Identifier
Created
Classification
Origin
09CAIRO2103
2009-11-05 15:12:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Cairo
Cable title:  

EGYPT: MINISTRY OF HEALTH REVIEWS CURRENT INFLUENZA

Tags:  TBIO KFLU KSTH PGOV EAGR CASC PREL EAID EG 
pdf how-to read a cable
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TO RUEHC/SECSTATE WASHDC PRIORITY 4126
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UNCLAS SECTION 01 OF 02 CAIRO 002103 

SENSITIVE
SIPDIS

DEPT FOR AIAG (DAVID WINN),NEA/ELA

E.O. 12958: N/A
TAGS: TBIO KFLU KSTH PGOV EAGR CASC PREL EAID EG
SUBJECT: EGYPT: MINISTRY OF HEALTH REVIEWS CURRENT INFLUENZA
ACTIVITIES

REF: CAIRO 1802

Sensitive but Unclassified. Please handle accordingly.
UNCLAS SECTION 01 OF 02 CAIRO 002103

SENSITIVE
SIPDIS

DEPT FOR AIAG (DAVID WINN),NEA/ELA

E.O. 12958: N/A
TAGS: TBIO KFLU KSTH PGOV EAGR CASC PREL EAID EG
SUBJECT: EGYPT: MINISTRY OF HEALTH REVIEWS CURRENT INFLUENZA
ACTIVITIES

REF: CAIRO 1802

Sensitive but Unclassified. Please handle accordingly.

1.(SBU) Key Points:

--Dr. Samir Refaey, the Ministry of Health's executive director for
disease surveillance, characterized current Egyptian influenza
measures as a collaborative government effort effectively tracking
the disease and its impact on the country.

--Refaey emphasized that close monitoring by the Ministries of
Health and Education have convinced the Egyptian government (GoE)
that there is no need at this time to enact a general closure of the
country's school system.

--The GoE has purchased 5 million doses of a H1N1 vaccine and will
distribute the first batch of 70,000 doses to health workers and
Hajj pilgrims.

--He views current H1N1 measures as a trial run for the upcoming
H5N1 season.


2. (U) Emboffs met with Dr. Samir Refaey, executive director of
disease surveillance the Ministry of Health (MoH),to discuss GoE
planning and preparation for the winter influenza season. Refaey is
the Ministry's point person on influenza issues and is a key advisor
to Health Minister Hatem El-Gabaly.

--------------
Egypt's Schools: Open for Business
--------------


3. (SBU) Since Egypt's academic year began on October 3rd, the
Ministry of Health (MoH) has confirmed 175 H1N1 cases in its school
system. In addition, 29 university students have contracted the
virus. Government authorities continue to follow their school
closure plan (Ref A) and have closed 12 schools as of November 5
(none have reopened). According to Refaey, the MoH and the Ministry
of Education (MoE) have encountered no "significant problems"
concerning H1N1's impact on the country's schools. On a daily
basis, the ministries track the number of confirmed H1N1 cases in
all schools - receiving this information directly from the
governorates. Suspected cases are isolated in specially designated
rooms at schools, and school administrators instruct everyone from

parents to teachers to bus drivers to discourage sick students from
attending classes. An inter-agency government task force, directed
by the Information and Decision Support Center (IDSC) and including
all ministries involved in influenza issues, meets twice a week to
discuss new problems concerning affected governorates.


4. (SBU)Refaey indicated that the government does not plan for a
general closure of the entire education system at this time. He
explained that the United States is "overwhelmed with H1N1 cases yet
its schools remain open." If the United States does not plan to
close its schools, then Egypt - with far fewer reported cases - does
not need to either. More importantly, the MoH employs a national
severity index to monitor H1N1's impact. This color-coded system
(green for normal circumstances, yellow and orange for worsening
conditions and red for the most critical situation) tracks the
number of infected cases, the severity of symptoms, and mortality
rates from the virus. If there is a spike in two of these factors
(such as the percentage of severe cases),the index will shift
upwards. However, Egypt currently is in the green category and
faces what Refaey termed normal conditions.

--------------
Vaccine Situation
--------------


5. (SBU) The MoH has purchased 5 million doses of a H1N1 vaccine
from the British pharmaceutical company GlaxoSmithKline. This week,
the first batch - 70,000 doses - arrived in country. Priority for
the vaccine will be given first to individuals traveling for the
Hajj (the annual pilgrimage to Mecca) later this month and then
health workers. Starting in January 2010, the GoE will receive 1-2
million doses monthly (or bimonthly) The MoH has identified what it
labels "people in vital positions" as the next groups who will
receive the later shipments of the vaccine: government ministers and
senior GoE officials managing the transportation, water, and police
sectors. Health Minister El-Gabali stated publicly that he would be
among the first to receive the vaccine in a move designed to show
the Egyptian public that it is safe for consumption.

--------------
LOOKING AHEAD TO H5N1
--------------

CAIRO 00002103 002 OF 002




6. (SBU) Despite MoH concerns about H1N1, H5N1 (avian influenza)
remains among the biggest health concerns for the government. In
2009, Egypt has confirmed 36 H5N1 cases - the third highest total
globally - with four fatalities. Refaey stated he believed current
H1N1 programming is serving as a trial run for the H5N1 influenza
season, likely to begin in December. As a result of the country's
focus on H1N1, public awareness and education activities as well as
disease surveillance have increased significantly. Refaey indicated
he was optimistic that this level of preparation will transfer to
the government's H5N1 programs, especially related to behavioral
change communication efforts (such as washing your hands often with
soap and water) targeted toward personal and non-pharmaceutical
protective measures.


7. (SBU) Comment: Influenza remains the country's number one health
priority. To combat the virus, the MoH has designed a strong
influenza surveillance system - for both H1N1 and H5N1. As a
result, health care workers at the country's hospitals rapidly
detect and identify symptoms that might present an influenza case,
leading to prompt treatment for patients. Since H5N1 first emerged
in 2006, Egypt has a 31% fatality rate for its avian influenza
cases, far below the global rate of 66%. In 2009, the fatality rate
has dropped even further - to 11%. As a result of its H1N1
programming this year, MoH's influenza program, led by some of its
most respected health officials, appear prepared to address the next
H5N1 outbreak this winter.

Scobey