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Published Date: 2005-11-16 23:50:00
Subject: PRO/AH/EDR> Avian influenza, human - East Asia (173): China
Archive Number: 20051116.3349

AVIAN INFLUENZA, HUMAN - EAST ASIA (173): CHINA
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[1]
Date: Wed 16 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: New York Times, Wed 16 Nov 2005 [edited]
<http://www.nytimes.com/2005/11/16/international/asia/16cnd-flu.html?hp&ex=1132203600&en=73c27d4b8e63700c&ei=5094&partner=homepage>
China: three cases of avian influenza in humans confirmed
---------------------------------------------------------
BEIJING: The Chinese Ministry of Health today confirmed 3 human cases of
bird flu, including 2 in central China's Hunan Province and one in east
China's Anhui Province.
The announcement, which provided no further details, was posted on the
website of Xinhua, the official news agency, a day after China's
agriculture ministry said that it would inject all of the nation's 5.2
billion chickens, geese, and ducks with a vaccine against bird flu. That
campaign, disclosed by the official New China News Agency, would be the
largest single vaccination effort ever for any species, according to the
United Nations Food and Agriculture Organization in Rome. It promises to be
logistically complicated, not least because it entails chasing and catching
billions of free-range birds. The Agriculture Ministry did not provide a
timetable.
Dr Qi Xiaoqiu, the director-general of the department for disease
prevention and control at China's Health Ministry, said at a news
conference on Tue 15 Nov 2005 that it was "highly probable" that a boy and
a girl who suffered high fevers last month -- the girl died -- had been the
country's first human cases of avian inflenza. Prime minister Wen Jiabao
warned last week that China faces a "very serious situation" as it seeks to
control the virus.
At any one time, China has about 4 billion chickens and 1.2 billion ducks
and geese, but even those numbers understate the size of the vaccination
task. The country consumes about 14 billion domestically grown chickens,
ducks and geese every year. Dr Qi said that three fifths of the poultry in
China were kept by families, who let the birds and other domesticated
animals wander around the neighborhood and the yard and often through the
house. Constant close contact between animals and people is worrisome
because birds and pigs can carry the H5N1 bird flu virus and may transmit
it to people. "People raise pigs and people keep birds just like Americans
keep dogs," Dr Qi said. "Those pigs and birds are part of the family. It is
a kind of self-sufficient, outmoded production method."
Dr Qi and Roy Wadia, a World Health Organization spokesman here, said on
Tuesday there had been no sign yet of human-to-human transmission of bird
flu, a critical ability the virus needs to develop if it is ever to cause a
human pandemic.
In an interview at the same conference at which Dr Qi spoke, an American
official who insisted on anonymity said before the Chinese announcement
that migratory birds were likely to spread flu to poultry in the United
States at some point. Kristen Scuderi, the Agriculture Department's deputy
press secretary, said the United States had 40 million doses of bird
vaccine in stock and another 30 million doses in production, which would be
used to create a barrier zone around an area with a severe outbreak. "The
initial response is culling, but if the outbreak was really egregious we
might go into the stockpile," she said. Some outbreaks have resulted in the
deaths of millions of birds.
China reported 50 outbreaks of bird flu in 16 provinces last year, and has
reported 11 more to international health agencies this autumn, including 2
more small outbreaks reported on Tuesday. Poultry infections have been
especially severe this autumn in Liaoning Province. The official New China
News Agency reported last week that a fake flu vaccine, possibly including
active virus, may have actually spread the disease [among poultry] instead
of preventing it, although there has been no suggestion that this occurred
elsewhere. "The harm is incalculable," said Jia Youling, the chief of the
veterinary department at China's agriculture ministry, according to the
news agency.
China has also developed its own version of Tamiflu, an antiviral drug, and
is preparing to produce it in large quantities if a human pandemic occurs,
official news media said. There is no human vaccine against bird flu
because it is impossible to predict the form the virus will take if it
develops the capacity for human-to-human transmission.
