian Authority, and Jordan, to
develop a common vision and to discuss national, regional and
global plans to combat AI. Dr. Rakha said the GOE intends to
accept the invitation.

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Ministry of Agriculture Concerns about AI
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9. (U) Subsequent to the meeting at the MOH, ECPO Counselor
and the acting Agricultural Counselor met with MOA
representatives Dr. Fadia Nossier, Undersecretary of the
Central Administration for Foreign Agricultural Relations,
and Dr. Mona Aly, a national laboratory director who has been
named the MOA's POC for AI.


10. (SBU) Aly noted that her organization is working with a
National Academy of Sciences project to screen chicken farms
for AI. The project was begun two years ago and will finish
in six months. According to Aly, AI has been detected in
migratory birds in Egypt, but the strain of AI is not
believed to be the virulent form of the disease.


11. (U) Egypt is currently working on an inspection program
that visits one farm per week and focuses on problem flocks,
e.g., those with high mortality, or where there is suspicion
of a need for isolation. The Poultry Producers Union is
cooperating with the Egyptian government on the screening of
small farms.


12. (U) Aly reports to the Chief Veterinary Officer, Dr.
Ahmed Tawfik, who in turn notifies the OIE (Office
International des Epizooties/the World Organization for
Animal Health) of any problems of contagion. Aly
acknowledged that the system still needs a lot of work. In
the event where AI is detected, the virus must be typed, and
further investigation would be needed.


13. (SBU) GOE officials know little about the presence of AI
in Egypt's neighboring countries. Saudi Arabia reported an
outbreak of the low pathogen H9 strain two years ago. There
have been prior instances of poultry destruction in Egypt,
e.g., in a case where ducks were infected with salmonella.
According to Aly, the farmers are willing to accept some
ordered destruction because of the government's authority.
However, large-scale destruction would be difficult to carry
out if there is no compensation.


14. (U) Aly noted that the GOE needs to send staff abroad
for laboratory training, and also needs reagent in order to
carry out virus typing, but is suffering from a lack of
funds.

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Migratory Routes and Egypt's Vulnerability
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15. (SBU) Bird migrations in Egypt are now underway. The
season begins in September-October and runs through
March-May. One of the main issues for Egypt is surveillance.
The country is a significant migratory route, which leaves
its very large poultry sector (800 million chickens)
vulnerable. Although surveillance of the domestic chicken
population has begun, it needs to be extended. There is
support from farmers for AI research. Many poultry farmers
in Egypt are educated, and vaccinate their chickens
regularly. A major problem, however, is that free-ranging
chickens are common in Egypt, and chickens are kept close to
migratory bird paths.

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Questions about Support
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16. (SBU) Rakha and El-Sayed asked what kind of
international support would be available should an AI
outbreak occur. They pointed out that, for transparency to
be effective, it requires that a nation be able to rely on
international help, e.g., compensation for slaughtered
chickens. Rakha and El-Sayed suggested that it would be
difficult to persuade Egyptian producers to destroy their
flocks if they were not assured of compensation. The two
opined that, since it is a global problem, i.e., an
international public health concern, there must be an
international response.

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NAMRU-3's Assistance
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17. (U) NAMRU-3 has spawned numerous collaborative efforts
in health research in Egypt, and has state of the art
laboratory equipment. NAMRU-3 is currently training
technicians from the region in virus detection techniques.


18. (U) NAMRU-3 has created an electronic national
surveillance system for the reporting of contagious diseases.
The technology is in place, with equipment and training
provided by funds from USAID. The system is near to being
implemented throughout Egypt's 26 governates and 375
districts. It can be implemented by laboratory diagnostic
systems in place in hospitals. The surveillance system has
limited detection capabilities, and it is not set up to
specifically detect AI. Few labs in the country can now do
AI analysis. The system uses standard WHO kits for flu
typing. Only five people in Egypt currently have the
training to do flu typing.

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Comment
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19. (SBU) As noted above, Egypt is vulnerable because it
lies in the path of migrating birds known to carry the virus,
especially the shoveler and teal. Egypt's vulnerability is
increased because most poultry is kept outdoors and cannot be
isolated from migrating birds. As in other countries,
large-scale, uncompensated destruction of affected or
potentially affected poultry would be politically very
difficult, thus our interlocutors' keen interest in learning
more about programs to reimburse farmers.


20. (SBU) The presence of NAMRU-3 and a USDA/APHIS
Veterinary Officer in Cairo and the close cooperation with
the Ministries of Health and Agriculture, respectively,
leaves post unusually well-positioned to detect any AI
outbreak in Egypt early and coordinate with the government on
an effective response.


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JONES