WHO suspects bird flu may go undetected in China's villages

Dec 7 2005

The World Health Organization (WHO) says there had been no reports of bird flu in the Chinese village where a 10-year-old girl has fallen ill with bird flu, and they are concerned that poultry outbreaks may be going undetected or unreported in China.

Henk Bekedam, WHO China representative says the circumstances, which had been found in other human cases both in China and in Southeast Asia, should be a warning that infections in people may not always be forewarned by mass deaths in animals.

Bekedam has said that it is not always that clear that something untoward is happening as birds and poultry die and farmers expect this, and it is not always clear that it is H5N1.

China's Ministry of Health reported the latest human case late on Tuesday, saying a young girl, from the southern Guangxi region, had been ill with pneumonia and fever since November 23 and was under emergency treatment in hospital, while experts were investigating the source of the virus.

Although to date none of China's reported outbreaks this year have been in Guangxi, the county where the girl fell ill borders Hunan province, where a 9-year-old boy has survived the disease from which his sister is suspected of dying.

China has also confirmed two human deaths from bird flu, both in the eastern province of Anhui.

According to reports China has had some 30 outbreaks this year of the H5N1 strain, and although in the main the disease mostly affects birds, scientists do fear it could mutate into a form that can pass easily between people, leading to a human influenza pandemic.

H5N1 is endemic in poultry in parts of Asia where it has infected more than 130 people altogether, killing 69.

The Chinese government has promised resources and openness in fighting bird flu after being widely criticized for an initial cover-up of the SARS virus in 2003, but Health Minister Gao Qiang has admitted that rural doctors might be ill-equipped and ill-trained to detect cases.

Guangxi is apparently embarking on a program to improve the training of medical workers and enhance public education, according to Tan Mingjie, deputy head of the regional health bureau.

Health organizations in Guangxi are also scrutinizing carefully any patients with fever or respiratory disease.

Markets are also being supervised to ensure sick poultry does not enter.

Bekedam has repeated again that reporting must be timely and there should be incentives to do so, adding that in the case of one outbreak in Hunan, birds began dying on Oct. 6 but it was another two weeks before the Agriculture Ministry was informed.

Bekedam also advises that though China has been compensating farmers about 10 yuan (US$1.25) per bird culled, they also need to be supported during the period before they are allowed to restock their birds and go back into business.

Bekedam says that people in the countryside were becoming more aware of the virus but the very fact that as much as 70 percent of China's poultry population lives in backyards means that monitoring the health of chickens and ducks is a huge challenge.

He says it is inappropriate and unrealistic to tell people they should be fearing birds and ducks in their area, when they live in the middle of it.