Veterinary experts at the Food and Agriculture Organization's headquarters
in Rome said that more information was needed to assess the wisdom of
China's decision to vaccinate all poultry. "With the recent multiplication
of outbreaks in China they have now decided on countrywide vaccination, but
at this point we cannot say if such a massive program is either possible or
advisable," said Joseph Domenech, chief of Veterinary Services. He added
that if any country can carry out such a program, "China can do it." Bird
vaccination campaigns involve a huge amount of manpower because the animals
must be injected one by one. The Food and Agriculture Organization normally
recommends such large-scale programs only in areas where the H5N1 bird flu
virus has become endemic - places where it persists in the environment and
where culls and quarantines have proved ineffective.
Parts of Viet Nam and Indonesia fall into this category, and widespread
vaccination programs have controlled influenza among poultry in some areas.
Dr Domenech said he had seen no evidence that this was true for all of
China. Bird vaccine has been widely available for several years. Costing
merely 10 cents a dose and produced by a dozen manufacturers, it is nearly
100 per cent effective. China's Agriculture Ministry said on Tuesday that
it was producing 100 million doses a day, a figure that Dr Domenech said
was plausible.
The difficulty with the bird vaccine, particularly in Asia, is
organizational: Veterinary workers must go village to village and door to
door, since most poultry in this part of the world is kept on small farms
and in backyards. In most parts of Asia, the vaccine is administered in
endemic areas and in areas surrounding outbreaks that have been controlled
by culls. The vaccine is also given to poultry in areas where wild birds
are known to be infected.
The Chinese have given no indication that H5N1 virus is widespread in their
country, and have said that all outbreaks this autumn have been brought
under control. The vaccine is not recommended for use in birds in Europe or
North America, as avian influenza is still rare in Europe and has not been
seen at all in the United States. In such places, the preferred method for
stamping out the disease is culling birds for a radius of up to a few miles
around the outbreak and quarantining poultry in a wider area for several
weeks. "The vaccine may be appropriate in Asia, but our first response
would definitely be culls and quarantines," said Philip Tod, spokesman for
the European Union's health department.
In the last month, Europe has experienced its first outbreaks - in Turkey,
Romania and Croatia. All have been controlled in this manner. Mr. Tod said
no European governments are currently stockpiling vaccines because they can
be produced relatively easily and quickly.
(by Keith Bradsher and Elisabeth Rosenthal)
******
[2]
Date: Wed 16 Nov 2005
From: quanyi wang <wangquanyi@yahoo.com>

Chiba: human avian influenza cases confirmed
--------------------------------------------
Three avian influenza cases in Mainland China were confirmed by the Chinese
Ministry of Health on Wed 16 Nov 2005. One 24 year old woman in Anhui
Province died on 10 Nov 2005, and a 12 year old sister and a 9 year old
brother were laboratory confirmed H5N1 positive The sister died on 10 Oct
2005. This is the first time that avian influenza cases have been found in
Mainland China.
--
Quanyi Wang MD,MPH
Associate Professor of Epidemiology
Beijing Center for Disease Prevention & Control
16 He Ping Li Zhong Jie, Beijing 100013, China
<wangquanyi@yahoo.com>
******
[3]
Date: Wed 16 Nov 2005
From: ProMED-mail <promed@promedmail.org>
Source: ABC News International, Associated Press Report, Wed 16 Nov 2005
[edited]
<http://www.abcnews.go.com/International/wireStory?id=1318107>

China: first three human cases of avian influenza reported
----------------------------------------------------------
BEIJING: China reported its first 3 confirmed human cases of bird flu Wed
16 Nov 2005 as the government raced to vaccinate billions of chickens,
ducks, and other poultry in a massive effort to stop the spread of the
virus. The World Health Organization said the victims contracted the
virulent H5N1 strain of bird flu, and 2 of them died.
