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. -------------- AI REEMERGES IN BACKYARD POULTRY FARMS -------------- ¶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. -------------- -------------- MINISTERS OF HEALTH, AGRICULTURE CONCERNED OVER OUTBREAK -------------- -------------- ¶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. -------------- GOE AND DONORS DISCUSS EFFORTS, NEXT STEPS -------------- ¶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. -------------- POULTRY INDUSTRY RECOVERING -------------- ¶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. -------------- EMBASSY AIWG RECONVENES -------------- ¶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