Although bird flu remains difficult for people to catch, it might conceivably mutate into a form that spreads among humans, sparking a global pandemic that could kill millions. Reem Leila reports on the possible king of killers Recent news about bird flu in Egypt and elsewhere is far from encouraging. Several cases of Avian Flu transmitted to humans have been reported in Egypt so far this summer. Experts expect a stronger strain will hit Egypt hard in the winter. Perhaps most worrisome is the discovery of how the virus could easily mutate into a human to human strain with catastrophic consequences. The H5N1 strain which is transmitted from poultry to poultry, then to humans, could potentially merge with the human influenza type "A" which is easily transmitted from human to human, thus undergoing a metamorphosis into a new deadly Avian Flu strain that would be transmissible from human to human, capable of causing a pandemic of worldwide proportions. Official Health Ministry spokesman, Abdel-Rahman Shahin said that in such a scenario the entire world would be racing to see who would be the first to produce an anti-viral for the new bird flu human to human strain. Most recent cases of bird flu in Egypt have been in children in Upper Egypt where the temperature is exceptionally high at this time of year. The latest patient was four-year-old Emad El-Daramalli, from the Upper Egypt governorate of Qena, 450kms south of Cairo, who was initially hospitalised with a high fever before being transferred to Abassiya Fever Hospital for treatment with Tamiflu and his condition, Shahin said, is stable. El-Daramalli's family members are being tested to see whether any have contracted the virus. El-Daramalli's positive diagnosis brought the number of people in Egypt infected with the deadly virus strain to 37, of which 15 have been fatal. Last month, a 10-year-old girl died from bird flu. Another, four-year-old girl from Sohag was infected with H5N1 but survived. According to a World Health Organisation (WHO) report, some countries which suffer from the deadly strain of bird flu virus are ill-prepared to tackle an outbreak because of poor resources and public apathy. Some countries, including Malaysia, have begun programmes to become self-reliant and to cut dependence on Western supplies. But officials state that the wide economic disparity among these nations, which range from wealthy oil-rich Gulf states to some of the world's poorest countries, could undermine the ambitions of such countries to jointly combat bird flu. "There is great disparity between countries," Hassan El-Bushra, a WHO official, said. "Some countries can do a lot but others are really in need." Indonesia, Egypt and Turkey are already among the worst-hit countries. According to WHO data, there have been 190 deaths globally from the H5N1 bird flu virus since late 2003, and 312 known infections. Indonesia has recorded 79 human deaths from bird flu, the world's highest. Egypt has registered 15, and Turkey four. Egypt was ranked third with regard to Avian Flu cases and fifth in fatality cases among countries infected with bird flu virus. "This is an excellent rating because this means the virus is under full control," Shahin said. "If it were not for the Health Ministry's strategy to combat the virus, there could have been more victims." Egypt's geographical location, along major bird migration routes, and the widespread practice of keeping domestic fowl near living quarters have led to it being the hardest-hit country outside of Asia. Since Egypt announced its first human death from bird flu, several precautionary measures have been adopted by the government to limit and if possible prevent the spread of the virus. The most recent was an Egyptian-French protocol to conduct joint research to produce a bird flu vaccine, an alternative to Tamiflu. But the infection of several persons this summer shows the gravity of the situation, the danger of which will not recede as long as poultry is found in rural homes. Consequently, some observers are calling for new strategies to be drawn up by the Supreme National Committee Combating Bird Flu. But adds Shahin, "nothing will change with the set strategy during the summer because everything is under control." Still, for all his optimism, "experts expect a stronger strain will hit Egypt hard in the winter," Shahin warned. Shahin links the emergence of summer cases to the public not complying to the letter with instructions given by specialists. The Ministry of Health and Population (MOHP) will continue with its current strategy and will in fact introduce a new one. According to Shahin, the MOHP will organise intensive campaigns beginning in early September to increase awareness among rural people about the dangers of H5N1. The MOHP has asked the popular singer Shaaban Abdel-Rahim and actress Inaam Salousa to be part of the campaign which will be broadcast on TV and radio. The MOHP will also place messages on billboards and on the relatively new tok toks, the three-wheel mode of cheap transport. Poultry bred in rural areas accounts for only 15 per cent of the overall number of birds in the country. Although the percentage is small, it could nevertheless pose a serious threat to human health. Mohamed El-Shafei, vice- head of the Egyptian Poultry Union, said that although the poultry market in Upper Egypt was not big, the virus recently appeared there as a result of bird smuggling between governorates. The bird flu virus has turned out to be resistant to high temperatures. El-Shafei said that while the virus can resist high temperatures, well boiled chicken is safe to eat. "There is a difference between high temperature and direct heat. The virus dies at 70 degrees centigrade and water boils at 100, so it is 100 per cent safe to eat," El-Shafei said. Mona Mehrez, head of the Central Laboratory for Poultry Monitoring at the Ministry of Agriculture and Land Reclamation, said an all-out campaign has been launched to vaccinate household poultry against bird flu to control the disease and protect people but added that the public was not responding positively to the effort. "NGOs and volunteers should help the government in its mission," Mehrez said. "It will not be able to do everything alone. There should be some help." While the government says it is conducting a vigorous campaign to combat the spread of the virus through vaccinations and raising awareness, cases continue to appear. Since the outbreak of H5N1 in Upper Egypt, more than 6,500 poultry have been culled.
