Rapid risk assessment: A(H5N1) Highly Pathogenic Avian Influenza in Egypt – Implications for human health in Europe

Highly pathogenic avian influenza A(H5N1) infections are continuing to occur in poultry and humans in Egypt. However there is no evidence of a significant change in the pattern of human illness and deaths related to A(H5N1) virus infections in the country. Certainly there are no epidemiological data or analyses consistent with adaptation of these viruses to humans. Although the limited virological analyses carried out may indicate that the risk of an A(H5N1) pandemic emerging could be greater in Egypt than other countries, the implications of these analyses are difficult to interpret. The first human cases in Egypt occurred in 2006. However, the risk of pandemic A(H5N1) viruses emerging in Egypt cannot be excluded and the continuing transmission of the virus among domestic poultry and on to humans in Egypt over the past five years is worrying. Egypt’s proximity to EU/EEA countries increases the concern since a pandemic strain, if it emerged, would presumably spread to Europe very quickly. Despite the lack of evidence that the risk might be increasing, intensification of veterinary control measures in Egypt is due to concerns over human health. Constant vigilance should be maintained for any enlargement in human A(H5N1) cluster size, other changes in the behaviour of the virus and/or individual human cases outside of countries like Egypt where the virus is recognised as being entrenched in domestic poultry.