A vendor cleans chickens for sale on the outskirts of Cairo, December 4, 2014.

A 20-year-old Egyptian woman died from bird flu on Wednesday, the ninth death in the country from the virus out of 18 identified cases, the Health Ministry said.

Ministry spokesman Dr Hossam Abdel Ghaffar said the woman came to a hospital in the southern province of Assiut on Sunday “in severe respiratory distress.” She was then transferred to another hospital where she died.

Out of the nine other infected patients, seven have been discharged and two others are still sick in hospital, he said.

According to the World Health Organization (WHO), from 2003 through Oct. 2, 2014, there have been 668 laboratory-confirmed human cases of H5N1 infection officially reported from 16 countries. Of these cases, 393 have died.

The WHO has warned that whenever bird flu viruses are circulating in poultry, there is a risk of sporadic infections or small clusters of human cases, especially in people exposed to infected birds or contaminated environments.

Egypt’s H5N1 cases have largely been found in poor rural areas in the south, where villagers, particularly women, tend to keep and slaughter poultry in the home.

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