Three human cases of bird flu in Egypt

The trouble with the influenza A/H5N1 virus is that it's a virus and doesn't know it's Christmas and time to take a break. It doesn't know anything because it doesn't think or know or believe or want anything. It just makes copies of itself and that can be done anytime it and a suitable copy machine (aka a competent host) are in the same place. Apparently they were in the same place in Egypt over the last week or so.

Egypt has detected a third new case of the H5N1 bird flu virus, just hours after confirming two new cases in a brother and sister, a World Health Organisation official said Sunday.

Hassan el-Bushra, regional adviser for communicable diseases surveillance at the WHO said the three cases were from the same household, which houses an extended family of 33 people living together in a village in Egypt's Gharbiya province. (Reuters)

That "third case" has now died, the 8th death and 17th case in Egypt. She was already in the hospital before doctors made the connection that she was of the same extended family as the brother and sister (ages 26 and 15, respectively) and did a diagnostic work-up for H5N1 (Boston Globe), but another report (AFP) says the deceased woman was one of two diagnosed cases admitted earlier.

All 33 lived in a single house in a village 80 km (50 miles) north of Cairo. The siblings were reported to have slaughtered a duck flock after some of the birds sickened and died. WHO says three of the dead ducks had H5N1. The sibs remain in the hospital (Boston Globe). All reports seem to say she denied any contact with poultry and was admitted on December 17, prior to the two siblings who did have poultry contact. She is thus yet another case without history of poultry contact, among the roughly one third of such cases. Despite this, we keep hearing that close contact with poultry is the rule, rather than the exception. It isn't the rule. The thirty other family members are said to be "under surveillance."

The situation is the same elsewhere. South Korea is reporting their 4th poultry outbreak in recent weeks and has embarked once again on a Draconian quarantine policy of culling poultry and pigs. It is not the first time:

Nearly 4,200 pigs were killed at a farm in Asan, about 90 kilometers (55 miles) south of Seoul, where a case of bird flu ? South Korea's fourth in less than a month ? broke out last week, said Yoon Chang-hee, an official at the South Chungcheong provincial government.

Yoon declined to give a reason for the measure, only saying there was an Agriculture Ministry instruction to cull all pigs within 500 meters (547 yards) of the outbreak site.

Ministry officials were not immediately available for comment, but Yonhap news agency said pigs are vulnerable to respiratory diseases and could spread viruses.

In the first two bird flu outbreaks last month, South Korea slaughtered pigs, dogs and 14 unspecified animals within a 3-kilometer (1.9 miles) radius of the outbreak sites in Iksan, about 250 kilometers (155 miles) south of Seoul.

Yoon also said about 2,000 chickens were slaughtered Saturday at a farm near the latest outbreak site.

That brought the number of chickens and ducks culled in the latest outbreak to 25,000. More than 1.1 million poultry had been killed in the earlier three outbreaks that hit the country since late last month.

South Korea slaughtered about 5.3 million birds during a bird outbreak in 2003. (International Herald Tribune)

The lesson we take from this is it is hard to make anything of sporadic reported human cases or their absence. The virus is clearly around and with lower temperatures on the way, most everyone is expecting more poultry outbreaks and more human cases. In the lat month Korea has killed 1.2 million poultry and thousands of pigs, Nigeria has widespread disease in birds and Vietnam is also struggling to contain outbreaks in the Mekong Delta. Those are just the ones we know about.

Maybe at least we can have an end to the tiresome "Whatever happened to bird flu?" meme that has plagued us recently.

Update, 12/25/06, 1500 EST: Sadly, Reuters (and others) is reporting the 15 year old girl has now died. We need to keep reminding ourselves this is not just a number (the 9th Egyptian death) but someone's little girl, younger sister, cousin, best friend.