JEDDAH, 3 October 2005 — As Saudi Arabia prepares to welcome Muslims from around the world who want to spend Ramadan in the holy cities and then the millions who come for Haj, concerns are high about the possible arrival of bird flu in the Kingdom. Many of those who come for Umrah and Haj are from areas in Asia where the virus has spread among humans with deadly effect.
“So far the infection has only been transmitted from birds to humans and not from humans to humans; the fear is that a mutation in the virus might occur which would allow the virus to be transmitted from one human to another,” said Dr. Nashaat Hamza, a consultant in infectious diseases at a government hospital.
Bird flu is an infection caused by avian influenza viruses. The viruses occur naturally but only among wild birds; they are very contagious and can kill domestic birds such as chickens, ducks and turkeys. The good news is there are no documented cases of human-to-human transmission so far according to the most recent medical reports.
Because all influenza viruses have the ability to change or mutate, scientists are concerned that the virus will one day infect humans and spread easily from one to another. That would constitute a medical disaster since the influenza would be highly contagious and there is little or no protection for humans. Based on these assumptions, the UN coordinator for avian influenza, David Nabarro, recently raised the alarm of a possible flu pandemic that might kill between 5 million and 150 million people worldwide. Efforts aimed at developing a vaccine are under way.
Meanwhile, many countries around the world, especially the US and UK, are stockpiling two medications commonly used for influenza, Tamiflu and Relenza, that can help in providing some protection. “However, the drugs have only been demonstrated in the lab but not on humans,” said Dr. Hamza.
The key issue for pandemic preparedness is informing the public ahead of time, ensuring that panic does not occur and adhering to general infection control precautions. Possible symptoms include typical flu-like ones — fever, cough, sore throat and muscle aches — as well as eye infections, lung infections and other complications.
Currently there is no documentation of infected birds in the Middle East. The Saudi Ministry of Agriculture has announced an emergency plan for preventing the spread of the bird flu virus here. Dr. Fahad Balghunaim, minister of agriculture, said that his ministry was liaising with the World Animal Health Organization and as soon as a country is confirmed to have the virus, the ministry issues an immediate ban on imports from it.
The plan also consists of regular surveys of poultry farms and checking migratory birds. If a case is confirmed, the plan calls for containing the cases in a limited area and destroying the infected birds and others in contact with them as well as quarantining the area.
The ministry also discussed the problem with specialists in the Ministry of Health, Ministry of Municipal and Rural Affairs and the National Wild Life Protection Commission as well as concerned specialists in the private sector, the poultry sector, universities and others. A circular has been sent to all the Ministry of Agriculture’s departments and branches urging them to increase supervision activities of poultry projects and provide regular reports.
Dr. Amin Mishkhas, general director of infectious disease department at Ministry of Health, said that the first goal is to prevent the entry of infected birds to the Kingdom and that the Ministry of Agriculture and Ministry of Commerce have already banned live and frozen poultry from countries with infected birds.
He continued, “The second goal — and a more serious worry — is to prevent the spread among humans if a mutation occurs in the virus making human-to-human transmission possible. Today, the spread of an infection is faster than ever due to modern transportation and we are cooperating with all entry points to the Kingdom to check on and vaccinate incoming travelers against influenza. There is no vaccine at present but some antiviral medications used for common influenza are helpful and we are planning to inoculate those most susceptible to the virus, including health sector employees and Haj personnel in the private and public sector. Each country, including Saudi Arabia, is planning and stockpiling antiviral medications.”
