الفهرس 
Biological properties of avian influenzaOnly 14 pages are availabe for public view
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Abstract
Although avian influenza A viruses usually do not infect humans, rare cases of human infection with avian influenza A viruses have been reported. Most human infections with avian influenza A viruses have occurred following direct contact with infected poultry.
Currently, illness due to influenza A (H5N1) viruses typically manifests as severe pneumonia that often progresses rapidly to the acute respiratory distress syndrome. The nonspecific clinical presentation of influenza A (H5N1) disease has often resulted in misdiagnosis of subsequently confirmed cases. Influenza A (H5N1) virus infection has been suspected in only a small number of patients. Health care staff should include influenza A (H5N1) virus infection in the differential diagnosis for patients who present with epidemiologic risk factors and unusual courses of illness, especially rapidly progressing pneumonia.
Febrile upper respiratory illnesses without pneumonia in children have been reported more frequently since 2005. Early consultation and antiviral therapy may have altered the clinical course of these illnesses. Less frequent gastrointestinal symptoms have been reported since 2005, Leukopenia, lymphopenia, mild to moderate thrombocytopenia, and elevated levels of aminotransferases are common but not universal.
The aim of this study was to review the current situation of avian influenza in Egypt & to describe the clinical picture and laboratory investigations of the human cases admitted to one of the major referral hospital (Abbasiah Chest Hospital) & to test Knowledge, Attitude and Practice of the Egyptians toward this disease.
This was done by:-
• Retrospective and prospective study of all patients (positive for H5N1by PCR by throat swab) admitted to Abbasiah Chest Hospital available data (personal history, medical history, clinical examination and risk factor documentation, radiological investigation, laboratory investigation, documentation of patient treatment and 2ndry complications and outcome of treatment.
• A self fulfilled questionnaire was done to 100 medical staff (doctors & nurses) in Shobra General Hospital and 100 of non-medical staff of visitors of Saraya Elkoppa Primary Health Center.
• Data was collected, verified, revised and then statistically analyzed.
In our study we found that the main sex distribution among studied patients was females’ accounting for 93.75% this is due to exposure.
The main residence distribution among studied patients was from Gharbia accounting for 37%.
As regard exposure to birds prior to onset of symptoms all patients have had history of exposure to birds prior to onset of symptoms except one case. The main type of exposure to birds between studied patients was slaughtering de-feathering accounting for 56.25% with no statistically significant difference of different types of exposure.
As regard symptoms at initial presentation the main presenting symptom was fever accounting for 93.75%, has no statistically significant difference in outcome of treatment, shortness of breath accounting for 81.25% has statistically significant difference in outcome of the disease, muscle & joint pain accounting 37.5%, vomiting accounting 12.5% and diarrhea accounting 6.25%.
As regard complications ARDS was the most noticed and dangerous complication accounting for 81.25%, there was statistically very high significant difference between patients had ARDS and patient had not in the outcome of the treatment.
The study show that there was statistically high significant difference between patients who had right lobar consolidation, who had left lobar consolidation , who had bilateral lobar consolidation and patient had not as regard of first chest radiograph in the outcome of the treatment as the less the sign in the first chest x ray the better the prognosis.
About knowledge of Egyptians toward avian flu the study shows that about 67 % of medical staff gains their information about avian flu from TV and mass media comparing with 77 % of non medical staff, about 100% of medical staff believes that avian flu is a viral disease comparing with 72% of non medical staff.
On testing attitude of Egyptians toward avian flu the study shows that 82% medical staff answer that they should isolate infected human from healthy one comparing with 18% answer they should not comparing with 89% of non medical staff answer they should isolate infected human from healthy one 5% answer they should not.
About if it’s possible to develop to flu pandemic 79% of medical staff answers yes and 9% answer no and 12% answer they don’t know, while non-medical staff 9% answer yes and 2% answer negative 89% answer they don’t know.
On review the current situation of avian flu in Egypt up to June 2009 the study found that the total number of suspected patients was 9214 cases with 81 confirmed cases and 27deathes with case fatality rate 33.3% with very high incidence at first 6 months in 2009 (30 cases out of 81 total cases), 11 governorates have 80% of poultry outbreaks and 76% of human cases which donate the strong relation between avian outbreaks and rising of new cases.
H5N1 poultry outbreaks in Egypt show a seasonal pattern (almost all outbreaks occurring between December and May) maybe due to cold weather 55% of human cases between Cairo and Mediterranean Sea perhaps because of population density.
The study show especial character of avian flu in Egypt as we find that average case fatality rate is lower than other countries 35 %, average days from symptom onset to hospitalization are lower than other countries 2.4 days, average age of male cases is lower 7.8 years, percent of cases exposed to sick or dead poultry is much higher 91%, percent of female cases is much higher 63%, percent of cases 15 years old or younger is much higher 62%, percent of female cases older than 15 years is much higher 83%.
Shorter time between symptom onset and hospitalization appears to correlate with a better health outcome for H5N1 human cases, presumably because of faster access to treatment including oseltamivir (Tamiflu).