DUBAI, 29 November 2007 (IRIN) - Most countries in the Middle East, especially those bordering Saudi Arabia, have taken measures to prevent bird flu after an outbreak of the disease there in early November.

About four million birds have been culled in Saudi Arabia since 12 November, according to the Ministry of Agriculture.

A Saudi Health Ministry official confirmed that there were no suspected cases of bird flu among humans in the kingdom but people who had had direct contact with infected birds were being tested.

"This is part of the precautionary measures taken by the ministry when new cases are confirmed among birds," Khaled Marghlani, a senior Health Ministry spokesman told IRIN on 28 November. "All farmers or workers who dealt with birds or poultry products in infected locations were tested and all results were negative."

Marghlani said there had been a great change in people"e;s attitudes towards the disease since its first appearance in the kingdom in 2004. "At that time people panicked because they didn"e;t know what the disease was and how to prevent it, which is not the case today." He attributed this to a public awareness campaign by his ministry.

There is particular concern in Saudi Arabia about the outbreak of avian flu because the hajj [pilgrimage] season, which is due to start in December, attracts over two million pilgrims worldwide.

WHO

John Jabbour, a medical consultant for emerging diseases at the World Health Organization (WHO) Regional Office for the Eastern Mediterranean, told IRIN: "All the countries in the area have started working on national plans to control the outbreak of the disease among birds and prepare for a possible pandemic influenza".

WHO also has technical teams which are evaluating these plans, Jabbour said.

"We also organise visits to medical centres to measure the readiness of the staff and the availability of medicines and laboratory elements," he added.

Egypt

Egypt, the country worst affected by avian flu in the Middle East, has registered 15 human deaths from the disease since it was first detected in 2006.

However, Jabbour said the country"e;s transparency in dealing with the disease was vital in "enabling the different UN organisations like WHO and the Food and Agriculture Organisation (FAO) to provide their services." He said Egypt was at an advanced stage in its national plan to counter avian flu and was also working with WHO on producing vaccines locally.

Jamal Suleiman, a Health Ministry spokesman, said Egypt"e;s preparedness had improved significantly compared to early 2006.

Suleiman told IRIN: "Today the Ministry of Environment is regularly monitoring migrating birds while the Ministry of Agriculture is continuing its vaccination programmes for domestically reared poultry. Medicines and medical equipment had also been made available to all hospitals and medical centres across the country".

"The media campaigns launched by the ministry across the country have made people more aware of the dangers of raising poultry at home," he said.

Iraq

The WHO Iraq office, which operates from Amman, has experts ready to go in as soon as an emergency occurs, said Jabbour.

Mohammed Jassim of the Iraqi Health Ministry said the ministry had set up an operational centre, which includes representatives from other ministries, to monitor any bird flu-related developments.

"We have printed thousands of health posters to be distributed to ordinary people through governmental and non-governmental parties," Jassim added.

Jordan

Jordan stopped importing fresh chickens and poultry products from Saudi Arabia and the UK after outbreaks of the disease in the two countries, Ministry spokesman Mohammad Najdawi said on 25 November.

The Royal Society for the Conservation of Nature (RSCN) has reportedly been monitoring sites at Jordan Valley and the country"e;s dams to detect the disease.

"The society is carrying out tests on dead birds, especially migratory birds from Europe that pass through Jordan to Africa," RSCN Director-General Yahya Khalid was quoted by a local paper as saying.

Nasser Hawamdeh, assistant secretary-general of animal affairs at the Ministry of Agriculture, told IRIN: "We have started field monitoring and are sending technical staff to farms, areas where poultry is reared domestically, areas of migrating bird flocks and poultry shops, to obtain field samples for inspection at our laboratories".

Jordan does not import large amounts of poultry since the country depends on local production, but it is on the path of millions of migrating birds between September and April.

Jordan"e;s Health Ministry laboratories are ready to examine suspected samples with the H5N1 virus, said Adel Bilbeisi, a Health Ministry official. He said the ministry had also intensified the monitoring of diseases in hospitals and medical centres, and doctors and nurses had been trained on how to deal with patients suspected of being infected with bird flu.

"The Ministry has a sufficient supply of Tamiflu - around three million capsules - in addition to 100kg of instant powder that can be consumed as a drink for children, and sufficient protective equipment such as respirators, gloves," Bilbeisi added.

Health authorities reported in early 2007 four cases of the deadly H5N1 virus in Ajloun, 80km north of Amman among domestically reared turkeys, prompting the authorities to cull 50,000 birds in that area.

The first human infected with the virus was reported in the kingdom in April when an Egyptian expatriate reportedly contracted the virus in Egypt before arriving in the kingdom. He was treated and released from hospital a few days later.

Lebanon

The WHO continues to report no confirmed cases of the H5N1 virus in Lebanon. Initial bans on hunting and a cut of 50 percent in poultry production from early 2006 have now been lifted.

Sales of poultry have bounced back to normal levels after dropping some 80 percent early in 2006 on news that bird flu had spread to neighbouring countries. Vehicle disinfectant dips on the main road running between Lebanon and Syria have now been removed.

A workshop in February 2006 at the Beirut Government University Hospital involving the Ministry of Public Health (MOPH) and the WHO built on a ministerial decree that established an avian influenza unit inside the MOPH.

Nada Ghosn, head of the Epidemiology and Surveillance Unit at the MOPH, discussed reporting mechanisms in case of a bird flu outbreak, explaining the roles of clinicians, MOPH officers, MOPH coordinators, patient transport services, designated hospitals, the national reference laboratory, and epidemiological surveillance units. The workshop also dealt with the role of first responders, such as the Red Cross or the Civil Defence.

The WHO says Lebanon remains at risk from avian influenza as it is a stopover point for migratory birds, has poor controls in place regarding the hunting of birds, and imports live poultry. Some farmers remain poorly informed of the risks, despite a widespread public awareness campaign launched early last year.

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