Identifier
Created
Classification
Origin
09CAIRO1215
2009-06-29 13:55:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Cairo
Cable title:  

INFUENZA CONFERENCE REVIEWS VIRUS SITUATION IN EGYPT

Tags:  TBIO KFLU KSTH PGOV EAGR CASC PREL EAID EG 
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DE RUEHEG #1215/01 1801355
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P 291355Z JUN 09
FM AMEMBASSY CAIRO
TO RUEHC/SECSTATE WASHDC PRIORITY 3021
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE PRIORITY
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UNCLAS SECTION 01 OF 02 CAIRO 001215 

SENSITIVE
SIPDIS

DEPT FOR AIAG (AMBASSADOR LOTFIS AND DAVID WINN),NEA/ELA
DEPT PASS TO AID (DENNIS CARROLL)

E.O. 12958: N/A
TAGS: TBIO KFLU KSTH PGOV EAGR CASC PREL EAID EG
SUBJECT: INFUENZA CONFERENCE REVIEWS VIRUS SITUATION IN EGYPT

Sensitive but Unclassified. Please handle accordingly.
UNCLAS SECTION 01 OF 02 CAIRO 001215

SENSITIVE
SIPDIS

DEPT FOR AIAG (AMBASSADOR LOTFIS AND DAVID WINN),NEA/ELA
DEPT PASS TO AID (DENNIS CARROLL)

E.O. 12958: N/A
TAGS: TBIO KFLU KSTH PGOV EAGR CASC PREL EAID EG
SUBJECT: INFUENZA CONFERENCE REVIEWS VIRUS SITUATION IN EGYPT

Sensitive but Unclassified. Please handle accordingly.

1.(SBU)Summary: At the avian and human influenza strategic review
workshop on June 22-23 in Cairo, the first ever lead by USAID,
senior Ministry of Health (MOH) and Agriculture (MOA) officials, as
well as representatives from UN agencies, the World Bank, and the
Communication for Healthy Living Project, examined the H5N1
situation in Egypt and identified ways to improve prevention and
control of the virus. Panel discussions also discussed the rapid
emergence of the H1N1 virus and the potential implications which
arise when in an H5N1 environment. End Summary.

--------------
Tracking the Virus
--------------


2. (SBU) USAID and Egyptian authorities recognized that nearly three
and a half years into Egypt's H5N1 program (the first human case was
reported in March 2006),the time had come for an assessment of the
overall on-the-ground situation. USAID's Dennis Carroll, Director of
Avian Influenza and Pandemic Preparedness in the Global Health
Office, posed two key questions at the workshop's opening session:
how best to support GOE efforts to combat the virus in the next 12
months and whether current program investments are consistent with
data emerging about the virus. While the detection of H5N1 human
cases in Egypt is faster and the fatality rate is lower in
comparison to other developing countries, Carroll stated significant
problems and gaps in information remain about the virus.


3. (SBU) Since 2006, Egypt has accounted for a significant portion
of the world's reported H5N1 poultry outbreaks and human cases. To
date, the MOH has announced 81 confirmed cases, with 27 of those
cases fatalities. Worldwide, nearly 30% of all human H5N1 cases
have emerged from Egypt - 11 governorates (8 from the country's
Delta region) contain more than three quarters of the human cases.
The virus primarily affects backyard famers and children.



4. (SBU) More than 90% of H5N1 cases are the result of exposure to
sick or dead poultry. Yet, while the number of reported poultry
outbreaks has decreased since 2006, and the number of human cases
followed the same trend through 2008, H5N1 human cases increased in

2009. It is unclear if this is a result of issues related to poultry
outbreak reporting, increased environment viral load, or risky
behaviors leading to bird-to-human transmission, or another factor.
Carroll noted that several USAID program areas require
consideration, including increasing capacity for detection and
outbreak investigation; working with the commercial poultry sector
to improve bio-security and control poultry movement; and refining
the communications message to improve prevention behaviors for
parents for all those who have contact with poultry.

--------------
GOE Capacity Building
--------------


5. (SBU) MOH and MOA officials confirmed the accuracy of this data
and reviewed current GOE H5N1 efforts. According to a 2008
demographic survey, a comprehensive and persistent media outreach
program using print materials, television ads, has led to near
universal awareness among men and women ages 15-59 years old, with
80% of people learning about H5N1 through television advertising
campaign. The MOH's Dr. Amr Kandeel detailed the Ministry's capacity
building in recent years, including stockpiling 2.5 million Tamiflu
doses, creating rapid response containment teams for health care
workers, implementing surveillance measures at ports of entry,
building new laboratories, and stronger coordination with other
ministries.


6. (SB) MOA efforts are not as comprehensive as those frm the MOH.
Dr. Amira Kamal, a member of the Minisry's General Organization of
Veterinary Services(GOVS),highlighted many problems confronting
th Ministry's response to H5N1. The MOA possesses aweak
notification and reporting system, deficien surveillance
mechanisms, inadequate bio-securitymeasures, and inefficient
veterinary teams to repond to outbreaks. The National Laboratory's
Dr Mohamed Khalifa noted the virus is endemic and ageed there is
no accurate reporting from affectedareas.

--------------
Consensus Building --------------


7. (SBU) On the workshop's scond day, GOE officials split into MOA
and MOH wrking groups to analyze ways in which their respecive
ministries can improve communication, trainig, community outreach,
and pandemic preparedness. A MOH presentation noted the need to
decrease te H5N1 incidence rate among children and improve te

CAIRO 00001215 002 OF 002


response rate among infected women, who often wait more than 5 days
to seek treatment.
The MOA team distilled their approach into three main programs:
bio-security (emphasizing segregating poultry and disinfecting
anything that is visibly dirty); surveillance; and outbreak
investigation.


8. (SBU) Comment: There is a significant disparity between MOH and
MOA H5N1 activities and preparedness. The country has had only 27
fatalities since the disease appeared in 2006, just 17 since 2007.
It takes less than two-and-a-half days from virus symptoms (i.e.
fever, coughing, sore throat) to the actual onset of the disease,
which translates into people seeking immediate treatment for H5N1;
other countries average more than 5 days. MOH officials communicate
constantly with the public about human H5N1 cases. In comparison,
the MOA lacks a comprehensive and coherent plan to address the
long-simmering internal squabbles among senior MOA officials, which
were evident at the conference. Two steps that could strengthen the
GOE's H5N1 program are 1) a refocused effort on bio-security and
surveillance programs which could improve the response to poultry
outbreaks and commercial and backyard farms and 2) organizing
regular GOE H5N1 stakeholder meetings (especially among senior MOH
and MOA officials) to ensure that there is a unified approach to
combating the virus. We will continue to stress the importance of
these steps as we engage with our GOE interlocutors.

Scobey