US embassy cable - 05CAIRO7552

UNCLAS SECTION 01 OF 03 CAIRO 007552 
 
SIPDIS 
 
SENSITIVE 
 
E.O. 12958: N/A 
TAGS: TBIO, ECON, PREL, SOCI, WHO, KSTH 
SUBJECT: EGYPT PREPARING FOR AVIAN INFLUENZA 
 
REF: A. STATE 153802 
     B. STATE 175585 
     C. STATE 180478 
 
This message is sensitive but unclassified, please handle 
accordingly. 
 
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Summary 
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1.  (SBU) Government of Egypt officials share our concerns 
regarding avian influenza (AI).  The GOE's close co-operation 
with Cairo's U.S. Naval Medical Research Unit (NAMRU-3) has 
positioned it for effective surveillance of AI, though the 
system has some limitations.  However, the political will to 
contain an outbreak absent a plan for compensation for 
poultry destruction remains a question.  Post is working with 
the GOE to facilitate the travel of an appropriate GOE 
official to the October 6 partnership meeting in Washington. 
End summary. 
 
2.  (U) In separate meetings, ECPO Counselor met with 
representatives from the Egyptian Ministry of Health and 
Population (MOH) and the Ministry of Agriculture and Land 
Reclamation (MOA) and addressed the USG's concerns regarding 
AI as laid out in Ref A.  ECPO Counselor was accompanied by 
representatives from NAMRU-3 at the MOH and from the Foreign 
Agricultural Service (FAS) at the MOA. 
 
3.  (SBU) In a separate meeting with Ministry of Foreign 
Affairs (MFA) Environmental Counselor Omar Ali Abou Eiche, 
EST officer delivered an invitation to the October 6 
International Partnership on Avian and Pandemic Influenza 
meeting in Washington to the MFA, per Ref B.  The meeting 
agenda and other information was separately delivered to the 
MFA, the MOH, and the MOA per Ref C.  The MFA informed the 
Embassy that it had no objection to the core principles, 
however, funding constraints would mean the MFA probably will 
not be able to send a representative from Cairo to the 
meeting.  The MOA informed FAS that Agricultural Attache Dr. 
Hussein Mansour from the Egyptian embassy in Washington would 
attend the event.  (Note: Subsequent to this discussion, 
NAMRU-3 confirmed it can fund travel for a GOE representative 
to the meeting.  Post is working with the GOE to identify an 
appropriate official and facilitate travel.  End note.) 
 
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AI Programs at the Ministry of Health 
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4.  (U) In the meeting at the MOH with Dr. Magda A. Rakha, 
First Under Secretary (i.e., Deputy Minister) of Health, and 
Dr. Nasr El-Sayed, Under Secretary for Preventive Affairs, 
ECPO Counselor explained the USG's concerns regarding avian 
influenza (AI), stressing its worldwide effect, the 
possibility of a pandemic, and the need for transparency on 
the part of all governments, both during the preventive 
stages of action as well as in the event of an outbreak. 
ECPO Counselor noted Egypt's already close cooperation with 
NAMRU-3 to conduct surveillance of migratory birds and of 
human outbreaks through the NAMRU-initiated health 
surveillance system. 
 
5.  (U) Dr. Rakha stated that the GOE is taking the AI threat 
seriously and noted that the Minister of Health, Dr. Tag El 
Din, postponed a recent trip to Sudan in order to deal with 
this issue.  The Ministry had also recently been briefed on 
the subject by the Canadian embassy. 
 
6.  (U) Dr. El-Sayed, who is the ministry's point of contact 
for AI, said that there has been much activity in the last 
month on AI. The Ministries of Health, Agriculture, 
Environment and Defense, including MOH staff from the 
pharmaceutical and virology departments, met on September 13 
to form a National Committee and to discuss influenza 
pandemic preparedness with representatives from the World 
Health Organization (WHO) and NAMRU-3.  The discussion 
touched on epidemiology, transmissibility and treatment 
options. 
 
7.  (U) The GOE is working with NAMRU-3 to strengthen its 
laboratory capabilities.  The GOE is now formulating a 
National Plan to deal with AI, and they already have an 
Emergency Plan in place to coordinate among concerned 
agencies and the poultry industry should an outbreak occur. 
 
8.  (U) According to Dr. El-Sayed, Egypt will represent the 
Middle East region at a proposed ministerial-level meeting in 
Canada in mid-October.  Also, the MOH received an invitation 
September 17 from Search for Common Ground to a meeting in 
December on AI.  Invited to the meeting are representatives 
from Egypt, Israel, the Palestinian Authority, and Jordan, to 
develop a common vision and to discuss national, regional and 
global plans to combat AI.  Dr. Rakha said the GOE intends to 
accept the invitation. 
 
