Background Sentinel surveillance of influenza-like illness (ILI) in Egypt started in 2000 at 8 sentinel sites geographically distributed all over the country. In response to the COVID-19 pandemic, SARS-CoV-2 was added to the panel of viral testing by polymerase chain reaction for the first 2 patients with ILI seen at one of the sentinel sites. We report the first SARS-CoV-2 and influenza A(H1N1) virus co-infection with mild symptoms detected through routine ILI surveillance in Egypt. Objective This report aims to describe how the case was identified and the demographic and clinical characteristics and outcomes of the patient. Methods The case was identified by Central Public Health Laboratory staff, who contacted the ILI sentinel surveillance officer at the Ministry of Health. The case patient was contacted through a telephone call. Detailed information about the patient’s clinical picture, course of disease, and outcome was obtained. The contacts of the patient were investigated for acute respiratory symptoms, disease confirmation, and outcomes. Results Among 510 specimens collected from patients with ILI symptoms from October 2019 to August 2020, 61 (12.0%) were COVID-19–positive and 29 (5.7%) tested positive for influenza, including 15 (51.7%) A(H1N1), 11 (38.0%) A(H3N2), and 3 (10.3%) influenza B specimens. A 21-year-old woman was confirmed to have SARS-CoV-2 and influenza A(H1N1) virus coinfection. She had a high fever of 40.2 °C and mild respiratory symptoms that resolved within 2 days with symptomatic treatment. All five of her family contacts had mild respiratory symptoms 2-3 days after exposure to the confirmed case, and their symptoms resolved without treatment or investigation. Conclusions This case highlights the possible occurrence of SARS-CoV-2/influenza A(H1N1) coinfection in younger and healthy people, who may resolve the infection rapidly. We emphasize the usefulness of the surveillance system for detection of viral causative agents of ILI and recommend broadening of the testing panel, especially if it can guide case management.
Background To describe demographic, clinical and epidemiological characteristics of pregnant and nonpregnant women with confirmed COVID-19 at reproductive age and determine risk factors of COVID-19 severe outcomes during pregnancy. Methods A retrospective study for females aged 18–49 with confirmed COVID-19 by RT-PCR in Egypt, February–July 2020. Data were obtained from Egypt National Surveillance, bivariate and multivariate analysis for demographic and clinical characteristics and outcomes of COVID-19 between pregnant and nonpregnant women including ICU admission, need for ventilator and death was performed. Results A total of 23 095 females were identified, with mean (SD) age of 35.1 (8.1) year. Of those, 408 (1.8%) were pregnant, with mean (SD) age of 29.3 (8.1) years. Compared to nonpregnant, pregnant patients were more likely to be admitted to hospital (OR = 1.7 CI = 1.4–2.1), ICU (OR = 2.4, CI = 1.3–4.3), need ventilator (OR = 3.9, CI = 2.1–7.4) and have severe outcome (OR = 3.0, CI = 1.9–4.7). Factors associated with severe outcome included: pregnancy, age > 30 years, underlying medical conditions, and living in rural areas. Conclusion Pregnant women with COVID-19 are at higher risk of severe symptoms and outcome including ICU admission, requiring ventilator and death. To reduce risk of severe outcome, counseling about for seeking medical care and health education about COVID-19 preventive measures should be performed.
Background This study aimed to compare knowledge, attitude and practice (KAP) regarding COVID-19 between public health workers (PHWs) attended field epidemiology training program (FETP-trained) and those who did not attend FETP (non-FETP trained). Methods Multi-country cross-sectional survey was conducted among PHWs who participated in COVID-19 pandemic in 10 countries at EMR. Online questionnaire that included demographic information, KAP regarding COVID-19 pandemic was distributed among HCWs. Scoring system was used to quantify the answers, bivariate and Multivariate analysis performed to compare FETP-trained with non-FETP trained PHWs. Results Overall, 1337 PHWs participated, with 835 (62.4%) < 40 years of age, and 851 (63.6%) males. Of them, 423 (31.6%) had FETP, including that 189 (44.7%) had advanced level, 155 (36.6%) intermediate and 79 (18.7%) basic level training. Compared with non-FETP trained, FETP trained were older, having higher KAP scores. FETP participation was low in infection control, and PH laboratories. KAP mean scores for intermediate level attendees are comparable to advanced level. Conclusions FETP-trained are having better KAP than non-FETP PHWs. Expanding the intermediate level, maintain the Rapid Response training and introduce the laboratory component are recommended to maximize the benefit from FETP. Infection control, antimicrobial resistance and coordination are areas where training should include.
This article briefly describes Egypt’s acute respiratory infection (ARI) epidemic preparedness and containment plan and illustrates the impact of implementation of the plan on combating the early stage of the COVID-19 epidemic in Egypt. Pillars of the plan include crisis management, enhancing surveillance systems and contact tracing, case and hospital management, raising community awareness, and quarantine and entry points. To identify the impact of the implementation of the plan on epidemic mitigation, a literature review was performed of studies published from Egypt in the early stage of the pandemic. In addition, data for patients with COVID-19 from February to July 2020 were obtained from the National Egyptian Surveillance system and studied to describe the situation in the early stage of the epidemic in Egypt. The lessons learned indicated that the single most important key to success in early-stage epidemic containment is the commitment of all partners to a predeveloped and agreed-upon preparedness plan. This information could be useful for other countries in the region and worldwide in mitigating future anticipated ARI epidemics and pandemics. Postepidemic evaluation is needed to better assess Egypt’s national response to the COVID-19 epidemic.
Background Older persons and people of any age with certain underlying comorbidities such as diabetes mellitus, cardiovascular disease, lung disease, kidney disease, liver disease, and cancer are at a higher risk of severe disease course and death if they become infected with COVID-19. Identifying at-risk groups and risk factors for COVID-19 severity and mortality is important for guiding the efficient and appropriate prevention and management of patients with COVID-19. Objective This study aimed at describing the demographics and epidemiologic characteristics of confirmed COVID-19 cases in Egypt and determining the impact of different comorbidities on patients’ outcomes. Methods The data of all confirmed COVID-19 patients admitted to 408 governmental hospitals all over Egypt from February to May 2020 were collected retrospectively from the National Egyptian Disease Surveillance System. The cases were confirmed using RT-PCR. Results Overall, 28,415 patients (55% male and 45% female) were identified. Their median age was 44 years. Of those, 743 (2.6%) were admitted to ICU, 408 (1.4%) required ventilator, and 1045 (3.7%) died. Of the 21,617 (76.1%) patients with completed data, 4687 (21.7%) had comorbidities. Overall, 11.8% had diabetes, 5.3% cardiovascular disease, and 4.3% chronic obstructive pulmonary disease. Those who had 1 comorbidity were more likely to die (odds ratio 2.83), were admitted to ICU (odds ratio 6.36), and needed a ventilator (odds ratio 5.95) compared to patients with no comorbidities. Having multiple comorbidities increased the risk of mortality (odds ratio 3.53), ICU admission (odds ratio 8.62), and requiring a ventilator (odds ratio 9.06). Conclusions COVID-19 patients with comorbidities had a higher risk of disease severity and mortality. Multiple comorbidities further increase the risk to a higher extent. All necessary precautions should be taken for patients with comorbidities to avoid COVID-19 infection in order to prevent the worst prognosis.
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