Precautions to take against H1N1

The World Health Organisation has brought out some practical and reasonable guidelines to try and prevent falling prey to the virus at http://www.who.int/csr/disease/swineflu/frequently_asked_questions/what/en/index.html

What can I do?

Updated 11 June 2009

What can I do to protect myself from catching influenza A(H1N1)?

The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms (trying to maintain a distance of about 1 metre if possible) and taking the following measures:

• avoid touching your mouth and nose;
• clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);
• avoid close contact with people who might be ill;
• reduce the time spent in crowded settings if possible;
• improve airflow in your living space by opening windows;
• practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.

What about using a mask? What does WHO recommend?

If you are not sick you do not have to wear a mask.

If you are caring for a sick person, you can wear a mask when you are in close contact with the ill person and dispose of it immediately after contact, and cleanse your hands thoroughly afterwards.

When and how to use a mask?

If you are sick and must travel or be around others, cover your mouth and nose.

Using a mask correctly in all situations is essential. Incorrect use actually increases the chance of spreading infection.

How do I know if I have influenza A(H1N1)?

You will not be able to tell the difference between seasonal flu and influenza A(H1N1) without medical help. Typical symptoms to watch for are similar to seasonal viruses and include fever, cough, headache, body aches, sore throat and runny nose. Only your medical practitioner and local health authority can confirm a case of influenza A(H1N1).

What should I do if I think I have the illness?

If you feel unwell, have high fever, cough or sore throat:

• stay at home and keep away from work, school or crowds;
• rest and take plenty of fluids;
• cover your nose and mouth when coughing and sneezing and, if using tissues, make sure you dispose of them carefully. Clean your hands immediately after with soap and water or cleanse them with an alcohol-based hand rub;
• if you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook of your elbow;
• use a mask to help you contain the spread of droplets when you are around others, but be sure to do so correctly;
• inform family and friends about your illness and try to avoid contact with other people;
• If possible, contact a health professional before traveling to a health facility to discuss whether a medical examination is necessary.

Should I take an antiviral now just in case I catch the new virus?

No. You should only take an antiviral, such as oseltamivir or zanamivir, if your health care provider advises you to do so. Individuals should not buy medicines to prevent or fight this new influenza without a prescription, and they should exercise caution in buying antivirals over the Internet.

Warning on purchase of antivirals without a prescription [pdf 35kb]

What about breastfeeding? Should I stop if I am ill?

No, not unless your health care provider advises it. Studies on other influenza infections show that breastfeeding is most likely protective for babies - it passes on helpful maternal immunities and lowers the risk of respiratory disease. Breastfeeding provides the best overall nutrition for babies and increases their defense factors to fight illness.

When should someone seek medical care?

A person should seek medical care if they experience shortness of breath or difficulty breathing, or if a fever continues more than three days. For parents with a young child who is ill, seek medical care if a child has fast or labored breathing, continuing fever or convulsions (seizures).

Supportive care at home - resting, drinking plenty of fluids and using a pain reliever for aches - is adequate for recovery in most cases. (A non-aspirin pain reliever should be used by children and young adults because of the risk of Reye's syndrome.)

Should I go to work if I have the flu but am feeling OK?

No. Whether you have influenza A(H1N1) or a seasonal influenza, you should stay home and away from work through the duration of your symptoms. This is a precaution that can protect your work colleagues and others.

Can I travel?

If you are feeling unwell or have symptoms of influenza, you should not travel. If you have any doubts about your health, you should check with your health care provider.

More on WHO travel recommendations

US Embassy Directive on H1N1 Flu in Egypt

Date: June 09, 2009

To: The American Community

From: Embassy of the United States, Cairo

Subject: Warden Message dated June 09, 2009

This Warden Message alerts U.S. citizens to the latest information regarding human cases of 2009-H1N1 Influenza. The Egyptian Ministry of Health has reported eight confirmed cases of H1N1 virus in Egypt. Seven of these cases are students from the American University in Cairo, all resident in AUC's downtown Zamalek dormitory. AUC has suspended classes and campus activities through Sunday morning, June 14, 2009, and all residents of the Zamalek dormitory are currently in quarantine, are being tested, and will remain under observation for one week. Cairo airport has also instituted new health screening procedures and they can be found at http://egypt. usembassy. gov/consular/ pa060809. htm

The Embassy reminds U.S. citizens that most cases of influenza are not 2009-H1N1 Influenza. Any questions or concerns about influenza or other illnesses should be directed to a medical professional. Although the Embassy cannot provide medical advice or provide medical services to the public, a list of hospitals and doctors can be found on our website at http://egypt. usembassy. gov.

