/ 2 May 2009

‘SA can’t handle an outbreak’

As swine flu threatens South Africa, experts say the country does not have enough of the medicines necessary to contain an epidemic.

”I’ll put my head on a block that we don’t have enough drugs to deal with a full-blown outbreak of swine flu,” University of Cape Town virology professor Ed Rybicki told the Mail & Guardian on Thursday.

Earlier this week the National Institute of Communicable Diseases said there were already two swine flu cases in South Africa but later reduced this to one, saying symptoms in a suspected case in Gauteng were not typical of the disease.

The government maintains it has adequate supplies of medicine. ”We do have a stockpile of antiviral drugs in the public sector,” Dr Frew Benson, chief director in the National Health Department, told the M&G.

”The private sector also has adequate drugs and additional stock from the World Health Organisation (WHO) is also available.”

But Wilmot James, director of the Africa Genome Education Institute, said: ”I just don’t believe what the government has said. I can’t see how we can have enough drugs and I honestly don’t think we’ve stockpiled.”

Health Minister Barbara Hogan said this week that a technical task team for the SADC region had been set up and more drugs would be obtained from the WHO. But Rybicki said these drugs would still not be enough. ”We would need millions of doses of the most commonly used antiviral drugs called Tamiflu and Relenza …

”The WHO said yesterday it only has 3.5-million doses available, which all countries in need would have to share. That’s not going to cut it. And if South Africa doesn’t have enough drugs our neighbours almost certainly would not have them.”

James said: ”The WHO has confirmed that this virus is spreading extremely fast and it has raised the infectious disease alert level to Phase Five, which indicates that the likelihood of an epidemic is very high or inevitable … There are no signs that [this strain] will fizzle out. No one is immune to it.”

He added: ”The swine virus has established a human-to-human transmission chain and you pretty much get it just like you would get normal flu or TB. This is different from, for instance, avian flu, where humans are only able to contract it from birds and not from each other.”

The government announced several measures, including the production of educational pamphlets and surgical masks for distribution among people entering the country at airports, as well as guidelines for hospitals on how to handle suspected cases.

The main goal is to identify suspected cases on board aircrafts and to escort those who test positive for the virus into isolation wards at hospitals.

”Quarantine might sound harsh,” said James, ”but the seven days of isolation during the incubation period is a much better option than exposing infected patients to friends and family members who they can infect.”

A thermal image detection machine that measures passengers’ temperatures to detect whether they have a fever is already in place at Lanseria Airport outside Johannesburg. OR Tambo International is to receive two similar machines.

But Rybicki maintained: ”That’s not nearly enough. I reckon you can count the number of thermal scanners in South Africa on one hand. You need considerably more.”

James echoed this, saying two or three thermal scanners ”just won’t do it” and that the country needs more equipment to be able to ”screen far more people so that we can detect as many infections as possible in time”.

Additional reporting by Irin and Sapa