Protecting the Kingdom of Saudi Arabia from the incidence of avian influenza (Bird Flu), by taking decisive preventive measures meant to prevent the virus (H5N1) from entering into the Kingdom. The plan also takes as its target avoiding human infection, as well as controlling or delaying the pandemic prevalence, aside from diminishing the disease and death toll, and addressing the social disorder in case of the occurrence of a pandemic, God Forbid!
• Plan Elements:
- Epidemiological surveillance.
- Laboratory surveillance.
- Vaccination.
- Using "Tamiflu" from prevention from avian influenza.
- Health regions' role.
- Health awareness.
- Societal participation.
- Infection control in hospitals.
- Treatment.
- Coordination with the relevant government authorities.
- Non-curative intervention aimed to limit the spread of the disease.
- Requirements.
- Other procedures.
• Plan Elements in Detail:
1) Epidemiological Surveillance:
- Conducting epidemiological surveillance throughout the year.
- Immediately reporting and suspected cases in both governmental and private hospitals (in accordance with the scientific material included, through which suspected and potential cases could be identified) to the health affairs directorate to which the hospital belongs, so as for these cases to be instantly reported to the MOH Communicable Diseases Department.
- Conducting epidemiological surveillance in the nearest hospital, and sending the surveillance form to the health affairs directorate, and then to the Communicable Diseases Department.
- Referring any suspected cases at any of the Kingdom's ports to the nearest MOH hospital.
2) Laboratory Surveillance:
- Three laboratories in the main regions have been assigned for examining samples:
- Central Laboratory, Riyadh
- Regional Laboratory, Jeddah
- Regional Laboratory, Dammam.
- Specialists from these laboratories have been trained in NAMRU-3 laboratories, in coordination with the WHO Regional Office for the Eastern Mediterranean Region
- The needed reagents necessary from laboratory diagnosis have been provided.
3) Human Influenza Vaccination:
At present, there are no specific human vaccines protecting from avian influenza. And underway are relentless efforts seeking to develop and try some of the recently produced vaccines.
It is true that vaccination against human influenza may not protect those vaccinated from Bird Flu infection; yet, it is recommended for the most prone persons to be given this vaccine, to prevent the infection of human influenza simultaneously. This may cause the two viruses to exchange their genetic materials, giving way to the appearance of a new human virus, easy to be transmitted among humans.
Human influenza vaccination is recommended for the following groups:
- Persons in contact with the birds or bird farms proven or suspected to have avian influenza (H5N1), especially those working in the field of culling and eliminating infected birds.
- Persons working in the health field, especially those responsible for treating suspected or confirmed bird flu cases among humans.
- If the vaccine is available in adequate quantities, it will be recommended to vaccinate all workers at the hospitals receiving emergency cases at the regions proven to be hit by avian influenza (H5N1).
This is aside from giving the human influenza vaccine for the other known medical causes of human influenza.
4) Using "Tamiflu" (Oseltamivir) with the cases confirmed to have avian influenza (H5N1).
- Giving the medicine for treatment:
Giving "Oseltamivir" is recommended for treating those suffering from the avian influenza symptoms, after being in contact with infected birds, humans, or laboratory samples.
- Giving the medicine for prevention:
The medicine is recommended for all people in contact with infected birds or humans, especially those working in the field of culling the infected birds. The medicine should be given regularly for prevention until after eliminating these birds, and cleansing the contaminated environment.
5) Health Regions' Role:
Implementing the MOH plan concerning the avian influenza prevention and control.
Participating with early preparations committees in their endeavors to control the disease and implement the MOH plan.
Ascertaining reporting all the suspected cases, recorded in any of the region's health facilities.
Coordinating with the affiliates of the competent authorities (Ministry of Agriculture, and Ministry of Municipal and Rural Affairs) in handling the disease when appearing among birds.
Distributing the scientific material circulated by the Ministry to all the governmental and private health facilities, with the aim to provide doctors with the necessary information on the disease, and immediately reporting any suspected cases.
Setting the health awareness to work, for the purpose of raising citizens' awareness with regard to heading for any of the MOH facilities on the appearance of bird flu symptoms, as well as the ways of prevention.
6) Health Awareness:
Raising the health awareness of all health staff working in all health sectors, both governmental and private; with the aim to immediately report any suspected cases, in addition to the ways of prevention of the disease.
Raising the awareness of the public (both citizens and resident) on the disease, and the ways of prevention.