For further information about 2009-H1N1 Influenza, including steps you can take to stay healthy, please consult the Department of State information at http://travel. state.gov/ travel/cis_ pa_tw/pa/ pa_pandemic. html, the U.S. Centers for Disease Control website at http://www.cdc. gov/h1n1flu/ , the U.S. Government pandemic influenza website at http://www.pandemicflu.gov, and the World Health Organization website at http://www.who. int/csr/disease/ swineflu/ en/index. html. For additional travel safety information, please consult the State Department's website at http://www.travel. state.gov.

2 More H1N1 cases detected in Alexandria

Supposedly 2 more people in Alexandria have tested positive for the H1N1 virus.

This is the link to the story in Arabic:
http://www.youm7.com/News.asp?NewsID=106984

and the English translation?
http://soberhigh.wordpress.com/2009/06/10/1252-10-h1n1/

5 more H1N1 cases at AUC dorm

After 2 students at AUC dorm in Zamalek were diagnosed with H1N1, all the students at the dorm were quarantined and checked for the virus.

5 new cases have been identified as stated in the Straits Times. The nationalities of these students hasn't been identified.

Maybe now is the time to start talking serious preventive measures. Like washing hands with soap and water and maintaining basic hygience.

H1N1 virus detected in 2 students at AUC Zamalek Dorm

Looks like the virus has entered the city, inspite of the thermal imaging and masks and gloves at the airport & the extermination of pigs. See H1N1 for reference.

2 American AUC Students were found to be infected and the whole dorm of 140 students has been put under quarantine. Reuters broke the story earlier today. Classes on the campus seem to have been suspended for a week.

This email was circulated to the students of AUC earlier this morning. (I have removed the email addresses to prevent them from being spammed by harvesters)

From: Brian MacDougall
Date: Mon, Jun 8, 2009 at 8:27 AM
Subject: H1N1 Flu
To:

Please be advised that overnight the Egyptian Ministry of Health confirmed positive H1N1 test results for two AUC students. These two students have been hospitalized and are receiving the necessary medical treatment. A third student was also hospitalized as a cautionary measure because she had a high fever, which is symptomatic of this flu.

These students are all residents of the Zamalek dormitory and as a result the dormitory has been quarantined for 24 hours. The Ministry of Health has obtained samples from all residents of the dormitory and those results are expected later today.

AUC's medical clinic is working closely with the Egyptian Miistry of Health to effectively manage this testing process and to provide the necessary care for all of our students.

This is all of the information available at this time; as we receive further information, it will be shared immediately with the AUC community.

--
Brian MacDougall
VP for Planning and Administration
The American University in Cairo
AUC Avenue, PO Box 74
New Cairo 11835, Egypt
Office Tel: +20-2-2615-2212

Egypt Reports 1st case of swine flu

A young girl with American Citizenship of Egyptian origin was coming from America to Egypt on holiday on Monday, on a flight from Europe.

Health Minister Hatem el-Gabali said she showed flu symptoms and tested positive for the virus and is being treated. He said she is in good condition.

Read the news here:
Voice of America News

in Arabic - Masrawy

An earlier news report had said that Egypt had suspected 101 cases of H1N1 and 100 had tested negative. At the time of the report, the 101st person was being quarantined and tested.

Looks like those Thermal Scanning cameras at the airport worked, but the culling of pigs seems to have surprisingly not had any effect in scaring the virus away from entering the country.

Latest update on Quarantine at Cairo Airport

Flew in this morning from Dubai. Had heard a few stories of the nurses at the Cairo airport, most of them uncomplimentary. Was completely prepared to give them a earfull - Egyptian style - if they decided to thrust a reused thermometer in my ear, wiped with the same swab of cotton over the day.

They were a lot less nurses swarming around, than when I returned to Cairo at the beginning of the month. They seemed to be better organised. I didn't see signs of a thermometer, but there were 2 video cameras which passengers had to file in front of. Some passengers were made to show their side profiles, chin up-chin down the type of mug shots you see taken in Hollywood before seomeone is thrown into jail. How these passengers were singled out, I have no clue.

