Cases of swine flu in Kuwait expected to surge

The government delays the reopening of public schools in one of two measures to combat the spread of swine flu.

KUWAIT CITY // The government has delayed the opening of public schools and rushed through the completion of a new laboratory for infectious diseases in two new measures this week to combat the spread of swine flu. The minister of education, Moudhi al Humoud, said after a cabinet meeting on Monday that high schools will begin on September 27, followed by middle schools, and Grades Four and Five on October 4 and Grades One to Three on October 18, the state news agency reported. The decision was based on a proposal by a committee comprising the ministries of health and education.

Ms al Humoud said the time will be used to prepare clinics and isolation rooms in the schools and for providing materials for cleaning and sterilisation. The schools' nurses and teachers will also be trained to prepare for the pupils' return. The postponement comes after growing pressure from members of parliament to delay the opening of schools after their summer break because of the large increase in the number of people infected with the H1N1 virus, known as swine flu, in Kuwait. Last week, the ministry of health reported that 443 new cases were registered in just one week, bringing the country's total number of infections since the beginning of April to 1,779, with five deaths.

Private schools have already begun classes after their summer breaks though with reduced attendance. Some schools are reported to have bought infrared cameras to help detect infected students; two cases of children with swine flu have been confirmed, though it is unclear if they were caught by the new scanners. In Saudi Arabia, a neighbouring country, more cases of swine flu have been recorded than anywhere else in the region, with 3,500 infections and 26 deaths. Saudi Arabia's population of 27 million people is nine times greater than Kuwait's population of three million, so proportionately, Kuwait's swine flu problem looks much worse.

The director of Kuwait's Infectious Diseases Hospital, Jamal al Duaij, said Kuwait is reporting its results honestly, though there have been problems in how the country has responded to the spread of the disease. "I thought that in Saudi Arabia the situation would be worse, but they are not telling." He said Kuwait has an official spokesman who has to report infections accurately while some other Gulf countries adjust their results to match political agendas.

Dr al Duaij said his staff was under huge pressure when the number of patients they were receiving every day shot up to 300 from about 50 after the outbreak of the disease in mid-June. He said all of the other hospitals in Kuwait tried to avoid treating the disease by sending all their patients to the Infectious Diseases Hospital. To deal with the extra workload, he cancelled summer leave and started a programme of "household management" in which the hospital gives medication and instructions to the patients and tells them to recover at home.

He said the minister of health, Hilal al Sayer, passed a resolution on August 24 which "demanded all of the health sector get involved in the problem" by treating patients locally and only sending the worst cases to the Infectious Diseases Hospital. The new resolution eased the pressure on the hospital by reducing the number of cases they received per day to 100 from 300. Dr al Duaij said the hospital was still so busy that it had to stop taking new cases for several hours on three separate occasions and ask that they be treated in their local hospitals.

The hospital's protocols divide infected people into three groups. In group one, people with influenza-like symptoms who are low risk should take paracetamol and rest at home. Group two patients, with such risk factors as pregnancy, diabetes or youth should seek treatment at their local hospitals. Only those in the third, high-risk group, such as people with chest pains, should seek treatment in the Infectious Diseases Hospital.

When he passed the new resolution, Dr al Sayer also established a new laboratory in the Infectious Diseases Hospital to test swabs for diseases. The laboratory opened this week. Before, Dr al Duaij said that because of slow procedures, samples could take up to four days to return from the Central Virology Laboratory in another part of the country and "this was putting a big pressure on us". Despite some initial setbacks, the lab is now running. "We're processing samples. It's the early stages and there are still things to be done," said Husam Osman, an adviser to the ministry of health from Britain's Royal College of Pathologists who is working on establishing the lab. He said issues relating to the management of the lab needed more work.

"We're getting about 100 to 150 samples a day. We have a capacity to do 250 per day, but that can go up," he said. "Hopefully, we will be able to get results on the same day, or the next day max. It will speed up things for the management of patients." Mr Osman said the lab was currently recruiting 10 to 12 biologists and lab technicians because the World Health Organisation expected cases of swine flu to spike after the Haj and after schools resume classes, especially in the winter. "Everybody expects the worst is still to come," he said.