H5N1 Update: unconfirmed Chinese mini-outbreak

[Windy]

As reported by The Frankfurter.

Translation, for those who can't read German:

WHO Avian Influenza Expert Says 300 Dead In China
- -------------------------------------------------
Dr. Masato Tashiro, a Japanese WHO consultant, believes that China
has had 300 human deaths from avian influenza and is hiding the true
extent of the disease from the rest of the world. Dr. Masato Tashiro,
Director of the WHO Collaborating Center on Influenza at the National
Institute of Infectious Diseases, Tokyo, and head of the Department
of Virology of the National Institute of Infectious Disease (Japan),
astonished colleagues with this information during a speech at a
recent retirement dinner for a fellow virologist, Hans-Dieter Klenk.

Having just returned from the Hunan province of China on behalf of the World
Health Organization (WHO), [Dr. Masato Tashiro] claimed that a reliable source
had provided him with details of the true nature of the H5N1 virus in
China. "We are systematically deceived," he is reported to have said.

Tashiro visited China on behalf of the World Health Organization (WHO) in
Hunan province. His laboratory, at the National Institute for Infection
Research in Tokyo, as one of the Asian points of contact for the United
Nations, had been particularly entrusted with investigations into avian
influenza in Asia and China. Dr. Masato gave his lecture in the University of
Marburg Clinic before some the most outstanding virologists in the world and
shocked the meeting with his unauthorized data [report] from inside China.

The Japanese virologist [said he] firmly believes in the reliability of the
source and its data. The secrecy of the Peking government is still causing
concern as it was at the beginning of the SARS epidemic disease, complained
Tashiro. At least 5 medical co-workers who should be reporting on the
situation in the provinces were arrested, and [other] publication-willing
researchers were threatened with punishments [he said].

[Brent]

Oh lovely.

[MGC]

Not surprising. The Chinese did hide the extent of the SARS outbreak a couple of years ago. The Chinese are trying to dupe the world into believing they are the perfect society.....MGC

[cjrciadt]

The question here is not if. but when?

[Forecaster Colby]

Hundreds? Oh man, I wonder if it...

[Cookiely]

I'm becoming more optimistic in regards to loss of life when it does develope. We have the technology and resources to confine and eventually destroy this flu. The early warning system in effect at various hospitals will give us a tremendous edge. Also, monitoring the airports.

[wxmann_91]

I'm becoming more optimistic in regards to loss of life when it does develope. We have the technology and resources to confine and eventually destroy this flu. The early warning system in effect at various hospitals will give us a tremendous edge. Also, monitoring the airports.

Let's hope so.

[Radar]

I believe that when the Avian flu virus does make it to the U.S./Canada the deaths caused by it will be relatively minimal if you look at the grand sceme of things. First of all the U.S. and Canada have excellent health care systems and we do not turn people who are unable to pay for services in China you must pay upfront for any medical services. Forcing the middle and lower class in their country to go without medical care when they can not afford it. Secondly, Most of us go to the doctor frequently and are up to date on immunizations. In China I imagine that many of the people that have died from Bird Flu do not go to the doctor very often and most probably havent had immunizations from the flu. Thirdly, in our developed countries we have good sanitation and our hospitals and clinics are watched very closely to ensure that certain health standards are maintained. In China I imagine in the lower income areas they do not have the sanitation infrastructure as we do and their living conditions are not as healthy as ours.

I believe our country will meet this challenged when it does threaten us and we will be prepared. Maybe not 100% prepared but we as a society will fare much better then many nations of the world.

[Windy]

I believe that when the Avian flu virus does make it to the U.S./Canada the deaths caused by it will be relatively minimal if you look at the grand sceme of things. First of all the U.S. and Canada have excellent health care systems and we do not turn people who are unable to pay for services in China you must pay upfront for any medical services. Forcing the middle and lower class in their country to go without medical care when they can not afford it. Secondly, Most of us go to the doctor frequently and are up to date on immunizations. In China I imagine that many of the people that have died from Bird Flu do not go to the doctor very often and most probably havent had immunizations from the flu. Thirdly, in our developed countries we have good sanitation and our hospitals and clinics are watched very closely to ensure that certain health standards are maintained. In China I imagine in the lower income areas they do not have the sanitation infrastructure as we do and their living conditions are not as healthy as ours.

I believe our country will meet this challenged when it does threaten us and we will be prepared. Maybe not 100% prepared but we as a society will fare much better then many nations of the world.

You need to read up more on H5N1 flu. More or less everything that you just said is irrelevent. There are currently no vaccinations for H5N1, and even those given advanced medical care have a 50% mortality rate. The only effective treatment appears to be a course of antivirals that must be taken nearly immediately (within a day of getting H5N1), and even then the moralitiy rate is still quite high. Lastly, for all of our medical advancements, we don't have the capacity to treat 15 to 30 million Americans at the same time for something like this. If it were the worst case scenario, expect people to die at home or in "superdome-like" buildings, then be carted off to mass graves and buried with lime.