The Health Ministry confirmed 2 human cases in the central province of
Hunan and one in the eastern province of Anhui, the official Xinhua News
Agency reported. Both areas reported outbreaks in poultry in the past
month. Experts are especially worried about the potential for bird flu to
spread and mutate in China because of its vast poultry flocks and their
close contact with people. It also is a major migration route for wild
fowl, which experts say might be spreading the virus.
The fatalities were a 12 year old girl in Hunan province and a 24 year old
female poultry worker in Anhui province, said Roy Wadia, a WHO spokesman in
Beijing. The third case was the [12 year old] girl's 9 year old brother,
who fell ill but recovered. China initially said the girl, her brother and
a schoolteacher who fell ill at the same time were negative for the
virulent H5N1 strain of bird flu. But the government later reopened the
investigation and asked WHO for help.
Agency [WHO] experts traveled to Hunan this week. Wadia said China recorded
the girl as a bird flu death, but WHO could not reach a conclusion because
her body was cremated. He said Chinese investigators based their decision o
the girl's shared background with her brother and the circumstances of her
illness. There was no official word on the teacher's status.
The government had not previously disclosed there were any suspected human
cases in Anhui, where an 20 Oct 2005 outbreak in the city of Tiancheng
killed about 550 birds. Wadia said the poultry worker did not live near the
site of that outbreak. "She apparently had close contact with sick birds,"
he said. "She died in a hospital. She was therefore tested adequately."
China has reported 11 outbreaks in chickens and ducks over the past month
nationwide, prompting authorities to destroy millions of birds in an effort
to contain the virus. The government also announced an ambitious effort
Tuesday to vaccinate all the country's more than 14 billion farm birds.
Experts also are testing a poultry worker who fell ill in the north eastern
province of Liaoning, which has suffered 4 outbreaks. All farm birds in the
province were ordered vaccinated early this month, said Fu Jingwu, deputy
director of the provincial Animal Health Supervision and Management Bureau.
He said the effort covered 320 million birds. The province also has
destroyed more than 15 million chickens, ducks, and other birds.
Also Wednesday, the State Council, which is China's Cabinet, discussed
enacting regulations on bird flu prevention, epidemic monitoring and
emergency contingency plans, state television said. The council also said
it would offer tax breaks and subsidies to help counter the effects of bird
flu outbreaks.
Meanwhile, government ministers at the Asia-Pacific Economic Cooperation
summit in Busan, South Korea, urged more regional and international
cooperation and response to combat bird flu. US secretary of state
Condoleezza Rice urged governments to improve communications and to
encourage the private sector to help prepare for outbreaks before they
happen. "New global pandemics, like avian influenza, require new, concerted
action," she told APEC trade and foreign ministers.
--
ProMED-mail
<promed@promedmail.org>
[Three cases and 2 fatalities are reported in the above reports, all of
which were designated suspected cases previously. The fatalities include a
12 year old girl in Hunan province and a 24 year old female poultry worker
in Anhui province. The third case was the [12 year old] girl's 9 year old
brother, who fell ill but recovered.
China initially said the girl, her brother, and a schoolteacher who fell
ill at the same time were negative for the virulent H5N1 strain of bird
flu. But the government later reopened the investigation and asked WHO for
help.
The Chinese authorities regard the 12 year old girl as a bird flu death,
but WHO have been unable to reach a conclusion because her body was
cremated. Chinese investigators based their decision on the girl's shared
background with her brother and the circumstances of her illness. So far
there is no verdict on the disease status of the 2 children's teacher. -
Mod.CP]
[Elsevier reference Ilyushina NA, et al. Detection of amantadine-resistant
variants among avian influenza viruses isolated in North America and Asia.
Virology 2005; 341(1) 102-6.
<http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=SDPROMED&_urlVersion=4&_returnURL=&_method=citationSearch&_version=1&_volkey=0042-6822%23341%23102%231&md5=20066fe6384ac2109a632ee7eb31f754>]

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