Egypt imposes further restrictions on omra pilgrims as part of its campaign to contain the spread of swine flu, reports Reem Leila Dozens of Egyptians have protested at Cairo International Airport after they were barred from travelling to Mecca for the omra despite having visas and tickets. Airport authorities called in extra security to disperse 300 protesters, who sat on the terminal floor and refused to leave. Despite extensive media coverage of new restrictions on pilgrims, designed to minimise the spread of swine flu and including a blanket ban on those over 65 from travelling, many claimed they had no idea of the new rules. Against a backdrop of an increasing number of fatalities from swine flu in Saudi Arabia -- 10 have been reported so far -- on 13 August Prime Minister Ahmed Nazif restricted the age range of pilgrims to adults between the ages of 25-65, a far more draconian measure than the minimum age of 12 suggested by the World Health Organisation (WHO). In addition, no new tickets or visas are being issued. The new restrictions were put in place after an emergency cabinet meeting was held. In Egypt the number of swine flu cases has reached 495, of which 349 have been discharged from hospital. The Health Ministry reports a higher incident of infections from travellers returning from Saudi Arabia than from other countries. "Out of 80 returning passengers carrying the virus on 9 August, 23 per cent were from Saudi Arabia, 17 per cent from Britain and 10 per cent from the United States," said Minister of Health Hatem El-Gabali. More alarming, 14 of the 27 cases identified three days ago were Egyptians who had neither travelled abroad nor come into contact with anyone who had. "There is considerable evidence to suggest swine flu is now passing between Egyptians," says Hamdi El-Sayed, chairman of the Doctors' Syndicate and head of People's Assembly Health Committee. "We can expect the number of cases to sky- rocket." El-Sayed supports the new restrictions, pointing out that facilities do not exist to quarantine and provide medical care for 500,000 pilgrims. "Pilgrim numbers must be reduced to the minimum in order to contain the spread of the virus," he said. The new rules, says El-Gabali, are an attempt to control the spread of swine flu ahead of the start of the new school year and thus protect large numbers of those among the most vulnerable age group. Travellers are also required to submit a health certificate certifying they are free of chronic illnesses such as kidney, liver or heart problems, diabetes and hypertension. "It is a criminal offence to forge the certificate and any doctor who fails to follow standard procedures will face trial in a criminal court," said El-Gabali. The certificates can be issued by public and private health institutions for LE200. "Visa holders will not be allowed to leave Egyptian airports if they fail to submit a certificate," says El-Gabali. The restrictions do not, however, apply to Egyptians who have permanent residency in Saudi Arabia. At least 150,000 of an estimated 500,000 pilgrims are likely to be prevented from travelling under the new regulations. "These precautions are intended to protect the citizen inside the country and to protect the person who is travelling," says Abdel-Rahman Shahin, official spokesman at the Ministry of Health. In addition to travel restrictions El-Gabali has this year banned the perennially popular Ramadan tents in which hotels and restaurants serve Iftar and Sohour. "This year," says Shahin, "enclosed venues accommodating groups that can comprise more than 500 people will be banned. Communal meals of this sort will be allowed only in open air venues." Travel agencies approved by the Ministry of Tourism to organise hajj and omra trips are likely to face major losses. "Tourism agencies organise between 20 and 50 omra trips daily," says Deputy Minister of Tourism Osama El-Ashri. "This ban could see them lose between 35 and 50 per cent of revenue, a sum that could reach LE250 million." Seif El-Amri, a member of the Egyptian Travel Agencies Association, wonders what mechanisms will be put in place to refund pilgrims who cannot travel. "Travel agencies will not be able to foot the cost of refunds," El-Amri argues, "since more than 50 per cent of the money travellers have paid for their packages has already been transferred to Saudi Arabia." "We will request the Saudi authorities to pressure hotels there to return the money. Those who refuse will be boycotted in the future." Civil Aviation Minister Ahmed Shafiq has stated that airline fares will be refunded in full. Pharmaceutical companies are racing to ensure they have the necessary production capacity in place should a vaccine be developed. The WHO has unofficially estimated that currently global capacity may be as low as 900 million doses a year. The Health Ministry is to order five million doses of any future swine flu vaccine, sufficient to immunise 2.5 million people. "Egypt will buy five million doses as soon as the vaccine becomes available," says Nasr El-Sayed, deputy to the Minister of Health. The order, he says, could be increased to 10 million doses depending on how the virus develops over the winter. Glaxo has already announced human trials of its swine flu vaccine. The 16 clinical trials will involve more than 9,000 people in Europe and North America. It expects initial results by September. Glaxo currently has orders for 291 million doses of its putative vaccine, and has announced it will donate 50 million doses to the WHO for use in poorer countries.
