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Additional H5N1 Suspect Cases in Gharbiya in Nile Delta
December 24, 2006
Revealed yesterday, as a result examine situations injury Reza Farid and his cousin Shafiqah contracted avian flu, which caused panic and fear of citizens and especially after the detention of two new cases in Tanta and Mahala, and immediately, Dr. Mr. Husseini, Undersecretary of the Ministry of Health and Sami opened the door, head of the Center City and the Main formation of a committee to examine all Almkhalten and execution of birds within a half kilo of the focus of infection and taking samples from all Almkhalten village of Kafr shop.
The above translation provides additional detail on the two suspect cases in Tanta and Mahala. These cases are in addition to the four confirmed cases in the Gharbiya Province. The first case (39F) died in October. She had raised ducks in Summanud, which is adjacent to the Nile River and about 15 miles north of Zifta, which is also on the Nile and just south of Kafr village, the location of the confirmed family cluster of three. This cluster is also linked to ducks.
H5N1 from the earlier case has been sequenced, and the HA has M230I, which is also present in all three human influenza strains (H1N1, H3N2, influenza B) that are currently circulating. This sequence has Egyptian linked polymorphisms found in H5N1 bird flu isolated earlier this year. However, it also has several additional polymorphisms found in various Qinghai isolates from Europe and Africa, signaling additional recombination between local Qinghai strains.
In addition to the four confirmed cases, the above translation describes patients in Tanta, which is about 15 miles west of Zifta. Mahala probably refers to Mahalla el Kubra, which is a few miles west of Samannud. Earlier, there were reports of an additional suspect case (23F) from Tanta.
Thus, the four confirmed cases and recent suspect cases are within a 10 mile radius of each other, in the heart of the Nile Delta, adjacent to the Nile River. This location is in the flight path of migratory birds, including the H5N1 positive teal detected in December, 2005 in Egypt.
The large number of confirmed and suspect cases in this small geographical area remains a cause for concern.