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Published Date: 2005-07-24 23:50:00
Subject: PRO/EDR> Undiagnosed deaths - China (Sichuan) (02)
Archive Number: 20050724.2139

UNDIAGNOSED DISEASE, DEATHS - CHINA (SICHUAN) (02)
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[1]
Date: Sun 24 Jul 2005
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Washington Post Foreign Service, Sun 24 Jul 2005 [edited]
<http://www.washingtonpost.com/wp-dyn/content/article/2005/07/23/AR2005072300936.html>

Undiagnosed illness kills 9 in south west China
-----------------------------------------------
BEIJING: An unidentified disease has killed 9 farmers and sickened 11
others in a rural part of China's western Sichuan province, prompting the
government to dispatch an emergency team of researchers to investigate
whether the deaths are related to avian influenza, a Health Ministry
spokesman said on Sat 23 Jul 2005. State media said the illnesses occurred
between 24 Jun and 21 Jul 2005 in about 15 villages surrounding the city of
Ziyang, 945 miles southwest of Beijing. All of the farmers had recently
slaughtered sick pigs or sheep, and researchers from the health and
agriculture ministries are investigating a possible link, the official New
China News Agency said.
Mao Qunan, a spokesman for the Health Ministry, said such a concentrated
cluster of abrupt, unexplained deaths was rare, and that the government was
taking necessary precautions. Mao said researchers hoped to quickly
determine whether the outbreak might be related to the avian influenza
virus that has devastated poultry flocks in 9 countries across Asia and
killed at least 56 people in Viet Nam, Thailand and Cambodia [and recently
3 in Indonesia - Mod.CP]. International health experts have warned that
avian influenza, which so far has not been able to spread quickly among
humans, could undergo a genetic change and cause a global pandemic, killing
millions if not tens of millions of people. Experts have also warned that
pigs, which often carry the human influenza virus, could contract bird flu
and act as a "mixing bowl," accelerating the process of mutation.
Scientists in China and Indonesia have already found bird flu in pigs, and
the Indonesian government announced on Saturday that it would kill about
100 pigs near the home of 3 people who are believed to be the country's
first fatalities from the disease.
In late April, the Chinese government reported an outbreak of avian
influenza among migratory waterfowl at a nature reserve in Qinghai
province, which is northwest of Sichuan. Then, last month, China reported 2
more outbreaks in Xinjiang province, which is north west of Qinghai. But
the government has never reported any outbreaks of avian influenza in Sichuan.
United Nations officials and independent researchers have complained that
the Chinese government has not fully responded to urgent requests by the
World Health Organization and other international health groups for
information about the 3 outbreaks, including samples of the virus found,
analyses of its genetic makeup and details about the extent of the
infection and efforts to contain it.
Reached by telephone, a disease control official in Ziyang said health
authorities have already ruled out avian influenza as the cause of the
farmers' deaths. He also said there had been no cases of avian influenza
reported among poultry or other livestock in the region. But the official
declined to give his name and there was no official announcement of
findings. A state-run newspaper in western China, the Huaxi Metropolitan
Daily, reported that the sickened farmers suffered flu-like symptoms in the
early stages of the disease, including fever, fatigue, nausea and vomiting.
Later, the farmers suffered bleeding under the skin, shock and other
symptoms, the newspaper said. The newspaper said only one of the patients
had recovered from the disease, while 6 of the 10 other surviving patients
were in critical condition. The farmers were between the ages of 30 and 70,
and all but one were men, the New China News Agency added.
State media said researchers have found no evidence the disease has been
transmitted from person to person, noting that none of the farmers were
related or had contact with each other. Local authorities have taken steps
to limit the spread of the disease, including forbidding farmers from
slaughtering any more sick pigs or sheep, the New China News Agency said.
The agency also said local authorities were immediately burying dead pigs
or sheep discovered by farmers and carrying out sterilization measures,
while requiring personnel to use protective gear and avoid direct contact
with the carcasses.
(byline: Philip P Pan and Zhang Jing)
******
[2]
Date: Sun 24 Jul 2005
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Xinnhua News Agency, Sun 24 Jul 2005 [edited]
<<http://news.xinhuanet.com/english/2005-07/23/content_3257310.htm>http://news.xinhuanet.com/english/2005-07/23/content_3257310.htm>