[Windy]

The virologist in question comments, as does a collegue. Either he was misquoted or he is backpedaling; it would seem that the recollections of those in attendence are somewhat different than that of the speaker:
AVIAN INFLUENZA, HUMAN - EAST ASIA (182): CHINA
***********************************************
A ProMED-mail post
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International Society for Infectious Diseases
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[1]
Date: Thu 24 Nov 2005
From: "Masato Tashiro, NIID JPN" <mtashiro@nih.go.jp>


Statement from Dr. Masato Tashiro
---------------------------------
I am surprised to read the report in ProMED-mail, Avian influenza,human - East
Asia (180): China, RFI [part 1] {archive number 20051123.3399).

First of all, it is not correct. Therefore, I would ask you to correct it.

In my presentation at the meeting in Marburg, I stated that WHO's
official numbers of H5N1 human cases are only based on laboratory
confirmed cases. It should be therefore an iceberg phenomenon. Due
to poorly organized surveillance and information sharing systems in
many affected countries including China, it is reasonable to consider
that more cases have occurred actually. We have heard many 'rumors'
or unauthorized information which we cannot confirm. In this context,
I talked about a few examples of non-authorized information and rumors
about Asian countries which I received through private channels. I
clarified that I do not know the original sources and I cannot confirm
whether they are true, how these numbers were derived and what
laboratory tests and epidemiological investigation were done.

Therefore, the article cited in ProMed-mail is incorrect and
misleading. I did not receive any interview during my stay in Germany.
I did not say anything that I believe the figures of the unauthorized
information.

My message at the meeting was that international societies should help
China to establish and perform nationwide surveillance and information
sharing systems. I do not think that the Chinese Authority will
conceal the facts from the world. Since the SARS event, they are
collaborative to WHO. But they may have still limited capacity to
monitor all human cases particularly in rural areas.

--
Masato Tashiro, NIID JPN
WHO Collaborating Center for Reference and Surveillance on Influenza,
National Institute of Infectious Diseases, Tokyo
<mtashiro@nih.go.jp>

[The article published in the Tue 22 Nov 2005 edition of the Frankfurter
Allgemeine, a reputable German newspaper, was referred to ProMED-mail
independently by two reliable correspondents. ProMED-mail was not able to
verify the accuracy of the newspaper report prior to posting and we
regret propagating inaccurate information [but see [2] below]. The hysteria
surrounding the outbreaks of HPAI H5N1 avian influenza in East Asia, and the
associated threat of an imminent pandemic of human influenza, has generated a
great deal of misinformation fueled by journalists competing to establish a
presence in the field, particularly with regard to events in the People's
Republic of China. We are grateful to Dr. Tashiro for clarifying his
position. - Mod.CP]

[2]
Date: 24 Nov 2005
From: Arnon Shimshony <arnon@promedmail.org>


The Israeli daily "Haaretz" included the following information in a front-page
article earlier today [24 Nov 2005] (translation from Hebrew):

"One of the participants in the meeting, Prof Hans-Dieter Klenk from Marburg
University in Germany, confirmed -- in an interview with "Haaretz"
yesterday [23 Nov 2005] -- the quote from Dr Masato Tashiro of the Japanese
Ministry of Health. "Dr Masato presented a well-detailed table, in Chinese,
which included more than 300 human fatalities, resulting from avian influenza,
recorded in China during recent years", said Prof Klenk yesterday. "He
[namely Tashiro - A.S.] said that he had received the unofficial report during
his visit to China in recent weeks", said Klenk". End translated passage.

According to the Frankfurter Allgemeine, Dr Masato sharply criticised the
Chinese authorities, saying they are "deliberately misleading the West"; this
was denied by Prof Klenk. [As I understand it, the denial means that the said
criticism was not said by Masato - A.S.].

Assaf Uni, the "Haaretz" reporter who interviewed Klenk, is a reputable one.

--
Arnon Shimshony
ProMED-mail Animal Disease and Zoonoses Moderator
Associate-Professor, Koret School of Veterinary Medicine
Hebrew University of Jerusalem, Israel
<arnon@promedmail.org>

[see also:
Avian influenza, human - East Asia (180): China, RFI 20051123.3399
Avian influenza, human - East Asia (177): Indonesia, China 20051119.3368
Avian influenza, human - East Asia (175): China 20051118.3358
Avian influenza, human - East Asia (174): China 20051117.3354
Avian influenza, human - East Asia (173): China 20051116.3349
Avian influenza, human - East Asia (172): China, seroconv 20051115.334
Avian influenza, human - East Asia (171) 20051115.3336
Avian influenza, human - East Asia (170): China, susp 20051114.3329
Avian influenza, human - East Asia (166): China, q... 20051110.3282
Avian influenza, human - East Asia (162): China, susp. 20051106.3252
Avian influenza, human - East Asia (161): WHO trav... 20051106.3249
Avian influenza, human - East Asia (159): China, H5 antibody 20051104.3231
Avian influenza, human - East Asia (157): China, RFI 20051103.3214
Avian influenza, human - East Asia (153): China, retest requested
20051028.3145]
.......................jw/cp/arn/jw