Reports of escalating infections of measles and bird flu in Egypt have been appearing in the newspapers recently, but the outbreaks have been successfully contained, officials said this week. Despite more than 157 cases of measles in the Siwa Oasis and Marsa Matrouh governorate over the past few days, from which six children have died and 43 others were hospitalised, health officials say that the outbreak is no longer serious. The disease has been spreading in schools. While the number of infections is expected to increase over the coming days, health officials say that the situation is under control and the overall number of new infections is decreasing. Minister of Health and Population Adel Al-Adawi visited Marsa Matrouh this week to follow-up on the spread of measles, especially since 50 per cent of the infections are located in the nearby Siwa Oasis. “There are 700 to 1,500 cases of measles in Egypt per year. The high rate of infection in the Marsa Matrouh governorate is because more than 45 per cent of residents refuse to immunise their children despite the vaccine's availability,” Al-Adawi said. “Residents also refuse to send their children to hospital and prefer to keep them at home, thus leading to death in some cases.” The minister said that doctors in the governorate have received special training in dealing with the infections. “A treatment plan has been developed to end this life-threatening disease, in addition to measures of early detection and surveillance,” Al-Adawi said. Amr Qandil, head of the Health Ministry's Preventive Medicine Department, said that the outbreak occurred at a time when Egypt is facing a shortage of vaccine distribution among the governorate's residents. “Unfortunately, more than 45 per cent of Marsa Matrouh children under the age of six year were not vaccinated and so did not have protection against the measles virus,” he said. “The longer the government fails to immunise children, the more vulnerable to disease they are.” The ministry has now sent 70,000 doses of measles vaccine to Siwa and Marsa Matrouh, where 1,300 children out of 4,000 between the ages of nine months and six years have now been vaccinated. “The remaining children will be vaccinated by 13 December,” Qandil said. It is recommended that children receive three doses of the measles vaccine, the first at the age of nine months, the second at 15 months and the last at between four and six years. “The ministry has sent a medical team of six nurses and nine doctors to the area to increase people's awareness of the importance of vaccinating children and newborns against measles, as well as other diseases,” Qandil said. The team will help doctors at Siwa Central Hospital to diagnose cases in the area. “Measles is a highly infectious virus that lives in the mucus of the nose and throat of people suffering from the illness. Direct and indirect physical contact, coughing and sneezing spread the infection. Infected droplets of mucus from measles patients can remain active and contagious for at least two hours. This means that the virus can live outside the body on surfaces and door handles,” Qandil said. Mohamed Abu Soliman, deputy to the Ministry of Health at Marsa Matrouh, said, “Most children improve within seven to 10 days of contracting the virus. An irritating cough may persist for a few days after other symptoms have gone, however.” Initial symptoms of measles are a high temperature, eye infection and runny nose. Small spots usually develop inside the mouth a day or so later. Loss of appetite, tiredness, and aches and pains are common, along with diarrhoea and/or vomiting. Breathing difficulties and a red blotchy rash normally develop about three or four days after the initial symptoms. The rash usually appears on the head and neck and spreads down the body over a period of two to three days. The fever then tends to break, and the rash fades with the other symptoms. Soliman said it is important that children receive all three doses of the vaccine, as one or two doses are not enough to provide complete immunity against the disease. “One dose of measles vaccine provides children with 50 per cent immunity, while this percentage increases to 78 per cent if children are vaccinated with two doses,” he said. “Children who get the three doses are immunised against the disease to 95 per cent.” The first cases appeared two weeks ago, with reports of children presenting at the hospital in Siwa with symptoms. The first death was that of a three-year-old child in hospital, while the second died in an ambulance on his way to hospital. Soliman said the disease spread because of a lack of public awareness and a reluctance to receive the necessary vaccinations. The ministry also announced the death of the seventh case of a person infected with the H5N1 (bird flu) virus last week. The 26-year-old man from Minya was transferred to hospital where he was put on a ventilator and given the antiviral medication Tamiflu but eventually collapsed and died on 2 December. The man was reportedly suffering from a sore throat, shortage of breath, coughing and pain in the limbs. The ministry added in a press release that a woman from Sohag was also infected with H5N1 and transferred to hospital. The 33-year-old woman is currently on a ventilator and said to be in a critical condition. Hospitals across Egypt have declared a state of emergency following the recent death from the H5N1 virus. According to Qandil, the ministry has started taking intensive precautionary measures in various hospitals. “All governorate hospitals have stocks of the drug Tamiflu which treats the flu symptoms. A total of seven cases of bird flu have been recorded this year, three of whom have died,” he said. “The disease is still a threat in the countryside because of the way people handle poultry,” Qandil said. Most cases of bird flu have been identified in rural areas, where villagers tend to raise poultry in their homes, increasing exposure to live or dead infected birds. The World Health Organisation (WHO) has reported that 180 people have contracted bird flu in Egypt since 2006, and of these 65 have died. The Veterinary Medicine Authority is taking the necessary precautions to deal with poultry in potentially infected areas.
