EGYPT'S 53RD BIRD FLU VICTIM

UNCLAS CAIRO 000173

SENSITIVE
SIPDIS

DEPT FOR AIAG (AMBASSADOR LANGE AND DAVID WINN),DEPT PASS TO AID
(DENNIS CARROLL)

E.O. 12958: N/A
TAGS: TBIO KFLU KSTH PGOV ECON KSCA EAGR EG
SUBJECT: EGYPT'S 53RD BIRD FLU VICTIM

REF A 09 CAIRO 074
REF B 08 CAIRO 784

Sensitive but Unclassified. Please handle accordingly.


1. (SBU) Summary and comment: Egypt's 53rd human avian influenza
(AI) victim-a two-year-old girl from Shebin El-Kom, the capital of
the Menoufiya Governorate- has recovered. Twenty-four of the 25
Egyptian pre-teens struck with bird flu here have now survived,
including all 22 of those under age ten (ref A). This good news
comes at the same time a leading daily newspaper has published a
sensational report about a possible AI epidemic. End summary and
comment.

IS QUICK HOSPITALIZATION THE KEY TO SURVIVAL?


2. (SBU) Egypt's Ministry of Health and Population (MOHP) announced
the latest AI case on January 25, 2009. Two aspects of the case, the
second this year and the third this "season," deserve further
comment. First, the little girl from Menoufiya got sick, was
hospitalized and received Tamiflu all on the same day: January 23,

2009. Egyptians do take kids afflicted with AI to hospitals quickly.
The average time between onset of symptoms and hospital admission
for the pre-teen AI survivors here is only 1.4 days. The teenage and
adult AI victims have taken a lot longer to get to the hospitals, on
average, twice as long-over 3 days. This fact may, at least in part,
explain why 96% of the pre-teen AI victims in Egypt lived, while 80%
of the older victims died. Moreover, early hospital admission is, in
all likelihood, synonymous with early administration of Tamiflu.
ESTHOff has spoken with several Egyptian doctors who treated
pediatric AI patients. They said they administered Tamiflu to the
children without waiting for proof of contact with sick poultry or
for lab results. The one pre-teen to die from AI in Egypt, a
ten-year-old Qena girl who passed away June 10,2007, was not
hospitalized until five days after she got sick, and all seven of
the older patients who waited five days or more for hospitalization
died.

A QUICK DISCLOSURE AND CONFIDENCE IN EGYPT'S CENTRAL HEALTH LABS

3. (SBU) The MOHP also appears to have handled Case 53 flawlessly.
On January 25, 2009, just two days after the young girl from
Menoufiya sought medical treatment, MOHP's Central Laboratories
confirmed she had AI and the Ministry, in a departure from past
practice, disclosed the case to the public without waiting for
NAMRU-3 to double-check Central Labs's results. The MOHP's
confidence in its Central Labs is well founded (ref B). Central Labs
did eventually provide a Case 53 sample to NAMRU-3: it contained the
H5N1 virus.
PRESS HINTS AT EPIDEMIC


4. (SBU) Al Masry Al-Youm, a widely read independent Egyptian
newspaper, reported on January 30, 2009, on the large number of
suspect AI cases in Egypt. The report, apparently based on a MOHP
report noting there have been 5,800 suspect AI cases in Egypt since
2006, was carried under a banner hinting at an epidemic. While the
headline was sensational, the number of suspect cases reported is
consistent with what Embassy Cairo has been hearing from the MOHP
all along. The MOHP's report apparently indicates Cairo has had the
highest number of suspect cases, 780, followed by Gharbiya with 715,
Kafr El-Sheikh with 499, Giza with 466 and Menoufiya, with 444.

MENOUFIYA'S GRIM MILESTONE-- THE MOST CONFIRMED CASES


5. (SBU) There appears to be no relationship between the number of
cases suspected and the number confirmed. With the confirmation of
the latest case, Menoufiya, the birthplace of Egyptian Presidents
Mubarak and Sadat, which is located in the Nile Delta about 65
kilometers north of Cairo, is now the Egyptian Governorate most
afflicted by human AI. Six human AI cases have been confirmed in
Menoufiya since the H5N1 virus emerged in Egypt in early 2006. The
Governorates of Qena, Qalubiya, Gharbiya and Fayoum trail with five
confirmed human cases each.
Scobey