WHO backs investigation into Bird Flu situation in Egypt

Following an increase in infection rates and what appears to be a change in the pattern in Egypt the World Health Organisation is backing more detailed investigation

In Egypt the World Health Organisation is backing further examination and investigation as the numbers contracting the disease rise and and the pattern of infection change. At first sight the changes appear to be good news with all of those infected in the country have survived pointing to a reduction in the virulence of the H5N1, but clinically this change could be bad news.

This possible change in the nature of the virus may be the precursor of a more substantial evolutionary stage. Clinically, the virulence of a virus imposes a factor that limits transmission rates and the time available for further mutation; as virulence decreases, the potential for a much increased rate of infection increases.

As the virulence drops, it can mean more potential for individual infections although fewer die overall in percentage terms. In Egypt this year all 12 cases survived, in China where 7 cases have been reported the mortality rate was 57% and Vietnam 100%. Most experience shows this is one of the precursor conditions for a Pandemic to occur.

Last week, a WHO organisation spokesman reported that investigations were to centre on a search for Sub-clinical cases in H5N1 infection and other factors that may mean the virus is changing. Sub-clinical cases are milder infections which provide a primary breeding ground for virus mutation.

Egypt is the most populated country in the Middle East and the third most populated in Africa with an estimated 83 million people (as of April 2009).

Egypt's economy depends mainly on agriculture, media, petroleum exports, and tourism; there are also more than three million Egyptians working abroad, primarily in the Middle East and Europe. 

Professor Robert Webster, of St Jude Children's Research Hospital in the US commented “that WHO in Egypt was raising a very, very important issue which should receive maximum attention. He added: "I hope to hell they are wrong. If this thing becomes less pathogenic, it will become more transmissible."

Whilst the lower mortality rate does look like at first sight like good news, it is all to easy to misinterpret this a diminished risk. The real risk is that as infection rates rise numerically and the Case Fatality Rate falls the total number at risk of infection can start to rise rapidly. Although there is no suggestion yet of human to human infection the increased number of cases in Egypt poses the question is this first stage in the creation of the conditions needed for the jump.Professor John Oxford, of Queen Mary, University of London, a leading international expert concurred saying “that any evidence that H5N1 was becoming less deadly would be serious, as the greatest cause for concern was the disease's ability to spread.”

Pandemic Flu tops the National Risk Register and for those planning serious consideration needs to be given to the organisations ability to cope with its impact

All organisations in the public and private should have created plans to curb the effects and mitigate the impact of the disruption caused by a Pandemic yet our study shows 73% do not have proper plans to protect the business or its employees.

This stark finding comes after the Risk Register produced by the Cabinet Office highlighted the threat of a pandemic as the most serious threat to the UK.

With over 90% of organisations not calculating the possible financial impact of a pandemic on their operations few realise how expensive it could be and falsely judge the risks to the organisations as being not relevant or unmanageable.

Even those who had developed plans confessed to a lack of confidence in over two thirds of respondents with many stating a lack of executive support as the main issue (75%).

The threat of a pandemic is real, yet our finding show that most businesses are ignoring the threat, often considering it to be vastly overhyped despite the evidence from the last century when three pandemics killed tens of millions.