Apr 7, 2008 (CIDRAP News) – A 19-year-old Egyptian man died of H5N1 avian influenza Apr 5, raising the country"e;s H5N1 toll to 48 cases with 21 deaths, according to news services.

The man was from the Nile Delta province of Beheira and had been exposed to infected poultry at home, said reports by Agence France-Presse (AFP) and Bloomberg News.

He was hospitalized in Alexandria on Apr 3 after complaining of a high fever and shortness of breath, a health ministry official told the MENA news agency, according to AFP. Another official told Bloomberg that the man was treated with oseltamivir (Tamiflu), but it was too late to save him.

Egypt has had four previous human H5N1 cases this year, one of them fatal, according to the World Health Organization (WHO). The country has had more cases than any other non-Asian nation and the third most overall after Indonesia and Vietnam.

Egypt"e;s location on major bird migration routes and its many households with backyard poultry flocks have contributed to the high number of cases there, the AFP story noted. Most of those infected in Egypt have been women and children, who take care of the backyard poultry in most cases, the story said.

Of the four previous cases in Egypt so far this year, three of the patients were children and one was a 25-year-old woman, WHO reports show.