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Ministry of Agriculture Concerns about AI 
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9.  (U) Subsequent to the meeting at the MOH, ECPO Counselor 
and the acting Agricultural Counselor met with MOA 
representatives Dr. Fadia Nossier, Undersecretary of the 
Central Administration for Foreign Agricultural Relations, 
and Dr. Mona Aly, a national laboratory director who has been 
named the MOA's POC for AI. 
 
10.  (SBU) Aly noted that her organization is working with a 
National Academy of Sciences project to screen chicken farms 
for AI.  The project was begun two years ago and will finish 
in six months.  According to Aly, AI has been detected in 
migratory birds in Egypt, but the strain of AI is not 
believed to be the virulent form of the disease. 
 
11.  (U) Egypt is currently working on an inspection program 
that visits one farm per week and focuses on problem flocks, 
e.g., those with high mortality, or where there is suspicion 
of a need for isolation.  The Poultry Producers Union is 
cooperating with the Egyptian government on the screening of 
small farms. 
 
12.  (U) Aly reports to the Chief Veterinary Officer, Dr. 
Ahmed Tawfik, who in turn notifies the OIE (Office 
International des Epizooties/the World Organization for 
Animal Health) of any problems of contagion.  Aly 
acknowledged that the system still needs a lot of work. In 
the event where AI is detected, the virus must be typed, and 
further investigation would be needed. 
 
13.  (SBU) GOE officials know little about the presence of AI 
in Egypt's neighboring countries.  Saudi Arabia reported an 
outbreak of the low pathogen H9 strain two years ago.   There 
have been prior instances of poultry destruction in Egypt, 
e.g., in a case where ducks were infected with salmonella. 
According to Aly, the farmers are willing to accept some 
ordered destruction because of the government's authority. 
However, large-scale destruction would be difficult to carry 
out if there is no compensation. 
 
14.  (U) Aly noted that the GOE needs to send staff abroad 
for laboratory training, and also needs reagent in order to 
carry out virus typing, but is suffering from a lack of 
funds. 
 
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Migratory Routes and Egypt's Vulnerability 
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15.  (SBU) Bird migrations in Egypt are now underway.  The 
season begins in September-October and runs through 
March-May. One of the main issues for Egypt is surveillance. 
The country is a significant migratory route, which leaves 
its very large poultry sector (800 million chickens) 
vulnerable.  Although surveillance of the domestic chicken 
population has begun, it needs to be extended.  There is 
support from farmers for AI research.  Many poultry farmers 
in Egypt are educated, and vaccinate their chickens 
regularly.  A major problem, however, is that free-ranging 
chickens are common in Egypt, and chickens are kept close to 
migratory bird paths. 
 
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Questions about Support 
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16.  (SBU) Rakha and El-Sayed asked what kind of 
international support would be available should an AI 
outbreak occur.  They pointed out that, for transparency to 
be effective, it requires that a nation be able to rely on 
international help, e.g., compensation for slaughtered 
chickens. Rakha and El-Sayed suggested that it would be 
difficult to persuade Egyptian producers to destroy their 
flocks if they were not assured of compensation.  The two 
opined that, since it is a global problem, i.e., an 
international public health concern, there must be an 
international response. 
 
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NAMRU-3's Assistance 
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17.  (U) NAMRU-3 has spawned numerous collaborative efforts 
in health research in Egypt, and has state of the art 
laboratory equipment.  NAMRU-3 is currently training 
technicians from the region in virus detection techniques. 
 
18.  (U) NAMRU-3 has created an electronic national 
surveillance system for the reporting of contagious diseases. 
 The technology is in place, with equipment and training 
provided by funds from USAID.  The system is near to being 
implemented throughout Egypt's 26 governates and 375 
districts. It can be implemented by laboratory diagnostic 
systems in place in hospitals.  The surveillance system has 
limited detection capabilities, and it is not set up to 
specifically detect AI.  Few labs in the country can now do 
AI analysis.  The system uses standard WHO kits for flu 
typing.  Only five people in Egypt currently have the 
training to do flu typing. 
 
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Comment 
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19.  (SBU) As noted above, Egypt is vulnerable because it 
lies in the path of migrating birds known to carry the virus, 
especially the shoveler and teal.  Egypt's vulnerability is 
increased because most poultry is kept outdoors and cannot be 
isolated from migrating birds.  As in other countries, 
large-scale, uncompensated destruction of affected or 
potentially affected poultry would be politically very 
difficult, thus our interlocutors' keen interest in learning 
more about programs to reimburse farmers. 
 
20.  (SBU) The presence of NAMRU-3 and a USDA/APHIS 
Veterinary Officer in Cairo and the close cooperation with 
the Ministries of Health and Agriculture, respectively, 
leaves post unusually well-positioned to detect any AI 
outbreak in Egypt early and coordinate with the government on 
an effective response. 
 
 
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JONES