The number of swine flu cases is on the rise. As winter approaches, how is Egypt prepared, asks Reem Leila A month after the new academic year began in October, more than 95 school children, and 23 university students, are reported to have contracted swine flu. The latest death was a 22-year-old woman from Imbaba in Giza. She died on Monday, bringing the total number of swine flu deaths in Egypt to five. The patient was admitted to a private hospital on 28 October and was diagnosed with common flu and treated accordingly. Her condition deteriorated after also contracting pneumonia. There has been one fatality -- though somewhat disputed -- among the country's 16 million students, nine-year-old Mustafa Ahmed, who died on 31 October. The boy was a student at the Egyptian Language School (ELS) in Helwan. "Ahmed was taken to a private clinic after showing swine flu-like symptoms on 29 October, where he was injected with 75mg of Voltaren instead of 25mg. His condition deteriorated immediately after the injection. The boy, who was transferred to the Abbasiya Fever Hospital, fell into a coma and was placed on ventilators." According to Abdel-Rahman Shahin, official spokesman to the Minister of Health, the boy was later moved to Dar Al-Hekma Hospital in Nasr City at the insistence of his parents where he suffered heart failure and brain haemorrhage. However, Ahmed might have died from an overdose of Voltaren. The minister of health has formed a committee to investigate. ELS, says Shahin, is the fourth school in Egypt to be shut down for a period of two weeks. The swine flu virus has claimed the lives of four other Egyptians. Sabrin El-Sayed, a 36- year-old woman from Ismailia, died from swine flu on 29 October after being rushed to hospital suffering from fever and shortness of breath. "The patient was also suffering from high blood pressure and obesity," says Shahin. "We expect more infections and more fatalities as winter approaches. It is essential that people change the way they behave and follow all hygiene recommendations." Figures released by the Cabinet's Information and Decision Support Centre (IDSC) show 96.1 per cent of Egypt's reported cases have completely recovered. Across the Middle East, says the IDSC report, 187 people have died as a result of swine flu, 17,334 people have contracted the virus. Fatalities have been concentrated in three of the 21 countries of the region, with more than half the deaths reported in the Kingdom of Saudi Arabia, Israel and Oman. During the past week five schools have closed down due to the spread of swine flu. The IDSC said the three schools were in Cairo and two in Helwan. Since the beginning of the academic year on 3 October, 29 classes have been closed. The total number of swine flu cases have risen to 1,363; 1,278 have recovered. Swine flu was first detected in Egypt in June, and though health officials have tried for months to enforce preventative measures they are incapable of ensuring they are strictly implemented. "Government planning is random. It is using the wrong tactics to combat the virus," says independent MP Gamal Zahran. Close monitoring of the virus by the WHO's network of laboratories, Shahin points out, shows that viruses from all outbreaks remain virtually identical. There are no signs that the virus has mutated to a more virulent or lethal form. "The clinical picture of pandemic influenza is largely consistent across all countries. The overwhelming majority of patients continue to experience mild illness. Although the virus can cause very severe and fatal illness, even in young and healthy people, the number of such cases remains small and Egypt is still in the green zone, though it might step into the yellow zone soon." Zahran argues that even if the current pattern of mild illness continues, the impact of the pandemic during a second wave could worsen as larger numbers of people become infected. Growing numbers of severely ill patients requiring intensive care will place an intolerable burden on health services, he says, "creating pressures that could overwhelm intensive care units and possibly disrupt the provision of care for other patients". The Ministry of Health, says Shahin, is considering increasing the number of hospitals designated as swine flu centres in order to cope with escalating numbers of patients. "Doctors will be provided with extra training to enhance their performance. Mothers should also be shown how to identify symptoms and differentiate between seasonal flu and the H1N1 virus." Egypt's first batch of swine flu vaccine, 80,000 doses, arrived on 2 November, and a further 70,000 doses the following day. Distribution of vaccines will be administered by a committee including Ahmed Farag, deputy minister of health for financial and administrative affairs, and Deputy Minister of Health for Preventive Medicine Nasr El-Sayed. "Pilgrims and front-line workers, including physicians and employees working in vital fields, will be given priority. The vaccination process began on 3 November," confirmed Shahin. Rejecting reports that the H1N1 vaccine has harmful side effects, Health Minister Hatem El-Gabali, along with his assistants, took the vaccine injection live on Egyptian TV. "I took the shot in order to ease concerns among people who doubt the vaccine's validity. "More than one million H1N1 vaccine doses will arrive in the country next January while the remaining five million doses will reach the country in March 2010," added El-Gabali. The chairman of the Egyptian Holding Company for Vaccines, Mohamed Rabie, has announced that the H1N1 vaccine has been used by four million people worldwide and no unusual side effects have been reported. "In a few cases, side effects common with the regular flu vaccine occurred," Rabie said, mainly skin irritation around the site of the injection. Saudi Arabia's Ministry of Health has announced that pilgrims will not be allowed to enter the country if their temperature is higher than 38 degrees.
