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Viewing cable 09CAIRO2103, EGYPT: MINISTRY OF HEALTH REVIEWS CURRENT INFLUENZA

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Reference ID Created Released Classification Origin
09CAIRO2103 2009-11-05 15:12 2011-08-24 16:30 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Cairo
VZCZCXRO0020
PP RUEHAST RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHSL RUEHTM
RUEHTRO
DE RUEHEG #2103/01 3091512
ZNR UUUUU ZZH
P 051512Z NOV 09
FM AMEMBASSY CAIRO
TO RUEHC/SECSTATE WASHDC PRIORITY 4126
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY
RUEHPH/CDC ATLANTA GA PRIORITY
UNCLAS SECTION 01 OF 02 CAIRO 002103 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR AIAG (DAVID WINN), NEA/ELA 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU KSTH PGOV EAGR CASC PREL EAID EG
SUBJECT: EGYPT: MINISTRY OF HEALTH REVIEWS CURRENT INFLUENZA 
ACTIVITIES 
 
REF: CAIRO 1802 
 
Sensitive but Unclassified.  Please handle accordingly. 
 
1.(SBU) Key Points: 
 
--Dr. Samir Refaey, the Ministry of Health's executive director for 
disease surveillance, characterized current Egyptian influenza 
measures as a collaborative government effort effectively tracking 
the disease and its impact on the country. 
 
--Refaey emphasized that close monitoring by the Ministries of 
Health and Education have convinced the Egyptian government (GoE) 
that there is no need at this time to enact a general closure of the 
country's school system. 
 
--The GoE has purchased 5 million doses of a H1N1 vaccine and will 
distribute the first batch of 70,000 doses to health workers and 
Hajj pilgrims. 
 
--He views current H1N1 measures as a trial run for the upcoming 
H5N1 season. 
 
2. (U) Emboffs met with Dr. Samir Refaey, executive director of 
disease surveillance the Ministry of Health (MoH), to discuss GoE 
planning and preparation for the winter influenza season. Refaey is 
the Ministry's point person on influenza issues and is a key advisor 
to Health Minister Hatem El-Gabaly. 
 
---------------------------------- 
Egypt's Schools: Open for Business 
---------------------------------- 
 
3. (SBU) Since Egypt's academic year began on October 3rd, the 
Ministry of Health (MoH) has confirmed 175 H1N1 cases in its school 
system. In addition, 29 university students have contracted the 
virus. Government authorities continue to follow their school 
closure plan (Ref A) and have closed 12 schools as of November 5 
(none have reopened).  According to Refaey, the MoH and the Ministry 
of Education (MoE) have encountered no "significant problems" 
concerning H1N1's impact on the country's schools.  On a daily 
basis, the ministries track the number of confirmed H1N1 cases in 
all schools - receiving this information directly from the 
governorates.  Suspected cases are isolated in specially designated 
rooms at schools, and school administrators instruct everyone from 
parents to teachers to bus drivers to discourage sick students from 
attending classes.  An inter-agency government task force, directed 
by the Information and Decision Support Center (IDSC) and including 
all ministries involved in influenza issues, meets twice a week to 
discuss new problems concerning affected governorates. 
 
4. (SBU)Refaey indicated that the government does not plan for a 
general closure of the entire education system at this time. He 
explained that the United States is "overwhelmed with H1N1 cases yet 
its schools remain open."  If the United States does not plan to 
close its schools, then Egypt - with far fewer reported cases - does 
not need to either. More importantly, the MoH employs a national 
severity index to monitor H1N1's impact.  This color-coded system 
(green for normal circumstances, yellow and orange for worsening 
conditions and red for the most critical situation) tracks the 
number of infected cases, the severity of symptoms, and mortality 
rates from the virus. If there is a spike in two of these factors 
(such as the percentage of severe cases), the index will shift 
upwards.  However, Egypt currently is in the green category and 
faces what Refaey termed normal conditions. 
 
----------------- 
Vaccine Situation 
----------------- 
 
5. (SBU) The MoH has purchased 5 million doses of a H1N1 vaccine 
from the British pharmaceutical company GlaxoSmithKline. This week, 
the first batch - 70,000 doses - arrived in country.  Priority for 
the vaccine will be given first to individuals traveling for the 
Hajj (the annual pilgrimage to Mecca) later this month and then 
health workers.  Starting in January 2010, the GoE will receive 1-2 
million doses monthly (or bimonthly) The MoH has identified what it 
labels "people in vital positions" as the next groups who will 
receive the later shipments of the vaccine: government ministers and 
senior GoE officials managing the transportation, water, and police 
sectors.  Health Minister El-Gabali stated publicly that he would be 
among the first to receive the vaccine in a move designed to show 
the Egyptian public that it is safe for consumption. 
 
--------------------- 
LOOKING AHEAD TO H5N1 
--------------------- 
 
CAIRO 00002103  002 OF 002 
 
 
 
6. (SBU) Despite MoH concerns about H1N1, H5N1 (avian influenza) 
remains among the biggest health concerns for the government.  In 
2009, Egypt has confirmed 36 H5N1 cases - the third highest total 
globally - with four fatalities.  Refaey stated he believed current 
H1N1 programming is serving as a trial run for the H5N1 influenza 
season, likely to begin in December. As a result of the country's 
focus on H1N1, public awareness and education activities as well as 
disease surveillance have increased significantly.  Refaey indicated 
he was optimistic that this level of preparation will transfer to 
the government's H5N1 programs, especially related to behavioral 
change communication efforts (such as washing your hands often with 
soap and water) targeted toward personal and non-pharmaceutical 
protective measures. 
 
7. (SBU) Comment: Influenza remains the country's number one health 
priority.  To combat the virus, the MoH has designed a strong 
influenza surveillance system - for both H1N1 and H5N1.  As a 
result, health care workers at the country's hospitals rapidly 
detect and identify symptoms that might present an influenza case, 
leading to prompt treatment for patients.  Since H5N1 first emerged 
in 2006, Egypt has a 31% fatality rate for its avian influenza 
cases, far below the global rate of 66%. In 2009, the fatality rate 
has dropped even further - to 11%. As a result of its H1N1 
programming this year, MoH's influenza program, led by some of its 
most respected health officials, appear prepared to address the next 
H5N1 outbreak this winter. 
 
Scobey