Beijing appears more apt to seek flu help


HONG KONG — China’s appeal to the World Health Organization for help to determine whether three cases of “pneumonia caused by unknown factors” in Hunan province could have been the result of the H5N1 virus indicates that Beijing is taking the threat of bird flu seriously.

Previously, Chinese health authorities had denied that two children in Xiangtan county in Hunan province — a 12-year-old girl who died and her younger brother, 9, both of whom had eaten a sick chicken — had caught the bird flu virus. The third case is a 36-year-old teacher who had handled chickens with a wound in his hand.

However, the Ministry of Health said Nov. 6 that “the possibility of human infection of the highly deadly H5N1 strain of bird flu cannot be ruled out” and called on the WHO to help in testing blood and throat swabs from the three victims. This suggests that China is willing to be open in the way it handles this sensitive issue.

Although scores of H5N1 human infections have been reported in Southeast Asia, the mainland up to now has not reported a single case. This is surprising given that China has 14 billion poultry, and in rural areas people and poultry live in close proximity.

Although the bird flu up until recently has been very much an Asian issue, the inexorable move of the virus into Europe means it now has the attention of the world. U.S. President George W. Bush late last month outlined a $7.1 billion strategy to prepare for the danger of an influenza pandemic.

Last week representatives of the World Bank, WHO, the World Organization for Animal Health and the United Nations Food and Agricultural Organization met for three days in Geneva to formulate global and national action plans against bird flu.

The world is watching to see how China, which was severely criticized in 2003 for its secretive handling of the SARS epidemic, deals with the bird flu issue. On Nov. 7 the official People’s Daily published a front-page commentary on the way it was handling the bird flu issue. It said China had “established an open, transparent epidemic reporting system.”

Emphasizing China’s openness, the article said: “In case an epidemic occurs, it will be immediately made known to society according to law, and any acts of delaying or failing to report the epidemic, or of concealing the real situation, are impermissible.”

China has allocated $250 million to set up a bird flu prevention and control fund and create a national headquarters to supervise the work.

One problem in China is that frequently farmers cannot afford to kill their poultry when ordered to do so because the government compensation is considered inadequate. That’s why there have been cases of people eating dead or sick chickens, not realizing the risk that they were taking.

While Roy Wadia, a WHO spokesman in Beijing, described the Ministry of Health’s announcement as “very encouraging,” Dr. Kwok Ka-ki, who represents physicians in the Hong Kong legislature, said the announcement had come too late to curb any possible spread of the disease if, indeed, the brother and sister had been infected with bird flu.

That is because it is generally believed that, to avert a pandemic, an outbreak must be detected before it infects more than 20 people and before three weeks have passed since exposure. After that, the virus may well have spread too far to be contained.

The Health Ministry said 192 people who had had close contact with the three victims or with dead poultry are under medical observation, with one person showing signs of “acute bronchitis.”

China has reported four bird flu outbreaks in three weeks. The first was Oct. 14 on a farm in Inner Mongolia. Subsequent outbreaks were reported in Anhui province, Hunan and, most recently, Liaoning. Since December 2003, the H5N1 virus has led to the death of 140 million birds and infected 125 people, killing about half of them.

With the approach of cold weather, and the onset of another flu season, there is much concern that the chicken flu virus may come into contact with human flu virus and mutate in such a way that it can be spread through human contact. So far there has been no proven case of human-to-human transmission of the bird flu virus, which has a mortality rate of at least 50 percent. But once it does happen, the whole world will be in serious trouble in this age of globalization.