US embassy cable - 05CAIRO8878

UNCLAS SECTION 01 OF 02 CAIRO 008878 
 
SIPDIS 
 
SENSITIVE 
 
E.O. 12958: N/A 
TAGS: TBIO, SENV, ECON, EAGR, EAID, PREL 
SUBJECT: REQUEST FOR INFORMATION: AVIAN AND PANDEMIC 
INFLUENZA 
 
REF: SECSTATE 209622 
 
This document is sensitive but unclassified. Please handle 
accordingly. 
 
1.    (SBU) Summary:  This cable responds to requests for 
information in reftel regarding the government of Egypt's 
(GOE) planning and response capabilities with regard to the 
threat of avian influenza (AI).  The GOE has made AI a top 
priority, and has taken steps to mobilize government 
ministries and resources.  The GOE works closely with Cairo's 
Naval Medical Research Unit (NAMRU-3) and other agencies to 
enhance its surveillance and response capabilities. It is 
lacking in public health education, and needs to address the 
issue of compensation for the culling of poultry should an AI 
outbreak occur.  End summary. 
 
Following are answers keyed to questions in reftel: 
 
A) Preparedness/Communication 
 
2.    (SBU) The GOE has grasped the health and economic risks 
of AI, and has drafted a preparedness plan. It is neither 
comprehensive nor does it give details about how the plan is 
to be carried out.  Embassy has a copy, which it has provided 
to OES.  The GOE is working within the Ministries of Health 
(MOH) and Agriculture (MOA) to build its capacity for a 
comprehensive response to an AI outbreak. 
 
3.    (SBU) Post believes that the GOE will be truthful in 
reporting the scope of disease outbreak among people. 
However, the MOA has a strong incentive to minimize the scope 
of an outbreak in poultry.  The strongest incentive to 
transparency that could be offered by the USG to the GOE 
would be compensation to farmers whose poultry must be 
destroyed to contain an AI outbreak. 
 
4.    (SBU) Preparing for an AI epidemic is a top priority 
for the GOE, which has deemed it a national security issue. 
Recent interministerial meetings, which have been attended by 
AIWG representatives, confirm that the GOE is making serious 
efforts to work on a national response to AI and to enhance 
its surveillance capabilities, which rely heavily on U.S. 
assistance through USAID, FAS, APHIS and NAMRU-3, which is a 
WHO reference laboratory.  GOE's Minister of Health, Awad Tag 
el-Din, has been designated as the lead minister for 
planning. According to the Ministry of Foreign Affairs, MOH 
Undersecretary Dr. Magda Rakha is the POC for AI for the GOE. 
Another MOH undersecretary, Dr. Nasr El-Sayed, has been 
working closely with NAMRU-3 and USAID to develop an 
effective response to an AI outbreak.  Ministry of 
Agriculture Chief Veterinary Officer Ahmed Tawfik is the POC 
for domestic surveillance of the poultry industry.  To our 
knowledge, national laws have not been reviewed to ensure 
they are consistent with international health regulations. 
 
5.    (SBU) The GOE is working closely with international 
organizations and organizations of other countries.  These 
organizations include WHO, FAO and the EU, and U.S. 
organizations NAMRU-3, APHIS, FAS and USAID.  NAMRU-3 and WHO 
are invited to ministerial level AI planning meetings. 
NAMRU-3 also reports that it has been contacted by the 
Ministries of Foreign Affairs (MFA), Defense (MOD), and 
Agriculture (MOA).  In addition, USAID, FAS and APHIS are 
coordinating veterinary training activity with the MOA.  The 
GOE has requested assistance from the USG for laboratory 
supplies and equipment, and training for surveillance and 
response, both for poultry and human AI response. 
 
6.    (SBU) In Egypt, regular flu vaccine is available at 
pharmacies, but the proportion of the population immunized is 
very low. There is no centrally funded public health 
influenza immunization program.  Like the US, Egypt does not 
immunize poultry against AI. There is no Tamiflu stockpile 
available in Egypt.  Post is not aware of any efforts to 
develop an H5N1 vaccine in Egypt. 
 
7.    (SBU) At present, the populace is poorly informed about 
the AI threat and the precautions they need to take. 
Television, newspapers and mosques reach most of the 
population, but there is no education plan in place yet.  The 
MOH has approached USAID's behavior change communication 
project for assistance in developing informational materials, 
and is developing a plan for development and dissemination. 
 
B) Surveillance/Detection 
 
8.    (SBU) The GOE medical sectors are very capable of 
detecting new strains of influenza.  Should suspected human 
cases occur, specimens can be sent to NAMRU-3, the regional 
WHO reference laboratory.  A suspect specimen can be typed by 
PCR in less than 24 hours.  There is a similar capability to 
detect disease in wild birds.  However, the capability to 
detect AI in poultry remains problematic, since the GOE 
insists on processing specimens in MOA labs, which are 
well-equipped but not designed for testing a large number of 
specimens. 
9.    (SBU) Critical needs with regard to detection 
capabilities remain, including a need for aggressive 
surveillance of poultry by the MOA, and virology lab training 
for MOA technicians.  In addition, the GOE does not have a 
stockpile of medications or personal protective equipment, 
and the rapid response capability for animal and human 
outbreaks is limited.  Mobile Response teams having both 
medical and veterinary capability have been formed, but these 
teams require training.  USAID, APHIS and NAMRU-3 are working 
with the GOE to provide needed training and equipment. 
Post's RMO has expressed concern about Egypt's capability to 
respond to a human AI outbreak. 
 
10.   (SBU) No guidelines have been published with regard to 
culling, vaccination, quarantine and isolation to contain an 
AI outbreak. The GOE is mobilizing, with U.S. assistance, to 
be prepared to undertake necessary measures, through 
USAID-funded development of rapid mobile response teams and 
training for lab technicians and veterinary experts, with the 
assistance of APHIS, FAS, and NAMRU-3. 
 
 
RICCIARDONE