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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 | 2011-02-16 21:00 | UNCLASSIFIED//FOR OFFICIAL USE ONLY | Embassy Cairo

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    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

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    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

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