Friday, March 13, 2015

Egypt leads the world in the number of human H5N1 cases

In late December 2014, Egypt surpassed Indonesia in the number of reported A(H5N1) cases.[1] As of March 3, 2015, the World Health Organization (WHO) has confirmed a worldwide cumulative total of 784 human H5N1 cases, about 37% or 292 of these cases have been reported from Egypt (Table 1). Eighty-two of those cases from Egypt occurred in the first two months of 2015.[2] In addition, media reports suggests that another four cases have occurred since late February in Egypt and may be included in future monthly updates by WHO.[3]

The recent WHO report from 3 March 2015 notes “ The number of laboratory-confirmed human cases of avian influenza A(H5N1) virus infection in Egypt with onsets of illness in the months of December 2014, January and February 2015 are the highest numbers reported by any country in a single month.” To put these statistics in perspective, about 36% of all H5N1 cases reported from Egypt have occurred in the last 3 months. The graph below shows the distribution of WHO confirmed cases by ISO week number in Egypt since December 2014.

 Based on onset dates, since December 2014 there have been 105 H5N1 cases reported from Egypt. According to WHO at least 28 of these individuals have died. The fatality rate among this group is 27% to date, although only 17 of these cases have been reported in media reports to have recovered.

Besides the 82 cases from Egypt since the beginning of 2015, only one other case of H5N1 has been confirmed by WHO in 2015, a 37-year-old woman from Suzhou, Jiangsu Province in the People’s Republic of China. With 83 cases so far this year, the H5N1 case count for 2015 already exceeds the annual case count of H5N1 for the preceding seven years.[4]

While the spot light is on human H5N1 infections in Egypt, the single case from Suzhou, China is a reminder that the H5N1 influenza virus is endemic in many parts of the world and that human outbreaks of H5N1 in the size and the scope now occurring in Egypt could quickly develop elsewhere in the world.

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