I did what I normally do in Egypt, ignore everyone and walk past them, unless they are authority figures who try really hard to get your attention for a seemingly relevant reason ("I want to marry you", "are you married?" does not count)

Some of the Immigration officials who were walking around, among the queued up public had masks on, but the latex gloves were no longer visible.

So that's the status today at 7:30am.

Have a pic of the video sessions, will try & upload that, once I download it off my phone.

Horrific Expereince of a British family visitng Sharm el Sheikh on Holiday

From The Electric New Paper

Treat this as a cautionary tale, but hope for the best, if you plan to travel into Egypt shortly, especially if you have a Mexico stamp in your passport.

THEY expected a great family holiday in Egypt - and encountered fear instead.
14 May 2009

THEY expected a great family holiday in Egypt - and encountered fear instead.

British engineer Stewart Harbut, his pregnant wife Sasha and their four young children, aged between 2 and 8, had a hellish time when armed guards held them in quarantine.

They claim Egyptian guards, in what was seen as an act of panic in the midst of a possible Influenza A (H1N1) virus outbreak, 'pinned them down' at the country's Sharm El Sheikh International Hospital while doctors forced them to give swabs.

Mr Harbut, 37, told Sky News Online that his family spent £6,000 ($13,400) on their holiday.

But as soon as he and his family arrived at Sharm El Shiek airport, their holiday was anything but enjoyable.

He said: 'We were queuing up with the rest of the holidaymakers, looking forward to the break. All of a sudden, we were surrounded by armed guards and police. There must have been about 30.

'All the kids were crying, my wife was crying and I could not believe it. It felt like something out of a drug-smuggling film.'

Guns

Mr Harbut said he and his family saw guns trained on them as they were bundled into the back of a van and sent to the hospital with a police escort.

He thought his family was singled out because their passports showed they had visited Mexico six months ago.

Mr Harbut said he was promised that he and his family would be released in a few hours, but instead, they were held in a dusty room with just five beds.

He said: 'The kids were pinned down and instruments were put down their throats. The Egyptians were in a complete panic.'

When he tried to leave the hospital, he was confronted by three armed guards who blocked his way.

He said: 'There was absolutely no way out - there were large iron gates slammed shut at the front of the hospital and as I walked towards them, three armed guards came towards me holding their guns.'

The Harbuts were only allowed to leave the hospital yesterday after all of the tests were confirmed as negative, nearly 24 hours after landing in Egypt.

Speaking from their Red Sea resort hotel after his release, Mr Harbut said he had been treated like a drug smuggler.

He said: 'This was absolute hell. We're just hoping that the kids aren't too traumatised.'

Mr Harbut wanted to warn travellers about the current level of panic over the H1N1 virus in the country.

Screening at Egypt Airports - Advisory from Danish Embassy

Thanks "S" for forwarding this info.

Dear Colleague

I obtained the following information from a variety of sources, Ministry of Health, all UK Honorary Consul's (apart from Alexandria) and the MFA and would be grateful if you could pass to all EU colleagues. Their input and experiences would be useful if they have any additional information they can share with us all.

The Ministry of Health are still confirming no reported cases in Egypt of the H1N1 virus

Airport Screening:- Currently in place at Cairo, Hurghada, Luxor, Sharm El Sheikh and Taba airports

Full medical screening is aimed specifically at those fliights arriving in Egypt from countries that have confirmed/suspected cases of the virus. As well as this, passenger passports are checked on all international flights coming in and those passengers with Mexican stamps in their passports are subject to this screening.

The screening process and the make up of the medical teams should be identical for each airport. These consist of at least 5 doctors, 2 nurses and one medical technician per team.

All passengers arriving are processed by currently having a temperature check by use of a thermometer in the ear to gauge the temperature. Disposable tips for the thermometers are not being effectively employed. The same tip being used for a number of passengers then changed. The Ministry of Health were reluctant to confirm that this was the case and said that there was one tip for each passenger tested - however, on the ground evidence from tour operators in Sharm contradict this statement, the same tips being used on multiple passengers.

However, it is important to note that at Luxor airport for instance - full screening is not being carried out and thermometers are not being used. They have doctors present for international arrivals but their intervention is negligible. Sharm also reports that some of the flights checked appear to be on a random basis. Therefore the medical screening is not consistent and seems to differ from airport to airport despite the guidelines detailed by the Ministry of Health.

