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Bird flu blamed in Egypt child's death

Six-year-old Ali died last week, and health workers don't know the source of his disease. Bird flu has been blamed in the deaths of 26 people in Egypt since 2006, the most of any nation outside Asia.

April 30, 2009|Jeffrey Fleishman

CAIRO — Beyond smokestacks and whipped donkeys, past fish curled on dirty ice and sparrows skimming laundry hanging in alleys, the death of 6-year-old Ali Mohammed Ali brought mystery, health inspectors and truckloads of police to a poor Cairo neighborhood.

Ali, a first-grader and computer wizard from Shubra el Kheima, died last week in a hospital, his lungs full of fluid, a stent in his chest. Health officials say he had bird flu, but they can't pinpoint where he picked it up: The market, the school, on the rooftops with the pigeon keepers or on a recent trip to his grandfather's village in the Nile Delta?

Nobody knows. Homes and classrooms have been disinfected, neighborhood poultry has been confiscated and culled, and the man splitting chicken breasts with a machete next to the baker keeps watch for police in case he has to disappear in a hurry. There is alarm and nonchalance, talk of a health epidemic, grumbles of conspiracy.

"The Health Ministry came. They checked our flat, they took our blood. They tested everyone in this building for infection," said Ali's mother, Aleya Ismail. "But still they don't know how it got into my son. Where can I raise poultry here? Under the bed? How could this virus have found him?"

Egypt has had 65 cases of bird flu, including 26 deaths, since 2006 -- the highest national toll outside Asia, where the virus, designated as H5N1, was believed to have first appeared in humans in 1997.

Ali's fever and final hours in an intensive care unit came days before word came of the swine flu outbreak that is suspected in the deaths of more than 150 people in Mexico and has spread in the United States and into Europe and the Middle East. Egypt has ordered the slaughter of the nation's 300,000 pigs.

Bird flu, which has killed hundreds of people worldwide in the last dozen years, threatens to be a pandemic but has yet to reach that critical stage, though it has become embedded in bird flocks and spread to dozens of nations. Arising mainly from direct contact with infected fowl, bird flu lingers at the edge of the swine flu crisis, another deadly squiggle of cells and strands beneath the microscope.

The World Health Organization is concerned that, like swine flu, the avian virus could mutate and become easily transmissible between humans. Scientists fear that if this happens the avian virus could be more dangerous than the swine flu outbreak, overwhelming cities such as Cairo, where overcrowding, poor sanitation, suspicion and cultural traditions are more potent than Tamiflu prescriptions and warnings spoken through the masks of health workers.

Shubra el Kheima unfolds where the Nile ripples through marsh grass as it flows north out of Cairo toward the delta. Apartment buildings of brick, dried mud and mortar heave against one another, keeping daylight out of the alleys until the sun is at its highest. The market blows with garbage, flies whirl, donkeys chew grass off carts, and cats slip past coal bins and into the butchers.

Most families, like Ali's, arrived decades ago from villages. They were electricians, laborers, seamstresses. They hauled country life to the city; their sons and daughters raise chickens and race pigeons, and when they don't know the exact address of a friend or cousin they yell names through alleys and are guided by fingers pointing this way and that. Anyone passing a corner can sip water from clay jugs, known as ollas, a communal drinking habit since ancient times.

God moves them; the loudspeakers at the mosque crackle with his name. They are suspicious of police and anything that bears a government stamp or imprint of officialdom. They have rocked one another's babies, buried one another's dead and finished one another's sentences. And now they can't believe that Ali, a boy they knew, is gone, taken by a virus whose name is two capital letters and two numbers.

"The police have seized the chickens from the market," said Hayem Mohammed, a heavyset woman with gold looped earrings and an aluminum cane. "Why should we be scared? We all believe in God and God's will."

"I'm not convinced it was bird flu," said Alaa Abou Donya, a burly man standing in the shade near a mechanic's shop. "Ali's family used to have pigeons, but they cleaned up their house a year ago. They buried Ali in a normal grave. You wouldn't do this if the boy had been infected."

Down another alley, men sip from ollas, their eyes following a stranger. No one sneaks in here; life and space are too compressed. The alleys open to the wide street. The cabbage man lifts his tarp at the market, green spills into the dust; women sell eggplant and red onions, and fish, long dead, bob in the water of melted ice. A thwack and a tug, bits of chicken tumble from Sayed Mohammed Ahmed's chopping block; cats flock to his feet.

"I only sell farm-raised chickens," he said.

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