Jailed British-Egyptian activist Alaa Abdel Fattah’s health has “deteriorated sharply,” his sister said Thursday after visiting family for the first time since he ended a seven-month hunger strike.

In a message on Twitter, Mona Seif said the news of the visit was “disturbing”.

“Alaa has been very poor for the last two weeks but at least they got to see him and he needed to see family so badly,” she wrote.

After eating “100 calories a day” for seven months, on November 6, Abdel Fattah escalated his strike to all food and then water to coincide with the start of the UN climate summit COP27 in Egypt.

In a letter given to his family on Tuesday but dated Monday, he said he had ended the strike.

On Thursday, Laila Soueif, the activist’s mother, was allowed to visit him for the first time in almost a month after prison authorities repeatedly denied her access last week.

The family has not revealed any further information about the visit or Abdel Fattah’s status, but “will share the full details later,” Seif added.

The pro-democracy blogger is currently serving a five-year sentence for “spreading false news” by sharing another user’s Facebook post about police brutality.

In his short letter on Monday, he didn’t go into detail about the reasons behind his decision to end the strike, but asked his mother to “bring a cake” to Thursday’s visit.

“I want to celebrate my birthday with you,” wrote the activist, who turns 41 on Friday.

His family – who were concerned authorities would “force-feed” him and feared he would die behind bars – have raised questions about how the decision came about.

The dissident’s aunt, writer Ahdaf Soueif, wrote on Twitter on Tuesday: “And what happened inside? What was negotiated?

“Alaa had no idea how big the support was around him,” she continued.

Egypt’s hosting of the UN climate summit in the resort town of Sharm el-Sheikh comes to an end this week, with Abdel Fattah continuing to make global headlines as an example of Egypt’s human rights record, described by human rights groups as “miserable”.

World leaders have raised his case in bilateral meetings with President Abdel Fattah al-Sisi.

Several speakers at the summit ended with the words “You Are Not Defeated Yet” – the title of Abdel Fattah’s book. It has become a rallying cry for activists, both at the climate talks and in online posts calling for climate justice and human rights.

Human rights groups estimate that Cairo holds around 60,000 political prisoners, many of them in brutal conditions and in overcrowded cells.