Caijing Articles on Avian Flu: China Has Had the Flu for a Long Time
Thanks to China analyst David Cowhig for the following:
These are good articles on avian flu from Caijing magazine from mid October and early November issues (the original Chinese versions are available here and here). The bottom line is the H5N1 has been circulating in China for at least a decade but was not reported because information on epidemics of virulent avian influenza were state secrets in China until 2003. Even today only one laboratory in all of China has permission to do studies of avian influenza. Perhaps the existence of avian influenza may depend upon whether a laboratory is permitted to look for it. If they do not look for it, they do not find it and so official denials are true. Fortunately the times are changing. The author of the Caijing articles points out that China is becoming more open and China must not repeat the errors of SARS or there may be a great world avian flu disaster coming out of China.
This is a rough summary, not a full translation. The summary is not in exactly in the same order as the Chinese.
Avian flu, including H5N1 has occurred in 18 provinces over the past several years. HN51 was found in Guangdong Province in 1996, there was a big outbreak in Hong Kong in 1997. Chinese officials claimed that China did not have an avian flu problem, but the many articles published about avian flu in PRC veterinary journals are evidence to the contrary. Journal articles published about 2000 give the impression that avian flu was quite widespread in China at that time. January 27, 2004 was the first time the PRC Ministry of Agriculture admitted that China had H5N1. Later it stated that H5N1 had been detected in 18 provinces. Through 2003 Chinese officials stoutly insisted that there is no avian flu in China. Most likely it is more widespread than that, but the only laboratory authorized to do testing and to announce results is located in Harbin and is directly under the Ministry of Agriculture.
In July 2003, the State Council gave permission to remove from the state secrecy classification system information on current veterinary epidemics. As a result, information on epidemics such as hoof and mouth disease, Swine Vesicular Disease (SVD) and high virulent avian flu no longer were classified as state secrets. In 2004, China established an information reporting system for big veterinary epidemics. The 49 locations in which H5N1 avian flu became epidemic in early 2004 were reported immediately to the public. The information bottleneck has become looser, and so has drawn praise both in China and abroad. In 2005, China has a more transparent information environment. This is the starting point as China faces avian flu.
China is becoming more open but many officials still make statements that spread ignorance of the facts. Since 2003, China has invested 200 million RMB (USD 30 million) in building the Ministry of Health’s online epidemic reporting system. The system now covers 93% of hospitals at the county level or above and 43% of the township hospitals. A major obstacle to handling avian flu properly is the great difficulty in making the two ministries most closely involved, the Ministry of Public Health and the Ministry of Agriculture work together.
In 2004, the Ministry of Health proposed to the Ministry of Agriculture close cooperation and rapid information exchange on avian flu and avian flu to human transmission. The Ministry of Agriculture was slow to respond, a framework for cooperation was finally signed in mid October 2005 but a Ministry of Health told Caijing on October 10 that the procedures for exchanging data had still not been agreed upon. Caijing asked the Ministry of Agriculture about the emergency measures that would be taken in the event of an epidemic. The Agricultural official responded, that is not public. “The plan was distributed, the people who need to know have been told, there is no need to inform the public.” “Ëøô‰∏™ÊñπÊ°àÂ∑≤Áªè‰∏ãÂèëÔºåÂ∫îËØ•Áü•ÈÅìÁöÑ‰∫∫ÈÉΩÁü•ÈÅì‰∫ÜÔºåÊ≤°ÊúâÂøÖË¶ÅÂêëÂÖ®Á§æ‰ºöÂÖ¨Â∏É„ÄÇ” This lack of cooperation between Health and Agriculture was apparent during the June – August 2005 pig-human streptococcus suis epidemic in Sichuan Province. At that time the Health and Agriculture officials did not cooperate. In fact, an early August Ministry of Agriculture report about the epidemic stated that everything is calm and matters are being resolved but did not even mention that human beings were dying! The Health and Agricultural ministries did not get together to make a common study of the situation until the end of the month when they released a joint evaluation of the epidemic.
At present, the veterinary institute of the Harbin branch of the Chinese Academy of Agricultural Sciences subordinate to the Ministry of Agriculture is the only organization in China that has permission to do avian flu studies. Other organizations are not allowed to do this kind of research. A researcher from this institute made an international sensation in mid 2004 when it was revealed that H5N1 had been detected in a pig in Fujian Province. Although the viral load detected was very small, if pigs can be infected with H5N1, a mixture of human and avian flu could occur in a pig that was infected with both at the same time. This would be a very dangerous development. This case was reported in the first issue of 2004 of the Chinese Journal of Preventive Veterinary Medicine 2004Âπ¥ÂàùÁöÑ„Ää‰∏≠ÂõΩÈ¢ÑÈò≤ÂÖΩÂåªÂ≠¶Êä•„Äã.
The H5N1 in Vietnam and Thailand resemble each other and so the WHO puts them together in clade one. The H5N1 in Indonesia and in China resemble one another and so are classified in clade two by the WHO. The experience of Indonesia was that the first wave of H5N1 caused few deaths but the second wave was far more deadly. The second wave in China might also be more serious. [Note: Differences in virus clades might be important for making a successful vaccine. Could more than one type of vaccine be needed? End note]
The Hong Kong University virologist Guan Yi argued in Nature magazine that the virus spread from southern China to western China. Some Chinese officials disagree. Guan Yi said that avian flu can be detected in many poultry markets at varying levels. Some Chinese officials attacked him saying that Guan Yi’s lab is primitive and he gets false positives because of contamination in his laboratory.
The attitude and actions of China will not only affect the lives of the 1.3 billion Chinese, but it will have a strong impact on the entire world. This is not just because China raises 13 billion poultry birds but more importantly, if China should once follow the same disastrous policy it did during SARS, it will be a disaster for the world.
The second article discusses avian flu research in China over the past decade. China has constantly faced both high and low virulence avian flu. Low virulence avian flu is also important because it retards growth in poultry. According to the article, China has constantly had H5N1 avian flu circulating at least since 1996. [Compare that statement with official statements mentioned in the first article and the PNAS journal article on the evolution of H5N1 influenza virus in China]
In July 2004, Chen Hualan of the Harbin Veterinary Research Institute reported in the Proceedings of the National Academy of Sciences that analysis of HN51 from Chinese domestic ducks showed that there viruses are the earliest kinds of H5N1 found in China and that over a long period of evolution, these viral particles acquired the ability to produce deadly infections in mice. This suggests that they might also infect people.
[Here is the abstract of Chen's article available free from the PNAS website]