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Published Date: 2005-07-26 23:50:00
Subject: PRO/AH/EDR> Undiagnosed deaths - China (Sichuan)(04): Strep. suis susp.
Archive Number: 20050726.2160

UNDIAGNOSED DEATHS - CHINA (SICHUAN) (04): STREPTOCOCCUS SUIS SUSPECTED
***************************************************
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[1]
Date: Tue, 26 Jul 2005
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Reuters [edited]
<http://www.alertnet.org/thenews/newsdesk/PEK358534.htm>

Mystery deaths in southwest China linked to pigs
-------------------------------------------------
China's Ministry of Health has blamed a pig bacterium for a mysterious
disease that has killed 19 people in a southwest province and made 61 ill,
the China Daily reported on Tue, 26 Jul 2005.
Laboratory tests showed the affected people were suffering from
_Streptococcus suis_ infections contracted from the slaughtering or
handling of infected pigs, the ministry said on Mon, 25 Jul 2005. The
bacteria are endemic in swine in most pig-rearing countries in the world,
but human infections are rare.
Initially, 20 farm workers suffered fever, nausea and hemorrhaging after
handling sick or dead pigs and sheep in 12 towns and 15 villages in Sichuan
province, state media said. More cases were reported as health workers
combed villages for ill people. As of Sun, 23 Jul 2005, 80 people had been
confirmed or presumed infected and 19 had died, the China Daily said.
"No human-to-human infection has been found," it quoted a Ministry of
Health statement as saying.
The provincial and central governments have launched campaigns to identify
and destroy infected pigs and shut down channels for the bacteria to
spread, including forbidding farmers from slaughtering or processing
infected pigs, the newspaper said.
Hong Kong has ordered hospitals to be on alert for people exhibiting
symptoms such as fever and nausea and advised travelers to Sichuan to take
precautions such as not touching dead animals and using mosquito repellant.
But a China Ministry of Health spokesman cast doubt on speculation the
bacterium could be spread by mosquitoes. "If so, there would be many more
people infected with the disease," spokesman Mao Qun'an was quoted as
saying by the China Daily.
The government of Sichuan province earlier dismissed speculation that the
deaths were caused by bird flu or Severe Acute Respiratory Syndrome (SARS),
an assessment affirmed by the WHO.
Global health officials have been on high alert over a bird flu virus that
has killed over 50 people in Asia since late 2003.
--
Mary Marshall
<tropical.forestry@btinternet.com>
******
[2]
Date: Tue, 26 Jul 2005
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Canada.com [edited]
<http://www.canada.com/health/story.html?id=4c039e2f-dbe3-43a8-9c74-0e56bda853a8>

Death toll in China's mystery illness rises to 19; 17 in critical condition
----------------------------------------------------
Of the 80 people infected with a pig-borne disease in southwestern China in
the past month, nearly 20 have died and another 17 are in critical
condition, the Health Ministry said Tue, 25 Jul 2005.
At least 19 people are now known to have died in Sichuan province, the
ministry said. None of the infections was transmitted through human-human
contact, it said. Victims of the disease suffer high fever, bleeding under
the skin and poisoning-related shock, the ministry said.
"According to research and lab test results, experts believe the disease is
caused by _Streptococcus suis_," a disease commonly carried by pigs, the
ministry said in a statement. "People were infected because they
slaughtered and processed sick and dead pigs."
The deaths sparked fears of another outbreak of SARS or avian flu, or of a
new sickness emerging from China's south, which has been the breeding
ground for diseases that jump between animals and humans because of their
close proximity.
The latest infections were spread throughout 75 villages and 40 towns near
the cities of Ziyang and Neijiang, the ministry said.
"We are looking at not just a bacterium being active in one herd of pigs
but over a fairly wide area, with isolated villages," said Bob Dietz, a
spokesman for the WHO's regional office in Manila. "Gathering information
in that sort of situation is difficult."
While China has been open with information on the outbreak so far, WHO was
keeping watch on the situation. "We see this as a serious situation which
bears close monitoring," Dietz said. "This is a disconcertingly high
mortality rate."
China and Hong Kong have seen similar outbreaks in the past, but their size
was unknown because surveillance systems weren't as active before, he said.
"Our review of the literature says this appears to be bigger than in the
past," Dietz said.
Government officials have been "destroying infected pigs, eradicating
contagious channels and treating patients," the China Daily newspaper said.
Farmers have been forbidden to slaughter and process infected pigs, the
Health Ministry said.
State television showed masked doctors at a hospital examining patients who
were on intravenous drips.
On Tue, 26 Jul 2005, health officials in Sichuan wouldn't release details
about the outbreak beyond confirming the number of dead and sick.
A woman who answered the telephone at the Ziyang No.1 People's Hospital,
where most of the patients were being treated, said they were not allowed
to speak to the media.
[Byline: Audra Ang]
--
Mary Marshall
<tropical.forestry@btinternet.com>
******
[3]
Date: Tue, 26 Jul 2005
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Australia Broadcasting Co. [edited]
<http://www.abc.net.au/ra/news/stories/s1422711.htm>

