Suspect H5N1 Cases in Egypt Continue to Grow
Recombinomics Commentary 18:11
January 6, 2008
Harvest 25 new cases with symptoms similar to bird flu in 5 provinces
The above translation describes the daily rise in the number of hospitalized patients with bird flu symptoms (see updated satellite map). However, although the number of new cases increases daily, there have been no new confirmed cases in a week (color coded purple). Some of the earlier cases have been declared negative (color coded yellow in map above), including a number of patients in Daqahliya but most of the cases have not been updated, due in part to their recent admission.
Many of the new admissions form familial clusters (color coded pink), and many new cases are in regions were there was a confirmed case.
It remains unclear if the lack of new confirmed cases is due to delays in testing / confirmation, or if these cases are initially testing negative and are not turning positive because of the implementation of a Tamiflu blanket, which is keeping viral RNA levels below detection. The level of Tamiflu resisatnce also remains unclear because this issue has not been addressed in WHO updates, even though one media report suggested "some" of the recent fatal cases had "moderate" resistance, which would correspond to N294S.
The recent news on fatal cases, plus the repeated detection of H5N1 throughout the country, may be contributing to more hospitalization of suspect patients. In the past the number of suspect patients rose in the spring, when the number of season flu cases increased.
It remains unclear if the new cases are lined to increased awareness or increased infections. More information on negative patients and a status update on those admitted in the past few days would be useful.
Media Links
Recombinomics Presentations
Recombinomics Publications
Recombinomics Paper at Nature Precedings