H5N1 Kills 2nd In Egypt -
24th Suspected In Indonesia

World Health Organization (WHO)
CSR, Disease Outbreak News
Egypt - Second Fatal Bird Flu Death Confirmed
As of 29 Mar 2006, the Ministry of Health in Egypt has confirmed the country's 2nd fatal case of human infection with the H5N1 avian influenza virus. The person who died was a 30 year old woman from the Qaliubiya governorate near Cairo. She developed symptoms on 12 Mar 2006 following the home slaughter of chickens. She was hospitalized on 16 Mar 2006 and died on 27 Mar 2006.
The country's 1st case occurred in another 30 year old woman, also from Qaliubiya, who died on 17 Mar 2006.
Tests conducted by the Cairo-based US Naval Medical Research Unit 3 (NAMRU-3) have confirmed an additional 3 cases. A 32 year old man, who worked on a farm where poultry were recently culled, developed symptoms on 16 Mar 2006 and was admitted to hospital the same day. He has since recovered. A 17 year old boy, whose father runs a poultry farm in the Gharbiya governorate in the Nile Delta, developed symptoms on 18 Mar 2006 and was admitted to hospital the next day. He has since recovered. The 5th case is an 18 year old girl from the Kafr El-Sheikh governorate. She developed symptoms following the slaughter of sick backyard poultry and was admitted to hospital on 25 Mar 2006.
At present, the Ministry of Health has confirmed all 5 cases based on results from the NAMRU-3 laboratory. Samples from these cases have been sent to a WHO collaborating laboratory in the United Kingdom for diagnostic verification. WHO will adjust the figures in its cumulative number of cases following the results of this external verification. Test results are expected later this week.
Health authorities have screened more than 350 people who were contacts of these patients or had a recent history of exposure to diseased birds. All test results have been negative for H5N1 infection.
Egypt has a large population of poultry, many of which are kept on roof terraces in close proximity to humans. H5N1 outbreaks in poultry have now been reported in 19 of the country's 26 governorates. Since the 1st outbreak was confirmed on 17 Feb 2006, more than 25 million birds have died or been destroyed.
Egypt and these 5 suspected cases have not yet been added to the WHO cumulative list of laboratory-confirmed human cases of avian influenza virus infection, which was last updated on 24 Mar 2006. If confirmed by independent testing, the global total of human cases of avian influenza virus will become 191, with 107 deaths. - Mod.CP
Indonesia - 5 Year Old Child Dies 31st Suspected Avian Flu Case
A child under 5 years old who was admitted to the Dr Soedono General Hospital in Madiun, East Java with symptoms compatible with bird flu died on Tue 28 Mar 2006 after being treated for around 3 hours, a hospital spokesman said.
"The patient was accepted at the hospital at around 10:55 pm on Mon 27 Mar 2006 and died at 1:55 am on Tue 28 Mar 2006. The patient was referred to us by the Magetan General Hospital," the spokesman, Sugeng Haryanto, said. He said the patient was weak, in a coma, convulsive, and having breathing difficulty. The Magetan hospital suspected the child was suffering from avian influenza, and therefore needed further treatment. "We contacted the Dr Soetomo hospital in Surbaya, and a team from that hospital was expected to arrive Tuesday [28 Mar 2006] morning to take blood samples from the child, but the patient died before the team arrived. We tried hard to improve the condition of the patient, but the reality was not as expected." he said.
The Dr Soedono hospital has so far treated 3 suspected avian influenza patients, and 2 of them were eventually declared H5N1 virus-negative and recovered. The hospital has formed a special team to deal with avian influenza cases. "The team was the one that treated the child last night. The team is always ready any time it is needed," he said.
The city of Madiun is located in East Java to the west of Surabaya (see:
If this suspected avian influenza case is confirmed, it will rank as the
31st human case in Indonesia and the 24th death. - Mod.CP
Patricia A. Doyle DVM, PhD
Bus Admin, Tropical Agricultural Economics
Univ of West Indies
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