Mysterious disease kills 9 in south west China
----------------------------------------------
A strange and unknown disease has taken the lives of 9 people and infected
11 others in southwestern China's Sichuan province, state press said. The
Sichuan provincial health department has put out an emergency notice
warning of the illness that has infected at least 20 people, 10 of whom
remain hospitalized, with 6 in a critical condition. The victims of the
unknown disease have all been farmers, aged between 30-70, who apparently
did not have any contact with each other, a news report on the Sichuan
provincial government's website said. Doctors have no clue how the disease
is transmitted, it said.
Sick people began appearing "one-by-one" in hospitals in Ziyang city from
24 Jun to 21 Jul 2005, showing symptoms of high fever, a loss of strength,
vomiting, and shock, the report said. The sick came from 15 villages in 12
different townships, it said, mainly in the Ziyang area and Yingjiang
district. After receiving a report from local health departments, the
Ministry of Health in Beijing has sent a team to investigate the disease,
it said.
--
Mary Marshall
<tropical.forestry@btinternet.com>
******
[3]
Date: Sun 24 Jul 2005
From: ProMED-mail <promed@promedmail.org>
Source: BBC News, Sun 24 Jul 2005 [edited]
<http://news.bbc.co.uk/go/pr/fr/-/2/hi/asia-pacific/4711741.stm>

China: mystery illness kills 9
------------------------------
Health officials in western China are urgently investigating an
unidentified illness which has killed 9 farmers and put 11 more in
hospital. The farmers were taken ill with symptoms including high fever and
vomiting during June and July. All the victims, who came from Sichuan
province, had recently slaughtered pigs or sheep, local media said. The
researchers are hoping to establish quickly whether the illness is avian
influenza, which has been found in pigs.
The reports came a day after Indonesia announced the slaughter of 100 pigs
near the homes of the first 3 people in the country to die of avian
influenza. Experts have expressed fears that pigs, which can also carry
human influenza, could accelerate mutation of the virus into a form which
can be transmitted between people. However, an unnamed official told the
Washington Post newspaper [see part (1) above] that bird flu had been ruled
out as a cause of death. No official announcement has yet been made.
Chinese media said the farmers suffered flu-like symptoms during the early
stages of the disease but later developed bleeding under the skin and went
into shock. Only one patient has so far recovered, while six of the 10
still in hospital are in a critical condition. None are thought to have had
contact with each other.
The outbreak led Hong Kong health officials to issue a warning to hospitals
to look out for similar symptoms. Correspondents say the territory has been
wary of diseases spreading from mainland China since the outbreak of the
acute respiratory disease SARS, which killed nearly 300 people there in 2003.
******
[4]
Date: 24 Jul 2005
From: ProMED-mail <promed@promedmail.org>
Source: Xinhuanet
<http://news.xinhuanet.com/english/2005-07/24/content_3261256.htm>

Death toll from unknown illness rises to 17 in SW China province
----------------------------------------------------------------
An unidentified disease have claimed lives of 17 local farmers and stricken
41 others as of Saturday noon in south west China's Sichuan Province, the
provincial health department said on Sunday. Local hospitals have received
58 patients from 49 villages of 23 different townships in the city of
Ziyang and its neighboring city of Neijiang over the past 4 weeks.
All the patients showed similar symptoms like high fever, fatigue, nausea,
and vomiting and became comatose later with bruises under the skin. Of all
the hospitalized, 2 have recovered and 12 others are in critical condition
and 27 are in stable condition.
Preliminary probe found out that the affected farmers have butchered sick
pigs or sheep before coming down with the odd disease. Medical experts said
the mysterious disease doesn't seem to be spreading further among humans
and the detected cases show no obvious signs of epidemic.
Local governments and health and agriculture departments have set up
special investigation and rescue teams and are trying to determine the
exact cause of the disease.
--
ProMED-mail
<promed@promedmail.org>
[Some of the features of these illnesses are not characteristic of avian
influenza; in particular, the unrelatedness of the victims, the development
of hemorrhagic symptoms and shock, and the association with slaughter of
pigs and sheep. As suggested previously these features may be more
consistent with a disease such as Crimean-Congo hemorrhagic fever than
avian influenza. Virtually all infection diseases begin with "flu-like"
symptoms and this cannot be taken as indicative of avian influenza virus
infection. Furthermore the role of pigs as a mixing vessel allowing
interactions between human and avian influenza viruses is an attractive
hypothesis, but one that has still to be substantiated. A confirmed
diagnosis is awaited. - Mod.CP
Since the earlier report on this there have been an additional 8 deaths and
38 additional cases reported. The description of this illness has not
altered from the original description and one is still inclined to lean
towards Crimean Congo hemorrhagic fever as high on the list of possible
etiologies of this outbreak, given the background information on
seropositivity of sheeps and goats in the region. The one caution towards
that being the diagnosis is the lack of mention of that in the press
articles, as one would expect that specimens have been sent for testing of
previously known hemorrhagic fever organisms. We await further information
from knowledgeable sources in either the Chinese Ministry of Health and
Center for Disease Control China, or from international health agencies in
the area. - Mod.MPP]

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