Egypt's ham-fisted, pigheaded ploy leads to riots

In Egypt today, Coptic Christian shantytown residents rioted over government attempts to slaughter all pigs in the country.  The government's action was ostensibly undertaken as an attempt to prevent the introduction of the H1N1 swine flu virus into the country.  However, as the story linked above (from the Telegraph) says: 

"The Egyptian authorities have admitted since ordering the slaughter last week that it was mainly a pretext for carrying out a reorganisation of the country's pig farms, which are used to supply the country's Coptic Christians, ten per cent of the population." 

The goal, apparently, is to ensure that pigs in the country are no longer raised in small, "unhygienic" holdings, for instance by trash collectors who feed their hogs with the trash they collect.

A story by Reuters opines that:

"...culling swine, largely viewed as unclean in Muslim Egypt, could help quell any public panic in the most populous Arab country."

So far, the only known case of this H1N1 Swine Flu strain actually being found in pigs occurred in Alberta Canada when a farmworker who had recently visited Mexico passed the virus on to his porcine charges.  That's right, human-to-swine spread, not swine-to-human.  (The pigs are all expected to recover, by the way.)  

There have been no cases of the disease identified in Egyptian swine (or any other beyond that one farm in Alberta).  There is certainly no epidemiological justification for slaughtering an entire nation of uninfected pigs.  

Both the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) have issued statements condemning the action, but Egypt is clearly not as interested in the science of the situation as they are in the propaganda value of being seen to do something (especially if that something only hurts a powerless minority group).

So far, the only Swine Flu-associated casualties in Egypt aren't cases of the disease, but 13 to 15+ civilians and police who have been injured in the rioting.  Let's hope it gets no worse. 

Too soon to say

Suddenly, stories like this one abound, implying that the outbreak of H1N1 Swine Flu may not be such a big deal after all.

Of course, we all hope it turns out not to be a big deal, but as they finally got around to mentioning in paragraph 5 of the new article, it's "...too soon to be certain what the swine flu virus will do."

We are so early in this outbreak that we really don't know much about the epidemiology of this virus at all.  

• How many people have the disease?
• How many people have died?
• How readily is it transmitted from person to person?  
• What risk factors are there for infection (does it spread well among people crammed into the same airplane for several hours, but poorly in more open settings; are smokers or the elderly or some other group more likely to catch it)?  
• How lethal is the virus to those who catch it?  
• Who is most at risk of severe disease?
• When it does kill people, is it the flu infection itself (primary viral pneumonia) that causes death or is it secondary bacterial pneumonia that moves in after the flu virus is gone?
  

And it will be awhile before we have many of the answers.  In the UK, they are waiting for the results of more than 600 tests for the virus.  Mexico has a backlog of over 35,000 samples waiting to be tested, and their total number of confirmed cases shot up by nearly 250 overnight to 397 as a result of additional testing (not necessarily correlated to any new cases).  In the US, it's taking 4 days to get test results, which -with a virus that has only a 24 to 96-hour incubation period- means that our picture of confirmed cases here at home is far behind the times, as well.

And all that only goes to the epidemiological situation now.  The situation is likely to change over time, as the virus mutates.  In the case of the 1918 Pandemic, for instance, the first wave of infections spread around the world in the spring, and it was pretty mild.  It wasn't until the fall, when the next wave of infections struck, that the virus became so frighteningly lethal.

So I'm very pleased that the CDC, the Department of Health and Human Services, and the Department of Homeland Security are all continuing to take the situation very seriously and are doing an excellent job of letting the public know what we do and don't know.  

Dr. Besser, Acting Director of the CDC, has done a particularly good job of communicating the expectation that the government's response, the guidance to the public and the guidance to healthcare professionals will all continue to change as the situation evolves --and that that's a good thing.