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. Cocirculation of influenza (Flu) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (SARS-CoV-2/Flu) represent a public health concern as it may worsen the severity and increase fatality from coronavirus disease 2019. An increase in the number of patients with coinfection was recently reported. We studied epidemiology, severity, and outcome of patients with SARS-CoV-2/Flu coinfection seen at Egypt’s integrated acute respiratory infections surveillance to better describe disease impact and guide effective preventive measures. Methods. The first two outpatients were seen daily, and every fifth patient admitted to 19 sentinel hospitals with respiratory symptoms was enrolled. Patients were interviewed using a standardized questionnaire and provided nasopharyngeal swabs to be tested for SARS-CoV-2 and influenza by real-time polymerase chain reaction at the central laboratory. Data from all patients with coinfection were obtained, and descriptive data analysis was performed for patients’ demographics, clinical course, and outcome. Results. The total number of patients enrolled between January 2020 and April 2022 was 18,160 and 6,453 (35.5%) tested positive for viruses, including 52 (0.8%) coinfection. Of them, 36 (69.2%) were coinfected with Flu A/H3, 9 (17.3%) Flu-B, and 7 (13.5%) Flu A/H1. Patients’ mean age was 33.2 ± 21, 55.8% were males, and 20 (38.5%) were hospitalized, with mean hospital days 6.7 ± 6. At the hospital, 14 (70.0%) developed pneumonia, 6 (30.0%) ICU admitted, and 4 (20.0%) died. The hospitalization rate among patients coinfected with Flu-B and Flu A/H3 was 55.6 and 41.7%, with mean hospital days (8.0 ± 6 and 6.4 ± 6), pneumonia infection (40.0 and 80.0%), ICU admission (40.0 and 26.7%), and death (20.0% for both), while no patients hospitalized with A/H1. Conclusions. The recent increase in the number of SARS-CoV-2/Flu coinfections was identified in Egypt. The disease could have a severe course and high fatality, especially in those coinfected with Flu-B and Flu A/H3. Monitoring disease severity and impact is required to guide preventive strategy.
Introduction: An integrated surveillance for acute respiratory
infections (ARIs) was established 2016 at network of 19 governmental
hospitals to identify causes of ARIs in Egypt. In response to COVID-19
pandemic, WHO requested surveillance adaptation to address the emerging
challenges. This report aims at describing Egypt experience in adapting
ARI surveillance to COVID-19 pandemic. Surveillance methods: WHO case
definitions are used to identify ARI patients. NP/OP swabs collected for
influenza testing by RT-PCR at central laboratories. Data collected by
interviewing patients for demographic and clinical information and
entered at sites. During COVID-19 pandemic, the first two outpatients
daily and every fifth admitted patient were enrolled. Patients COVID-19
clinical data and testing for SARS-CoV-2 by RT-PCR were added. Results:
Between January 2020-April 2022, 18,160 patients were enrolled including
7,923(43.6%) outpatients and 10,237(56.4%) admitted. Of them
6,453(35.5%) tested positive including 5,620(87.1%) SARS-CoV-2,
781(12.1%) influenza and 52(0.8%) SARS-CoV-2/influenza coinfection.
SARS CoV-2 caused 95.3% of admitted cases and 65.4% of outpatients.
Influenza subtypes included A/H3 (55.7%), Flu-B (29.1%), H1/pdm09
(14.2%). Compared to influenza, SARS-CoV-2 infections prevail in
elderly, warm weather, and urban governorates. SARS-CoV-2 caused more
hospitalization, longer hospital stay, more severe course and higher
case fatality than influenza (16.3 vs 6.6%, p<0.001).
Conclusion: Egypt ARI surveillance was successfully adapted to COVID-19
pandemic and effectively describe clinical characteristics and severity
of circulating viruses. Surveillance reported re-emergence of influenza
viruses with severe course and high fatality. Maintaining ARI
surveillance is essential to monitor respiratory viruses activity for
guiding clinical management and preventive and control measures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.