AVIAN FLU CASES REEMERGE IN EGYPT AFTER SUMMER LULL

UNCLAS CAIRO 006196

SIPDIS

SENSITIVE
SIPDIS

STATE FOR NEA/ELA
ALSO FOR NEA/RA,
AMMAN FOR WHITTLESEY
CA/OCS-RICHTER

E.O. 12958: N/A
TAGS: TBIO KSTH KFLU ECON PREL WHO EG
SUBJECT: AVIAN FLU CASES REEMERGE IN EGYPT AFTER SUMMER LULL

REF: A) CAIRO 981 B) 05 CAIRO 8734 C) STATE 139889

Sensitive but unclassified, please protect accordingly.


1. (SBU) SUMMARY: Several new cases of H5N1 avian influenza
(AI) emerged in backyard poultry farms in August and
September, following a relative lull in outbreaks in the
early summer. Both the Ministers of Health and Agriculture
expressed concern about recent outbreaks. The re-emergence of
live bird markets, especially in the month leading up to
Ramadan, may be attributing to recent outbreaks. Egypt's
poultry market, devastated by last year by the virus, is
recovering. Post's Avian Influenza Working Group (AIWG) met
September 12 to discuss disseminating information to the
AMCIT community and coordination with the GOE. END SUMMARY.

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AI REEMERGES IN BACKYARD POULTRY FARMS
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2. (U) Following a decline in the number of reported cases
this summer, a second wave of H5N1 influenza appeared in
backyard poultry flocks on August 24, when three new sites
were reported in Sohag and Giza. On September 30, the GOE
reported two new cases of H5N1 in backyard flocks in the
Damietta and Giza governorates. Several days before, the
Ministry of Health and Population (MOHP) announced a new case
in Aswan, also in a backyard farm. Officials reportedly
culled all birds within a one mile radius. Since AI was
first detected in February 2006, at least 20 million birds
have been culled. AI, which exists in 21 of 26 governorates,
infected 14 humans last spring, 6 of whom died. No new human
cases have been reported since May 2006. The MOHP is
conducting a large-scale vaccination campaign to combat the
disease, but recognizes that reaching out to backyard farmers
is a challenge.

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MINISTERS OF HEALTH, AGRICULTURE CONCERNED OVER OUTBREAK
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3. (SBU) On September 20, a NAMRU-3 representative met with
Minister of Health and Population Dr. Hatem Mostafa El
Gabaly, who expressed great concern over recent outbreaks,
and the possibility that the virus may become endemic. MOHP
officials do not know if the current virus represents a
reemergence of the same strain that caused the spring
outbreak, or a new strain introduced by migratory birds or
illicit poultry smuggling. NAMRU-3 recently determined
through phylogenetic sequence analysis of H5N1 virus carried
by a wild teal found in December 2005, that the bird species
may have carried the parent of the virus that caused the
spring outbreak. This finding supports the claim that
migratory birds brought the virus to Egypt, but most believe
it is now being actively spread through poultry. NAMRU
offered to perform sequence analysis on virus strains found
in the new outbreaks in Upper Egypt, but so far MOA has not
accepted this offer.


4. (SBU) In a September 11 meeting with Minister of
Agriculture (MOA) Amin Ahmed Abaza, FAS Counselor, along with
officers from the American Soybean Association/United Soybean
(ASA/US),discussed the current AI situation, which Abaza
acknowledged is "less than optimal." ASA/US vets stressed
robust surveillance and vaccination programs are necessary to
truly contain the disease. They pointed out that Thailand,s
success in controlling the virus stemmed from precise
surveillance, tightened biosecurity, and strict stamping-out
policies, in close coordination with the private sector.
Abaza agreed, but said it is politically impossible to close
down backyard and small farmers and move toward a production
system of complete confinement. He also noted that in
Thailand, private industry made financial contributions to
overall control efforts, an unlikely scenario in Egypt.

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GOE AND DONORS DISCUSS EFFORTS, NEXT STEPS
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5. (U) In response to recent outbreaks and the impending flu
season, the UN Disaster Management Team chaired a meeting on
September 11 with GOE officials, donor agencies and NGOs to
ensure coordination. GOE officials highlighted current
efforts including the following:

--GOE is finalizing a national strategic action plan for
pandemic flu. They are updating the integrated national
contingency plan for AI.

--MOHP is training health care professionals in 20
governorates, including 4000 physicians, as well as nurses
and healthcare administrators. They conducted public
awareness outreach to 121,000 people in non-urban areas. They
are re-airing TV public service announcements used during
last year's outbreak.

--The Veterinary Serum and Vaccine Research Institute, an arm
of MOA, has requested H5N1 virus and aims to create a vaccine
using the Egyptian isolate. MOA is conducting active
surveillance, and has carried out 3,339 tests since the end
of the epidemic. Surveillance activities have been increased
in rural areas nationwide, including 1037 villages with more
than 13,000 samples collected from birds and 6,000 human
samples in the last three months.

-The State Information Service's portal on AI outbreaks and
information is http://birdflu.sis.gov.eg/html/index.htm.

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POULTRY INDUSTRY RECOVERING
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6. (SBU) Last spring's regional AI outbreak placed Egypt's
poultry industry in severe crisis (ref A),drastically
reducing demand in a country that normally consumes 800
million birds per year and relies heavily on eggs and poultry
as protein sources. In November, prior to the outbreak,
Egypt temporarily banned all poultry and poultry part imports
(ref B). The ban has been partially rescinded, and importers
are bringing in frozen whole chickens from Brazil to meet the
demand. According to the FAO, demand for chickens will reach
previous levels by January 2007. The Egyptian consumer,
however, continues to prefer purchasing birds in live
markets. To combat outbreaks in the spring, the GOE placed a
ban on backyard poultry farms in urban areas, as well as live
open markets. Despite an ongoing ban on these facilities,
live bird markets have emerged again in several locations
throughout Egypt. Case studies from other countries have
highlighted a correlation between market movement and virus
circulation.


7. (SBU) After last spring's outbreak, the GOE compensated
farmers whose birds were culled, doling out 3LE ($0.50) per
bird culled close to an outbreak site and 5 LE ($0.87) per
bird dying of the disease. Sixty-four percent of the overall
compensation, however, went to owners of thirty-five of the
total poultry flock. An estimated 4.5 million Egyptian rural
families have or have had small backyard poultry flocks; most
were not compensated in the ordered cull.
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EMBASSY AIWG RECONVENES
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8. (U) On September 12, post's AIWG, composed of
representatives from NAMRU-3, USAID, Public Affairs,
Consular, RSO, RMO, and USDA (APHIS and FAS) reconvened for
the first time since June. The group focused on outreach to
the American community for the upcoming flu season, including
distribution of a DOS-produced DVD on pandemic influenza to
both Embassy staff and the American community at large (ref
C). Consular is issuing a public announcement for the
American community on FAQs on AI. AIWG members also reviewed
coordination efforts with the GOE, on both financial and
technical assistance.


9. (SBU) Comment: While the GOE claims to be engaged in
active surveillance, it is unclear how systematic their
response has been. If their surveillance activities are
limited to biosecure, highly-sophisticated areas, there will
be a false picture of the real AI situation in Egypt.
Considering how widespread AI was earlier in 2006, it is
possible that AI H5N1 is endemic and we will continue to see
outbreaks in years to come.
RICCIARDONE