The death from bird flu of a 20 year-old woman from the Shubra Al-Kheima district of Qalioubiya governorate on 27 July, and of a 33 year-old woman from the same governorate on 29 August, brings the total death toll from avian flu in Egypt to 112 since the virus first appeared. The two deaths are the eighth and ninth fatality this year.
The bird flu virus H5N1 was first recorded in Egypt in 2006. Precautionary measures have long been in effect, though they are now being upgraded, says Mona Mehrez, head of the Central Laboratory for Poultry Monitoring at the Ministry of Agriculture and Land Reclamation. The sale of live poultry is once again to be banned across Egypt's 29 governorates, and a major awareness campaign has been launched to alert the public to the benefits of buying frozen fowl.
"Nearly 20 per cent of Cairo's poultry stores sell frozen birds. This percentage must be substantially increased over the next two years," says Mehrez.
Meanwhile, the World Health Organisation (WHO) issued a press release on 10 August. "The world is no longer in phase six of the pandemic alert. We are now moving into the post-pandemic period," said WHO Director-General Margaret Chan. "The new H1N1 virus has largely run its course."
Month on month reported infections have been below 200 for the past three months, compared to 2,000 to 4,000 at the beginning of the year.
Fears about the severity of swine flu, which appeared in the wake of the avian flu scare, and its possibly dangerous mutation, sparked a rush for specially-developed vaccines. Concern about the virus faded in 2009, to be replaced by accusations that fear had been deliberately fanned in order to generate huge profits for the vaccines' producers. In response the WHO has set up a committee of external experts to review the handling of the pandemic. The review panel is to report its findings by the beginning of next year.
Regular seasonal influenza vaccines now include protection against swine flu.
Nasr El-Sayed, Deputy Minister of Health for Preventive Medicine, says the ministry is coordinating with all concerned authorities to assess precautionary measures to combat both the H5N1 and H1N1 swine flu viruses. "It has yet to be decided whether stringent precautionary measures or more mild plans should be put in place during this academic year. The number of swine flu cases in Egypt reached 16,356, with 280 deaths since its first appearance in June 2009," said El-Sayed, adding that the ministry will follow all WHO recommendations during the post-pandemic period.
As far as the H5N1 virus is concerned, hundreds of alive fowl traders have been fined, and those convicted of second offences imprisoned for up to six months. Egypt has pressed ahead with centralising the slaughter of fowl. By the end of 2011 the capacity of slaughter houses, many built in cooperation with the private sector, will have increased by 30 per cent, says Mehrez.
Last week's WHO statement contained a number of recommendations for the post-pandemic period. "Though the level of concern has decreased it remains essential for health authorities to stay alert," said the statement. "This is especially critical in the immediate post-pandemic period, when the behavior of the H1N1 2009 virus cannot be reliably predicted."
The statement advises that incidents of respiratory disease be monitored and vaccination campaigns continued. "The WHO strongly recommends that high-risk individuals take the influenza shot in countries where influenza vaccines are available," it said.
Transparency, along with full abidance by WHO regulations, helped Egypt in overcoming the critical stages of the virus, says El-Sayed.
Between November 2009 until January 2010, the number of H1N1 infections increased from 2,226 to 8,064. The figures fell in February, when 284 cases were reported, and have been falling ever since. During March, April and May, the number of reported cases ranged from 56 to 93. According to El-Sayed, swine flu-related deaths were highest in January, with 122 fatalities, and in December with 115 fatalities. In February there were 12 deaths and during March, April and May three. Seventy-nine per cent of those who succumbed had chronic, underlying illnesses.
The Health Ministry's official spokesman, Abdel-Rahman Shahin, stresses that since the ministry's last official statement on swine flu on 1 June there has been no evidence of a possible new wave. There have been no mutations in the virus or any cases of resistance to Tamiflu. The highest number of swine flu cases reported was 2,650 cases during the last week of December 2009 after which the Health Ministry decided to stop issuing daily reports on the pandemic.
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