Egyptian Swine Flu Polices Under Scrutiny



28 September 2009

A CDC Image of H1N1 influenza virus
A CDC Image of H1N1 influenza virus
With the global concern over the H1N1 swine flu virus rising, some tourists are finding themselves inside a quarantine cell as their
first sightseeing experience. Egypt is attempting to curb the virus with strict measures, but its policies and quarantine system
have some questioning their efficiency.


With about 900 confirmed cases of swine flu, the Egyptian government has taken a number of controversial steps to fight the spread of the virus, including the closure of all schools until October 3.

Last month, the government banned elderly Egyptians and those younger than 25 from traveling to Mecca, Saudi Arabia for their Umrah or lesser pilgrimage.

Director of the Michigan Center for Public Health Preparedness Dr. JoLynn Montgomery understands the Egyptian government's concern; Cairo is a densely populated city of about 20 million and millions of pilgrims from around the world travel to Mecca.

"Certainly time in very crowded areas will result in cases of influenza right now," Dr. Montgomery. "I do know that Mecca is a big calling and a big issue and not being allowed to go is obviously a big issue for them [Muslims], but those locations have proved to be a big opportunity for spreading disease."

But some health experts and organizations like the World Health Organization have not always viewed Egyptian government measures as reasonable.

Earlier this year, the government ordered the killing of all pigs in Egypt despite WHO officials calling it a misguided attempt to
combat the H1N1 virus.

Then in June, the Egyptian government quarantined about 150 people residing in an American University of Cairo dormitory for a week after two students tested positive for the virus.

In Egypt, the policy is to quarantine those suspected of having swine flu. And as this reporter experienced firsthand, anyone is a suspect.

Out of the approximately 250 passengers aboard a recent flight from New York, I was the one person ushered to the side while an airport employee handed me a disposable thermometer.

They told me I had a fever and would have to wear a white hospital mask. Feeling completely healthy, this was definitely not the warm welcome to Egypt I had in mind.

A young woman wearing a headscarf and oversized sunglasses introduced herself as Dr. Germine. She said I would have to go to a hospital where they would "investigate" if I had swine flu. With my navy blue American passport between her fingers, there seemed to be not much of a choice.

The American Embassy, like many others, cannot directly intervene if a private citizen is held upon arrival in a foreign country.

But chief of American Citizens Services in Cairo Yolanda Parra says citizens do have rights.

"If you find yourself in a situation that you're not comfortable with or you have questions about definitely reach out to your embassy right away," said Yolanda Parra. "You can ask anyone at that medical facility that you please want to speak to your embassy and they will comply."

At the hospital, Dr. Germine announced that I would have to pay $300 for a throat swab test and 24-hour observation.

I refused to pay. The charge then dropped to $100 and I refused again. After a call to the American embassy, the charge was dropped.

Parra says that it is not standard procedure for governments to charge those quarantined but it can depend on the procedure.

"Each case is different," she said. "We on your behalf make sure that the payments that they're asking for are valid but in that particular case we investigated and the person didn't have to pay anything."

The quarantine area where the throat swab test was processed was, surprisingly, filled with energy. Muffled voices of children carried across the courtyard as they played soccer with surgical masks on. But with a closer look, it was clear many patients were
coughing and moving sluggishly nearby.

People apparently infected with H1N1 interacted with those under observation.

The WHO does not recommend the mixing of those infected and those under observation. It says it's critical for national authorities to distance patients and avoid crowding.

Dr. Montgomery says it's the government's responsibility to uphold these quarantine standards.

"Whether it's mandatory or not, they're playing a role in protecting the rest of us by doing that and so there should be respect and care given to people who are in those situations," said Dr. Montgomery.

Numerous requests for comment from the Egyptian Ministry of Health were not answered.

The Ministry of Health has recently announced that when schools re-open in October, they will be equipped with quarantine rooms.