To date, no thermal imagers/scanners have been installed at any of the airports.

The benchmark temperature is 38 degrees - anyone showing a temperature above this, is taken to an isolation room at the airport and from there they are transported to the nearest isolation facility where swabs are taken. For airports outside Cairo - all swabs are flown to Cairo for testing. The isolation centre for each airport is as follows:

Cairo: Al-Matar Mental Health Hospital located in the Heliopolis district of Cairo which is the closest medical facilty to Cairo International airport.

Sharm El Sheikh: Sharm International Hospital - a number of rooms at this facility have been set aside as an isolation area

Luxor: Luxor International Hospital - the nearest large hospital with adequate facilities to the airport

Hurghada: Hurghada International Hospital
Alexandria: Not known at this time
Taba: Taba Hospital

Period of quarantine is unknown and each case (if they do confirm one) will be dealt with in line with WHO guidelines on treatment.

I can confirm that the major UK tour companies flying into Egypt are advising clients of medical screening procedures at airports via their websites. They are also advising passengers of this before leaving the UK and on the aircraft whilst enroute.

It may be a good idea if colleagues from countries who do have suspected/confirmed cases perhaps advise their tour operators to do the same.

Regards

Jim Warren

Latest news on Swine Flu scenario in Egypt

Saw this in the Al Ahram Weekly:

Quite an interesting article

Read the article here

Swine Flu Quarantine for Travellers into Egypt?

There have been some rumors in some parts of the world about Travelers into Egypt being Quarantined. Today I received the same question from 3 different people. Is Egypt quarantining Air travelers and for how long? Since this may be a question that others would like an answer to as well, I am posting it on my blog.

The question of quarantine in Egypt may have arisen, from articles such as this one.

1. From My Personal Experience - 4 May 09:
I flew back to Egypt on the 4th of May from Lebanon. There were about 40 women in masks and gloves standing at the entry into the terminal building when we got off the shuttle bus. They had clipboards in hand. From the bus it looked to us like the terminal was full and it would take forever to complete Immigration. But it was just these women standing around that gave the impression of a huge crowd.

All the passengers walked past these women and went straight to the Immigration desks. The Women did not stop anyone.

The Immigration officials were wearing latex gloves and that was the extent of the precautions that we saw at the Cairo airport.

2. My Husbands Experience - 10 May 09:
My Husband returned from Istanbul, Turkey today. He said that there was a similar crowd of masked women at the terminal building. They seemed to have paired themselves in two's and were asking for passenger passports. My husband handed over his passport to them. The two women did a lot of giggling as they flipped through his passport and then they let him move on to Immigration. He did not fathom what they were looking for. I sincerely hope that they were perhaps looking for proof that the passenger had not passed through Mexico or other badly affected countries, recently.

The Immigration officials were no longer wearing latex gloves.

We both have Resident Visas for Cairo and have been living here for almost 3 years. But we frequently travel in and out of the country.

3. I heard from someone who arrived on the 8th of May 09, that he was asked to fill a form with Name, Address in Egypt and Nationality. Thermometer strips were then used (and reused) to take the passengers temperatures before letting them through.

I have not yet heard of any person being quarantined for the virus, so I would say that it is still safe to travel into Cairo without fear of enforced bed rest at a hospital.

I will keep you informed if any new information comes up that is significant to this issue.

Added on 13 May 09:
International SOS reports:
The government has ordered a psychiatric hospital near Cairo International Airport (CAI) to be converted into a quarantine centre for passengers suspected of infection.

Swine Flu and its Effects in Egypt

Fact : Swine Flu is now being called Influenza A (H1N1)

Fact : “We don’t see any evidence that anyone is getting infected from pigs,” said Dr. Keiji Fukuda, the World Health Organization’s assistant director general. “This appears to be a virus which is moving from person to person.”

Fact : Pork has disappeared off the menu's of the few restaurants in Cairo that did serve it.

Fact : There were about 40 masked (not veiled, but masked) women to receive us at the entry from the shuttle bus to the actual terminal in Cairo Airport, when we landed 3 days ago, all holding very fancy looking official clipboards. Every single passenger just walked past them and they did not stop a single person.

Fact : The immigration Officials at Cairo airport are all wearing Latex Gloves.

Some stories from across the press world on how Swine Flu is being handled in Egypt and reactions.
New York Times
IRIN Middle East
MSNBC
BBC
Yahoo News