Despite the death of Egypt's first human victim of avian flu, reports Reem Leila, carelessness remains rampant The streets of Nawa, the small village in Qalyoubiya Governorate, home to 30-year-old Amal Mohamed Ismail, Egypt's first victim of avian flu, are littered with the carcasses of dead birds. Children continue to play among chickens in the narrow alleyways, careless of any threat to health. And, according to Nawa resident Umm Ahmed, villagers still breed chickens inside their homes. Naema, Umm Ahmed's neighbour, even doubts that bird flu really exists. "I will not slaughter my chickens," she says. "I am hiding them inside my closet. Killing them is not an option. I cannot afford to," she explains. Residents of Nawa are far from impressed by government claims that it is taking every step to contain the spread of the virus. They complain that the authorities do not even clear away dead birds from the streets. "No one is talking to us. No one seems to care. The only people who have been here are the press," says Umm Ahmed. Ismail died last Friday, after being hospitalised three days earlier. During her initial examination she denied having come into contact with poultry, a necessary condition for contracting the virus, making it difficult for doctors to diagnose her condition. In fact she was hiding chickens beneath her bed. Three other suspected cases of infection with the deadly H5N1 strain of bird flu -- 17-year-old Mohamed Mahmoud Abdel-Ghani from Gharbiya, 30- year-old Fatima Mohamed Youssef and 28-year-old Mohamed Bahaaeddin Abdel-Moneim, both from Qalyoubiya Governorate -- have since come to light. Health officials say they are in a stable condition, and the final results of tests have yet to be received. Health Minister Hatem El-Gabali said the three had been hospitalised after it was discovered they had come into contact with infected poultry. Ahmed Mustafa, an official at the Nawa Municipality of the Governorate of Qalyoubiya, says the number of human infection cases are too small to justify the wholesale culling of poultry though the authorities will act should the situation worsen. "At this stage there is no reason for people to panic. Everything is under control." Staff at poultry farms had all, he said, been trained to identify symptoms and take the necessary precautionary measures. "And we are trying to increase awareness among the public, largely through mosques, of the dangers of keeping poultry inside houses." The municipality does not have the authority to search people's homes and confiscate livestock without, says Mustafa, there being a complaint from either the police or neighbours. "Despite isolated cases of human infection there is as yet no danger of avian flu causing an epidemic," says Salah Shousha, who works with the Nawa Authority for Veterinary Service. "I would not be surprised," he said, "to see more human cases of infection but we are far away from a pandemic." Shousha, who believes the biggest health risk comes from the haphazard disposal of bird carcasses, recommends measures to ensure that people stop rearing fowl domestically, and that birds are not moved around the country. "In every village a couple of policemen should be deployed to ensure recommendations are implemented. And the municipality should have the authority to search people's homes and confiscate any birds found." Humans are at risk of contracting bird flu only if they come into direct, and fairly continuous, contact with infected birds. Scientists fear, though, that the virus could mutate into a form that can be passed easily between humans, triggering a pandemic. Nawa resident Zaher Rizk, who has culled his own poultry, complains of laxity on the part of the municipality. "If you go and report that bird carcasses are littering the streets the municipality will either ignore you, or else levy an LE300 fine, accusing whoever is doing the reporting of being responsible for the dead birds being in the street in the first place." As a consequence, he says, no one bothers filing reports. Abdel-Rahman Shahin, spokesman at the Ministry of Health, insists that after identification every site is immediately quarantined. He confirms that doctors have taken samples from everyone who has had any contact with confirmed cases of infection, and that the samples are currently being tested. "There is no time for niceties," he says. "We have an emergency plan developed between us, the municipalities and Ministry of Agriculture. Infected birds must be killed as quickly as possible. A ban on all exports of poultry products will shortly come into effect and quarantine orders will be imposed on all sites of human infection. Since Sunday there has been a total ban on the transport of poultry." As the Egyptian authorities scramble to contain the virus Hassan Al-Bushra, the World Health Organisation's regional adviser for communicable diseases, says there is no need for the public to panic, and people can continue to eat well cooked chicken and eggs. "There are no known cases of infection with bird flu through eating eggs or cooked chicken. Eggs cooked in any way, including in baking, can be consumed safely," says Al-Bushra. The first cases of the highly pathogenic H5N1 strain of bird flu virus in poultry flocks were reported in Egypt last month. The poultry industry, which had attracted LE17 billion worth of investments, has been severely affected and is estimated to be losing LE10 million a day. Exports, of 180 million one-day-old chicks and 500,000 fowls a year, have collapsed, and the industry, which supports between 2.5 and three million people, is unlikely to recover any time soon. Nearly 75 per cent of poultry farms have closed, and many farmers face bankruptcy.
