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Published Date: 2005-12-23 23:50:00
Subject: PRO/AH/EDR> Avian influenza, human - East Asia (205): China
Archive Number: 20051223.3673

AVIAN INFLUENZA, HUMAN - EAST ASIA (205): CHINA
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[1]
Date: Fri 23 Dec 2005
From: ProMED-mail <promed@promedmail.org>
Source: NewsCom, Xinhua-PR Newswire, Fri 23 Dec 2005 [edited]
<http://www.newscom.com/cgi-bin/prnh/20040610/CNTH001LOGO>

News Conference on China's Response to Avian Influenza: Opening
Remarks by Dr Shigeru Omi, WHO Regional Director For the Western
Pacific Region
--------------------------------------------------
Good afternoon. Thank you for being here. I have visited China many
times in my official capacity. And I can truly say that this week's
visit, with its focus on avian influenza, has been one of the most
productive of all. I have met with officials at the Ministries of
Health, Agriculture and Foreign Affairs. I have visited the National
Influenza Centre in Beijing, whose laboratories have helped confirm
the 6 human cases listed so far on the mainland. I have visited
Hunan Province, where China experienced its 1st laboratory-confirmed
human case. And I have visited the very community where that
9-year-old boy lives. I have seen with my own eyes that China at all
levels is truly committed to the fight against H5N1 avian influenza.
I would like to personally congratulate China and its people for this.
For example, on the animal front, outbreaks in poultry -- once they
are identified -- are swiftly and aggressively contained. China has
carried out expansive and ambitious vaccination campaigns in poultry.
On the human front, China has done a good job in identifying human
cases in recent months, and in conducting the necessary laboratory
tests for confirmation. Collaboration between the Chinese Ministry
of Health and WHO is very strong in further enhancing China's
capacity to battle avian influenza.
However, there are also significant challenges. Not surprisingly, the
strongest challenges are found where animal and human surveillance
systems are at their weakest. The ability to spot animal outbreaks
and possible human cases at the grassroots level is a major challenge.
Of the 6 confirmed human cases so far, 5 were not forewarned by
reports of poultry outbreaks in the local community. There is a need,
therefore, for a concerted and greater focus at the grassroots level
-- so that capacity and human resources at the community level will
be strengthened, particularly in terms of awareness and surveillance.
After SARS, China made major improvements in public health from the
national to the provincial through the county levels. Avian
influenza, however, shows us that we need to penetrate even deeper --
all the way through the grassroots level. The front lines of the
battle against avian influenza are at the grassroots level. It is
here that some 70 percent of China's estimated 14 billion poultry are
spread across backyard farms. It is here that the 6 confirmed human
cases have come from. Now all of this poses a huge, huge challenge
to China's fight against avian influenza. The outcome of this battle
in China has ramifications not only for the region, but also for the
entire world. China is truly key to the global war against H5N1.
The strongest weapons in this war are collaboration, cooperation and
the sharing of information. Accurate and complete reporting about
outbreaks in animals and about human cases is vital. The sharing of
information must be timely, regular and global.
China reported its 1st laboratory-confirmed case just last month. But
already, the Ministry of Health has listed virus sequences from human
cases in international databases for scientists the world over to
access. During my visit, the Ministry of Health has agreed to share
the virus isolates from 2 of the human cases with the WHO
International Collaborating Network. A draft agreement was given to
me at the National Influenza Centre in Beijing. We commend the
Ministry of Health for this, and hope this process will become
routine -- something that occurs regularly and consistently.
However, human H5N1 viruses are only part of the story. To fully
understand how this virus is evolving, we need viruses from outbreaks
in animals. Last year, the Ministry of Agriculture shared 5 virus
isolates. This year, it has shared virus sequence information from
the Qinghai wild bird outbreaks. However, from the more than 30
reported outbreaks in animals in 2005, no viruses have been made
available so far. Ministry of Agriculture officials have told me
they understand the importance of sharing viruses. But time is of
the essence.
I shall end these remarks on a personal note. Yesterday, in Hunan, I
met China's 1st confirmed human case -- the 9-year-old boy whose
picture all of you must be familiar with, the boy who appeared on
national television earlier this week. The joy his parents feel at
his wonderful recovery is mixed with the sorrow over losing their
daughter -- the boy's sister -- who probably died of avian influenza,
but whose case could not be confirmed. This family's story
symbolizes the difficulty China faces in battling H5N1. But it also
shows how success can be achieved, if the necessary steps are taken.
China is truly committed to winning the battle against avian
influenza. Victory in this battle will benefit both China and the
world. Thank you.
--
ProMED-mail
<promed@promedmail.org>
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[2]
Date: Fri 23 Dec 2005
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Reuters Foundation AlertNet, Fri 23 Dec 2005 [edited]
<http://www.alertnet.org/thenews/newsdesk/PEK16129.htm>

