Reem Leila investigates the recent outbreaks of avian flu as well as salmonella Scores of victims of avian flu and water contaminated with salmonella have raised serious concerns about disease outbreaks in Egypt. Meanwhile, concerned authorities are scrambling to address health hazards caused by ignorance, negligence and poverty. Reports of people falling sick and dying from sewage-contaminated water in some Delta villages have been rapidly increasing in recent weeks. According to official reports, a salmonella outbreak has already caused one death and illness in 125 victims throughout 11 villages. These include Balgai, Gemezet Balgai and Serw in the Governorate of Daqahliya, located about 120 kilometres northeast of Cairo. But villagers are inclined to believe the rumour that the sickness is caused by cholera. Panic worsened after reports that Egypt's southern neighbour Sudan is suffering from a deadly cholera epidemic. But health officials have strongly denied that the epidemic has migrated to Egypt, insisting that Daqahliya residents are suffering from salmonella due to water contamination. Ministry of Health spokesperson Abdel-Rahman Shaheen told Al-Ahram Weekly that his ministry "has taken all precautions at the southern border to prevent cholera from infecting Egypt." After a meeting on Monday, the cabinet issued a report stating that preliminary results indicate that people are afflicted with salmonella, due to contaminated water. During the meeting, Prime Minister Ahmed Nazif stressed the need to overhaul Egypt's sewage and potable water systems. Shaheen explained that salmonella is a potentially deadly bacteria for human beings. "Salmonella can cause diarrhea and other flu-like symptoms, and can be deadly if not treated promptly with antibiotics," he explained. But according to Shaheen, it was not only the contaminated water that made people sick; all those who fell ill had drunk either fresh mango or guava juice, according to samples taken from their stomachs. "The fruits were also infected with salmonella," revealed Shaheen. Ten days ago, 19-year-old Sherihan Mamdouh died after she was admitted to hospital with a high fever, vomiting and diarrhea. Others, ranging from ages seven months to 55 years, were admitted to hospitals in Mansoura with similar symptoms over the last few days. So far, 107 people were released from hospital after receiving treatment, while another 18 are still hospitalised. Nearly 45 samples of the water were taken from villages in Daqahliya to be examined at the ministry's laboratories. Shaheen confirmed that the samples tested positive for three types of salmonella, in addition to the Streptococcus Faecalis microbe causing severe infection of the digestive system. Fresh water is not available in many of these villages, therefore residents pump underground water which passes very close to decaying sewage pipes, according to Daqahliya Governor Ahmed Said Sawan. Sawan ordered the cutting off of fresh water supplies in affected areas until the problem is fixed, banned water pumps, and ordered the sterilisation of all water in contaminated areas. He also allocated LE50,000 from the Fresh Water and Sewage Fund to supply the village of Serw with fresh water. This will be done by extending a three kilometre- long pipeline in the coming few days. "Other villages will eventually be provided with fresh water," asserted Sawan. Meanwhile, victim number 15 of human bird flu was admitted to hospital last week. Hanan Abul-Magd, 39, from the Nile Delta Governorate of Gharbiya had contracted avian influenza after buying and slaughtering infected ducks at her home. Abul- Magd is reported to be in a stable condition, and her family is being tested for the virus. Six of the 15 who were infected since the outbreak in February have died. Health officials blamed Abul-Magd's infection on the poor observance of government regulations aimed at stamping out the virus. According to Shaheen, people are maintaining their old habits and ignoring official warnings. "Earlier this year, the government and international agencies embarked on a nation-wide campaign to persuade people not to keep poultry inside their homes," stated Shaheen. Since then, the government has overseen the culling of some 30 million birds, and imposed tough restrictions on poultry breeding. "A fine ranging from LE1,000 to LE10,000 was strictly enforced on those who breed fowl on roof-tops," he added. Egypt witnessed a concentration of bird-flu infection this year, causing LE600 million in losses since February. John Jabbour, of the Communicable Diseases Surveillance Department at the World Health Organisation's (WHO) regional office in Cairo, said that "it is a matter of changing behaviour. People are sometimes not honest about breeding birds inside their houses. They know they are in danger, but for other reasons they still keep them." Jabbour continued that the government has succeeded in removing poultry from the homes of people in Cairo, "but in more rural areas people are not accepting that they have to get rid of backyard birds." According to Jabbour, the onset of cooler weather could still cause a flare-up of cases in poultry, and has urged increased surveillance accompanied by a fair compensation scheme. Experts had previously criticised the government for failing to tackle the first outbreak boldly, resulting in six deaths between March and May. "The first time, the government was partially caught by surprise and did not take all the necessary precautions," stated Mustafa Bastamy, head of the poultry department at the Faculty of Veterinary Medicine, Cairo University. "But they have been working very hard since. The threat has decreased since the government slaughtered many infected poultry during the last outbreak." Minister for Health and Population Hatem El-Gebeili declared that hospitals across Egypt had been put on high alert, and that the ministry was "working to 'recharge' the media message through all available channels."
