Experts say mutations in the swine flu virus are nothing to worry about, for now at least, reports Reem Leila The World Health Organisation (WHO) has reported mutations in the swine flu virus in several countries, including Brazil, China, Japan, Mexico, Ukraine, the UK, Hong Kong, Norway, the Netherlands and the United States. The changes, says the WHO, are sporadic and spontaneous. No links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to be spreading. There have been reports around the world of people developing resistance to Tamiflu while taking the drug but they have not passed on the strain to others. The WHO stresses that the mutation does not appear to cause a more contagious or dangerous form of H1N1 and cases observed so far have been mild. "The emergence of H1N1 infections that are resistant to Tamiflu was expected, especially in patients with underlying medical conditions and weak immune systems," says virologist Abdel-Rahman Zaki. "We should have stringent processes to monitor antiviral resistance cases so we can spot resistance early and the causes can be investigated and managed." The WHO is still assessing the significance of its latest observations. Ahmed Abdel-Latif, the WHO's regional advisor in Cairo, points out that changes in the flu virus have not altered the course of the illness in patients. "Although further investigation is still going on, there is no evidence suggesting that these mutations are leading to an unusual increase in the number of H1N1 infections or a greater number of severe or fatal cases," he says. "Treatment with Tamiflu is still appropriate for swine flu and people should continue taking it when it is prescribed. It's also important that good hygiene practices are followed to prevent the spread of the virus." According to WHO figures released last week 6,750 people have died from swine flu since the virus first appeared in Mexico in April. The WHO estimates that some 250,000 to 500,000 people die every year from standard seasonal variants of swine flu. "There is no comparison between the two flus. There is no need to worry, so far. The situation in Egypt is under control and the government is exerting its utmost effort to decrease and contain the virus's impact on the nation," says Abdel-Latif. Health officials in Egypt are less concerned about the virus mutating than about the possibility of a fresh outbreak of the disease caused by pilgrims returning from Saudi Arabia after the hajj. Dozens of Egyptian pilgrims are thought to have travelled without first taking the H1N1 vaccine. The Saudi authorities announced last week the death of four pilgrims as a result of swine flu. Abdel-Rahman Shahin, official spokesman at the Health Ministry, says eight Egyptian pilgrims have died while in Saudi Arabia, though none of the deaths is related to swine flu. Egypt's own swine flu death toll jumped to 13 last week. The two latest deaths included the first man, Shawqi Ibrahim El-Husseini, a 32-year-old who tested positive for the H1N1 virus and died on 21 November. El-Husseini was also suffering from advanced liver disease and pneumonia. On 22 November 50-year-old Farha Mohamed from Fayoum governorate and Alexandrian Yousr Gaber who was nine months pregnant died as they both tested positive for the H1N1 virus. On 24 November Egypt reported its 13th case for a 24-year-old female from Giza governorate. According to Shahin, the woman was also suffering from chronic obesity, diabetes and high blood pressure. Meanwhile, Minister of Health Hatem El-Gabali approved the local production of Tamiflu. El-Gabali stipulated that the raw material used in the drug production will be imported from producers certified by the WHO. The decision was made to prevent the sale of the drug in the black market, even though for the time being the ministry has enough stock. Seventy-one new cases of swine flu were reported in total, bringing the total number of cases in Egypt to 3,216, according to the Health Ministry's latest press release. Out of the 85 new cases, 51 cases were found in schools around the country, bringing the number of swine flu cases among school students since the beginning of the academic year to 1,177. "The majority of students who have contracted the H1N1 virus attend international and language schools where they are in constant contact with people returning from abroad," says Adel Abdel-Ghaffar, official spokesman at the Ministry of Education.
