VZCZCXRO0224
PP RUEHAST RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHTM RUEHTRO
DE RUEHEG #0173 0321355
ZNR UUUUU ZZH
P 011355Z FEB 09
FM AMEMBASSY CAIRO
TO RUEHC/SECSTATE WASHDC PRIORITY 1503
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY
RUEHPH/CDC ATLANTA GA PRIORITY

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