Case series / case reportindependent cross-checkabstract checked I-CHK-138 standard review
Egypt 2014-15: 165 human bird-flu cases, almost all after poultry contact
Increased Number of Human Cases of Influenza Virus A(H5N1) Infection, Egypt, 2014-15.
Overview
Refaey S et al.. Emerg Infect Dis 2015 · PMID 26584397 · DOI 10.3201/eid2112.150885
99% of 165 Egyptian cases had contact with poultry; 51 died.
Does the study support the specific claim? Yes · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
What were the characteristics and exposures of human H5N1 cases in Egypt in 2014-15?
- How was the study done?
Surveillance case series
- How many people, animals or samples were studied?
165 cases
- What was actually found?
165 cases incl. 6 clusters and 51 deaths; 99% reported poultry exposure (19% to ill poultry, 35% to dead poultry); only 1 person reported wearing personal protective equipment while working with poultry.
- How large was the observed effect?
165 cases incl. 6 clusters and 51 deaths; 99% reported poultry exposure (19% to ill poultry, 35% to dead poultry); only 1 person reported wearing personal protective equipment while working with poultry.
- What do the results mean in everyday life?
Contact with sick or dead household poultry was the danger.
- What are the study's limitations?
Descriptive; no control group
- What does it say about Elawady's specific claim?
Supports the zoonosis part for Egypt.
- Do the results apply to Germany and Europe?
EU human cases are rare.
- What can explicitly not be concluded from this study?
Does not concern eating cooked chicken.
Scientific in-depth review
1. Full reference
- Authors
- Refaey S et al.
- Journal
- Emerg Infect Dis
- Year
- 2015
- Identifier
- PMID 26584397 DOI 10.3201/eid2112.150885
- Verification
- verified – PubMed efetch 2026-10-26; Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
What were the characteristics and exposures of human H5N1 cases in Egypt in 2014-15?
3. Study design and population
- Study design
- Case series / case report – Surveillance case series
- Population
Human H5N1 cases
- Country
Egypt
- Period
Nov 2014-Apr 2015
- Sample size
165 cases
- Inclusion and exclusion criteria
as described in the abstract
4. Methods and endpoints
- Exposure / intervention
Poultry exposure
- Comparator
not applicable
- Endpoints
Cases, clusters, deaths, exposures
- Statistical methods
as reported in the abstract
5. Actual results
- Results
165 cases incl. 6 clusters and 51 deaths; 99% reported poultry exposure (19% to ill poultry, 35% to dead poultry); only 1 person reported wearing personal protective equipment while working with poultry.
- Absolute risks
not reported
- Authors' conclusion
Not separately stated in abstract.
6. Strengths
- National surveillance
7. Weaknesses
- Descriptive; no control group
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Case series.
9. Assessment of the statistical interpretation
Case fatality 30.9% (51/165), computed in stats/C-CHK-13_pneumonia_h5n1.py.
10. Relevance to the specific claim
Egyptian evidence that human H5N1 infections follow poultry exposure.
11. Independent contrary findings
12. Transferability to Germany and Europe
13. Overall methodological judgement
99% of 165 Egyptian cases had contact with poultry; 51 died.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | low |
| Adequacy of the interpretation (by the archive) | not applicable |