VZCZCXRO5071
PP RUEHBC RUEHDE RUEHHM RUEHKUK RUEHLN RUEHMA RUEHPB RUEHROV
DE RUEHEG #0379/01 0431609
ZNR UUUUU ZZH
P 121609Z FEB 07
FM AMEMBASSY CAIRO
TO RUEHC/SECSTATE WASHDC PRIORITY 3547
INFO RUEHEE/ARAB LEAGUE COLLECTIVE PRIORITY
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE PRIORITY
RUEAHLC/DEPT OF HOMELAND SECURITY WASHDC PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY
RUEHPH/CDC ATLANTA GA PRIORITY
RUEHRC/DEPT OF AGRICULTURE WASHDC PRIORITY

UNCLAS SECTION 01 OF 02 CAIRO 000379 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR NEA/ELA, AIAG FOR WINN AND LANGE 
USAID FOR CARROLL AND HILL 
USDA/APHIS FOR ANNELLI 
DHS FOR MCGINN 
HHS FOR BELL 
AMMAN FOR WHITTLESEY 
 
E.O. 12958: N/A 
TAGS: ECON EAGR TBIO KFLU AMED EAID EG
SUBJECT: SCENESETTER FOR INTERAGENCY AVIAN INFLUENZA TEAM, 
FEBRUARY 19-21, 2007 
 
REF: A) CAIRO 22 B) CAIRO 154 
 
Sensitive but unclassified, please protect accordingly. 
 
¶1.  (SBU) Embassy Cairo warmly welcomes the visit of 
Ambassador John Lange and the interagency avian influenza 
team.  We are looking forward exchanging ideas on local avian 
influenza challenges, potential areas of enhanced 
cooperation, and developing a more cohesive interagency 
strategy. 
 
-------------------------------- 
VIRUS STATUS: HUMANS AND POULTRY 
-------------------------------- 
 
¶2. (SBU) As of February 2007, the GOE confirmed twenty human 
cases of H5N1 virus, resulting in twelve fatalities.  All six 
human victims since September 2006 have succumbed to the 
disease.  According to the WHO, in 2006 Egypt had the highest 
number of human cases outside Asia.  In January 2007, CDC 
confirmed NAMRU,s diagnosis that the virus responsible for 
the deaths of human cases 17 and 18 was Tamiflu resistant 
(ref A).  Case 19 did not show the same resistance to Tamiflu 
(ref B) nor did the most recent death of a 17-year-old from 
Fayyoum on February 4. 
 
¶3.  (SBU) In broader terms, mutations in specimens from 
recent cases show Egypt could be acting as a type of &mixing 
bowl8 for diverse strains of H5N1 originating thousands of 
miles away.  This is likely due to the fact that Egypt is 
located on two major avian flight paths and millions of 
migratory birds fly over the country annually. 
 
¶4.  (SBU) On January 28, the Minister of Health and 
Population (MOHP) Hatem El Gebali announced the formation of 
a committee to study use of alternative drugs to Tamiflu. 
The Regional Medical Office at Embassy Cairo is also 
preparing receive as shipment of a second antiviral 
medication called Zanamivir (Relenza) as a backup medication. 
 We are scheduled to get enough to treat 23% of the official 
Embassy population.  We are also acquiring additional doses 
of the older antiviral medication amantadine. 
 
¶5. (SBU)  The initial AI outbreak in February, 2006 
devastated Egypt's poultry industry, and resulted in 
significant layoffs and estimated losses of at least $100 
million.  The GOE placed a widely enforced ban on live bird 
markets and backyard poultry raising in Cairo.  Commercial 
farmers began a stringent vaccination campaign, which 
continues today.   The commercial sector is almost 
universally AI free.  According to official MOHP figures, 
since February 2006, there have been 859 outbreak sites in 
the commercial poultry sector, but only one since July 2006. 
 
¶6.  (SBU) The &backyard8 poultry sector is ground zero for 
both poultry and human AI infections in Egypt, largely due to 
the fact that in rural areas, people live with poultry and 
slaughter it in their homes.  MOHP figures show a recent 
upsurge in the number of backyard AI cases.  Of the 244 
backyard sites identified since February 2006, 50 were 
identified during the period of December 2006-January 2007. 
Consequently, 18 of the 20 human cases were backyard farmers. 
 Live poultry markets are up and running again both in Cairo 
and in rural areas.  Rooftop poultry raising is again common 
in Cairo. 
 
¶7. (SBU)  During the initial AI outbreaks, the highest levels 
of government recognized the need to greatly reform the 
poultry sector.  At a March 5, 2006 meeting with poultry 
producers, Prime Minister Nazif stressed the need to 
transform Egypt's poultry industry, calling for a move from 
small-scale farming and live-bird trade to large-scale modern 
production at collocated breeding and processing facilities 
which would be subject to governmental health and 
environmental oversight.  The government is in the planning 
stages of these reforms. 
 
---------------------- 
 
CAIRO 00000379  002 OF 002 
 
 
BRIEF OF YOUR MEETINGS 
---------------------- 
 
¶8. (SBU) In addition to meetings with Embassy Cairo,s Avian 
Influenza Working Group (AIWG), Ambassador Ricciardone, and 
NAMRU, we are requesting the following non-Embassy meetings: 
 
---Minister of Health and Population Hatem El Gebali. 
Undersecretary Dr. Nasr El Sayed, an infectious disease 
expert and our main interlocutor at the Ministry on AI, will 
likely accompany the Minister at the meeting. 
 
---Minister of Agriculture Amin Abaza.  Dr. Mona Mahrez and 
Dr. Ahmed Tawfik, Chairman of the General Organization of 
Veterinary Services, will likely accompany the Minister at 
this meeting.  Giza Governor Fathi Saad, who leads the MOA's 
technical committee on AI, may also attend. 
 
---Tour of Central Public Health Labs, Dr. Hala Esmat.  All 
suspected human cases are initially analyzed at this lab 
facility. Dr. Esmat works closely with NAMRU. 
 
---Tour of Ministry of Agriculture labs, Dr. Mona Aly Mahrez. 
 All suspected poultry cases are analyzed at this lab. 
 
---Ministry of Foreign Affairs, Counselor Omar Abou Eiche, 
Environmental Affairs, and Minister Plenipotentiary Mohamed 
Aboul Dahab, American Affairs. 
 
---World Health Organization (WHO):  Dr. Mohammed Jama, 
Deputy Regional Director, and Dr. Zuhair Hallaj and Hassan 
El-Bushra, Division of Communicable Diseases. 
 
---Food and Agriculture Organization (FAO): Country Rep. Dr. 
Ahmed Chikhaoui and Regional Rep Dr. Talib Ali. 
 
---Abbassiya Chest Hospital.  Ten of the twenty human cases 
were treated in this hospital, adjacent to NAMRU. 
 
---Visit to Kohia Poultry Farms, Bilbis.  Bassim Kohia, owner 
of this commercial poultry farm 45 minutes north of Cairo, 
will lead the tour. 
 
---World Food Program consultants Mohy Sabry, Nargis Labib, 
Dr. Farid Hosni.  WFP hired this team to draft a consolidated 
national plan on avian influenza.  They expect to be done 
with the plan by February 19. 
 
---The Deputy Chief of Mission plans to host a reception in 
your honor on February 20 at his residence.  A wide range of 
ministry officials, international donor agencies, private 
sector representatives, and third country diplomats, in 
addition to Embassy staff working on AI, will be invited. 
This will be an excellent opportunity for you to engage 
informally with the AI community. 
 
---Press will be very limited and coordinated directly with 
the Ministry of Health. 
RICCIARDONE