Swine flu fears are sweeping Egypt after 172 cases were confirmed in January. Sixteen of those infected died this week. Fatalities occurred in Al-Qalyubia, Mansoura and Luxor governorates. Four of the dead, said the Doctors' Syndicate in a statement released on 2 February, were physicians who contracted the virus from patients. A day later Minister of Health and Population Maha Al-Rabat contradicted the Doctors' Syndicate statement. “Only two doctors have been infected by swine flu,” she insisted, “Naglaa Fathi from Al-Qalyubia governorate and Ahmed Shadowfi from Al-Sharqyia governorate. Fathi has recovered completely while Shadowfi is in a stable condition at Kasr Al-Aini hospital.” Al-Rabat ordered hospitals to stockpile swine flu vaccinations in December “as a precautionary measure”. The syndicate warned that ministry officials were underestimating the extent of the disease and urged the minister of health to “deal seriously and transparently with infections and take all precautionary epidemic measures”. According to Mokhtar “government hospitals are failing to diagnose infections and the ministry has still not recognised the extent of the problem.” The Doctors' Syndicate has called on all health workers to strictly comply with regulations when dealing with suspected cases, to wear rubber gloves when examining patients and change clothing once their shifts end. Though the H1N1 virus has been remarkably stable during the past three years virologists expected new cases of the virus. “The emergence of H1N1 infections is expected especially in patients with underlying serious conditions and weak immune systems,” said virologist Abdel-Rahman Zaki. “Stringent processes are needed to monitor the appearance of new cases. If we can spot them early causes can be investigated to immediately managed.” Health Ministry spokesman Ahmed Kamel says the H1N1 virus constitutes 11.6 per cent of seasonal influenza, followed by the A/H3 which accounts for 8.2 per cent and the FluB virus which accounts for 4.5 percent. “The H1N1 virus has become part of the seasonal influenza pattern. The ministry has taken all precautionary measures to monitor its spread. We monitor respiratory diseases through eight specialised clinics across the country,” said Kamel. Of the H5N1 virus, better known as bird flu, Kamel says only four cases were confirmed in 2013 though a further 284 were suspected. The last confirmed case was a 25-year-old woman who died in Sohag last May. Though bird flu remains susceptible to Tamiflu medication swine flu is less so. Groups at most risk from the latter include pregnant women, children less than five years old, the elderly and those with chronic diseases. Kamel recommends “hygiene measures, such as frequent washing of hands and covering the nose and mouth while coughing and sneezing”. The H1N1 virus, like seasonal flu, can become airborne if an infected person coughs or sneezes without covering their nose and mouth. “It is strongly recommended to avoid close contact with people who appear unwell and have a fever and cough. Those who suffer influenza-like symptoms should seek medical advice immediately,” warned Kamel. The H1N1 is not transmitted via the digestive system though it can be transferred due to direct or indirect contact with pigs or with people who have contracted the virus. Symptoms of H1N1 swine flu include fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. Many people with swine flu report diarrhea and vomiting. In resumption of the academic year on 22 February has raised concern about the spread of the virus among school students. The ministry, says Kamel, is prepared to deal with any H1N1 cases that might appear in schools and closing down schools will be considered as a last resort. “But closing schools will not guarantee the disease is contained. Children go out and play and interact with other children in their neighbourhoods,” says Kamel. The ministries of Health and Education have established a joint committee to follow up procedures to limit the spread of the virus among school students. The committee comprises the health ministry's official spokesman, the head of the preventive medicine department, the official spokesman of ministry of education and the minister of education's deputy.