The World Health Organisation urged China on Fri 23 Dec 2005 to pass
on samples from its avian influenza outbreaks in animals and said
that human cases could be going unreported because of its weak
healthcare system.
Shigeru Omi, WHO regional director for the Western Pacific, said no
viruses had been made available from China's 31 reported outbreaks in
poultry this year, despite requests to the Ministry of Agriculture.
"If we received these samples from animals, we would know what kind
of changes the virus is undergoing, which is very, very vital in
fighting against any potential pandemic," Omi told a news conference.
"Time is of the essence," he said.
Scientists fear the H5N1 strain of the virus could change from a
disease that affects mostly birds into one that can pass easily
between people, sparking a pandemic. 2 people have died from bird
flu in China, out of 73 known fatalities in Asia. China has had 4
other confirmed human cases who survived the disease.
Omi commended China's Health Ministry for sharing data on samples
from humans but said it was unclear why more animal viruses were not
being shared. China was widely criticised in 2003 for its cover-up
of the SARS virus [outbreak], contributing to its eventual spread to
8000 people around the world.
Omi said that there was no evidence of a similar cover-up of avian
influenza, but a lack of training and capacity in the countryside
meant human cases were probably under-reported. "The quality of the
surveillance is not sufficiently good. That is a fact. So therefore
in my view it is conceivable that the system could miss some of the
cases," he said. "I don't know how many. It's anybody's guess."
During his 5 days in China, Omi visited the village in the central
province of Hunan where a 9-year-old boy survived the disease, and
said there was no awareness there about how to avoid infection or
about the threat of a global pandemic. "The boy that I met did not
know anything about this," Omi said. "For him, chickens are friends,
so he touched. But if he had known about this, he may have avoided
them," he said, adding the family's stock of about 20 birds had died
of the disease. The boy's dead sister is a suspected case.
One of the major challenges in fighting the disease in China is that
about 70 percent of its poultry throughout the country are spread
across backyard farms, meaning a massive effort would be required to
educate villagers throughout the country. Most of China's human bird
flu cases were also not treated with Tamiflu, the frontline
anti-viral drug, either because it was not available quickly enough
to be effective or because the cases were not identified soon enough.
The drug is most effective within the first 48 hours of illness.
Omi also said that, despite findings published in the New England
Journal of Medicine that showed bird flu had developed resistance to
Tamiflu in 2 patients in Viet Nam, the WHO was not changing its
policy on the drug. "Tamiflu is still effective and we still
recommend the [stockpiling] of Tamiflu," he said. "Nonetheless, its
use should be carefully monitored to see whether the virus was
evolving in a way that it was developing resistance to the drug, made
by the Swiss firm Roche AG".
[Byline: Lindsay Beck]
--
Mary Marshall
<tropical.forestry@btinternet.com>
[Significant observations in the WHO press release are the following:
(1) From the more than 30 reported (Chinese) outbreaks in animals in
2005, no viruses have been made available (to international labs) so
far. (2) The front lines of the battle against avian influenza are at
the grassroots level. It is here that some 70 percent of China's
estimated 14 billion poultry are spread across backyard farms -- and
from here that the 6 confirmed human cases have come from. (3) Of the
6 confirmed human cases so far, 5 were not forewarned by reports of
poultry outbreaks in the local community. - Mod.AS]

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