Making clear to the public that the pandemic, when taking place, is very likely to sweep the whole world, and that the human influenza vaccine is not available in adequate quantities, and that there are no specific vaccine for avian influenza so far, and that the preventive medications given to workers (in the field of health, public services, ports, etc.) is the first line of defense.
It is of pivotal importance to build confidence between citizens and the competent authorities responsible for distributing information on the disease regularly, through a team of proficient experts in this domain.
Precautions recommended for travelers to stricken places:
So far, the WHO has not issued any travel bans to any of the countries affected by (H5N1).
The WHO has not recommended any measures to be applied on those coming from the countries affected by (H5N1).
It is advisable for travelers to see their doctors prior to heading for any of the countries affected by (H5N1). And on arrival, it is advisable to be aware of any health information or instructions concerning the infection, as well as any developments taking place during his stay.
When traveling to any of the countries affected by (H5N1), it is recommended to:
Avoid touching any birds or poultry (either live birds or meat), and keep away from their places.
Keep away from the places with high infection probability, like poultry farms and bird parks.
Avoid touching any of tools of aviculture or poultry transportation or storing, such as bird cages and bird pans.
Avoid eating white meat unless very well cooked (considering the virus does not survive 70° C).
Wash your hands well, using water and soap.
Food Precautions:
It is very unlikely for the virus to be transmitted to humans through well-cooked food; that no infections have been recorded to be caused by eating well-cooked poultry.
The virus (H5N1) is sensitive to temperature, as it dies at 70° C).
Some studies prove that highly pathogenic viruses, including the highly pathogenic avian influenza (HPAI) or (H5N1), affect all the parts of the infected birds, including meat. It is for this reason that following the healthy precautions when preparing food, and cooking it well, reduce the likelihood of infection.
Eggs have to be well cooked, as some studies have proven that the virus could be carried in the egg shells, as well as the inner contents.
7) Societal Participation:
Enlisting the community leaders (such as Islamic clerics and preachers, teachers, etc.) for raising the awareness of citizens and residents.
Reporting any suspected cases (either in humans or birds), as well as dead birds, to the competent authorities, such as the affiliates of the Ministry of Agriculture, or the Health Affairs.
Advising citizens and residents not to hunt wild and birds, and not to touch dead birds, as they are a major source of infection.
8) Treatment:
In case of infection, it will be advisable to:
Treat the symptoms (high temperature, throat pain, etc.)
Use antivirals, which are the main medication so far. They can also be used for prevention by persons with high vulnerability to the virus (workers at poultry farms, laboratories, and those in contact with patients.)
9) Infection Control in Hospitals:
Following are the instructions aiming at infection control in laboratories and hospitals:
Taking the necessary precautionary measures with regard to the respiratory and intestinal secretions.
Using protective facemasks by both the patient and the clinical team.
Assigning an isolated room with negative pressure for the patient.
10) Coordination with the Relevant Government Authorities:
Among the crucial actions to be taken, in addition, is to coordinate with the relevant authorities (such as the Ministry of Agriculture, the Ministry of Commerce and Industry, the Ministry of Municipal and Rural and the Saudi Wildlife Commission), so as to take the necessary measures for preventing the virus from entering into the Kingdom through birds, as well as raising the level of epidemiological surveillance and early detection of the potential sources of the disease.
11) Non-curative Intervention Aimed to Limit the Spread of the Disease, including:
- Closure of schools.
- Prevention of big agglomerations in narrow places.
- Reduction of traveling.
- Quarantining those in contact with H5N1 patient for 7-10 days.
12) Requirements:
A) Current Requirements:
A sum of SR 27 million has been allocated for the provision of the following requirements:
- Human Influenza vaccine: providing a stockpile of the vaccine to be used in emergency cases (such as the Hajj season.)
- Antivirals: providing a stockpile of antivirals, especially Tamiflu (Oseltamivir), either syrup or tablets.
- Reagents: providing a stockpile of reagents to be used when need be.
B) Future Requirements:
It is necessary allocate the following sums, in accordance with the requirements to be mentioned hereafter:
- SR 25 million for the provision of medications.
- SR 10 million for laboratories.
- SR 25 million for the provision of vaccines to be discovered in the future.
- SR 2 million for the provision of personal protective equipment (PPE).
- SR 2 million for health awareness activities.
13) Other Procedures:
- Calling upon the other governmental health authorities to provide the human influenza vaccine for their employees; those assigned to participate in the Hajj Program, such as the Ministry of Defense, the National Guard and the Ministry of Interior.
- Calling upon the Ministry of Hajj to make sure that all the incoming pilgrims have been vaccinated with the influenza vaccine before setting out for Hajj.