China halts export of pork products after outbreak of mystery illness
---------------------------------------------------
China has suspended all pork exports from 2 cities where a mystery illness
has killed 19 farm workers.
The Hong Kong government says all pork exports from Ziyang and Neijiang
cities in southwestern Sichuan province have been put on hold. It says
Chinese authorities have also moved to set up surveillance of registered
export pig farms.
China's Ministry of Health has blamed a pig bacterium for the disease. The
ministry says initial tests suggest the victims were suffering from
_Streptococcus suis_ infections contracted from the slaughtering or
handling of infected pigs.
The bacteria are endemic in swine in most pig-rearing countries in the
world, but human infections are rare.
Chinese state media reported 80 cases of the disease in Sichuan province as
of Monday, including 19 fatalities.
Hong Kong hospitals have been ordered to look out for people with symptoms
such as fever and nausea.
Travelers to Sichuan province are being advised to use a mosquito repellent
and avoid handling dead animals.
--
Mary Marshall
<tropical.forestry@btinternet.com>
******
[4]
Date: Tue, 26 Jul 2005
From: ProMED-mail <promed@promedmail.org.
Source: XinHuaNet.com [edited]
<http://news.xinhuanet.com/english/2005-07/26/content_3267456.htm>

Pig bacteria blamed for 19 mysterious deaths
---------------------------------------------
The mysterious deaths of 19 farmers in Southwest China's Sichuan Province
were caused by _Streptococcus suis_, a bacterium carried by pigs, the
Ministry of Health said yesterday, 25 Jul 2005.
By noon on Sun, 24 Jul 2005, 80 cases, 67 confirmed and 13 suspected, had
been reported, according to a ministry statement. Since the disease was
found in humans about one month ago, the bacteria has killed 19. At the
moment 17 patients are in critical condition in hospital.
After an emergency investigation, a group of experts organized by the
ministries of health and agriculture confirmed the epidemic was caused by
the bacteria, which can be passed to humans from pigs. Experts found that
the farmers infected had all slaughtered or processed infected pigs.
About half of patients also go into severe shock, and the death rate of the
disease is quite high, investigating experts said. 4 people infected during
the current outbreak have recovered and been released from hospitals.
Central and local government officials are working on an epidemic analysis,
identifying patients, destroying infected pigs, eradicating contagious
channels and treating patients. Farmers have been forbidden from
slaughtering and processing infected pigs.
In normal practice, meat-processing factories examine pigs from big farms
or single households before they buy them. When they refuse a pig because
it is infected, sometimes the farmer will take it home and process it for
consumption by his own family.
It is rare for _S. suis_ to infect a human being. The 1st-ever recorded
case was in Denmark in 1968, the ministry said. Records show that at least
200 human cases of the infection have been reported, mainly in countries
and regions breeding pigs and eating pork in Northern Europe and Southern Asia.
--
ProMED-mail
<promed@promedmail.org>
[A picture similar to toxic shock, with or without meningitis, has been
described in human _S. suis_ infection, and a hemorrhagic diathesis can be
associated with many bacteremic syndromes. What is quite unusual about this
situation is that it is an actual outbreak; cases in the past have been
sporadic. If it is the case that the porcine streptococcus is the cause of
these illnesses, perhaps the organism has acquired one or more virulence
factors (from, for instance, the Group A streptococcus or _Staphylococcus
aureus_) to increase its transmissibility and virulence in humans. It
would be interesting to assess any medical co-morbidities in the infected
cohort. - Mod.LL]

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