30 December 2005
China Reports Seventh Human Case of Bird Flu, December 30, 2005 (Source of victim's infection unknown, health officials say)
By Charlene Porter
Washington File Staff Writer
Washington – China’s Ministry of Health reports another human death from a highly pathogenic form of avian influenza, the seventh case to appear in the nation of 1.3 billion people, and the third death attributed to the H5N1 virus.
The World Health Organization affirmed China’s findings in the case December 30.
The latest victim is a 41-year-old woman from the southeastern province of Fujian who developed a fever December 6. That symptom was followed by lung inflammation that advanced to pneumonia. She was admitted to the hospital on December 8 and died on December 21.
China reported its first human cases of H5N1 in November, though China, like most nations of the region, has been battling animal outbreaks in domestic poultry flocks since the winter of 2003-2004. (See related article.)
In this two year period – during which the most extensive, widespread plague of avian influenza ever seen emerged -- China has not been among the most severely affected nations, according to figures compiled by the Food and Agriculture Organization (FAO) of the United Nations. Both Thailand and Vietnam have experienced seasons with hundreds of outbreaks, requiring the culling of thousands of birds, but China’s worst season was marked by 50 outbreaks in 2003-2004. Additional information is available on the FAO’s Web site.
When the first avian influenza cases appeared in humans, China became the fifth nation to document the movement of this animal disease into people. Cambodia, Indonesia, Thailand and Vietnam previously reported human illness and death from H5N1, a total of more than 140 cases now affirmed by the WHO with 74 deaths. Thailand and Vietnam have suffered the most with 14 and 42 deaths, respectively.
QUESTIONS ABOUND FROM NEW CASE
The questions that surround this new case in China might have come from a mystery story. The woman had no known exposure to poultry. Agriculture officials have not been able to detect H5N1 in the poultry found near where she worked or lived. None of her close contacts have developed disease symptoms, three weeks after this patient first took ill December 6.
Where did she get the virus? Where is it hiding in the environment? What can epidemiologists learn about H5N1 and it’s potential to cause broader outbreaks of human disease from the circumstances of her illness? Health officials still are working to answer those questions.
In most human cases, the path of infection from sick birds to humans has been readily identified. Poultry workers, farmers, people who have slaughtered chickens, children who have been playing in yards with infected chickens – these are the types of cases most frequently seen among humans.
The human cases so far have not shown a pattern of easy human-to-human transmission, through contact as casual as a cough or sneeze. That tells health officials that the H5N1 virus has not yet mutated to develop the capability to become easily contagious among humans. If it does, then an influenza pandemic could result because this viral strain has so rarely appeared in humans that people would have little immunity to fight the virulent pathogen.
The year ends with a markedly heightened international awareness of the possibility for pandemic and the need to prevent it. The issue has been at the forefront of a series of major international meetings and conferences since May.
In September, President Bush launched the International Partnership for Avian and Pandemic Influenza, which now has the support of almost 90 nations and the major international organizations involved with health and agriculture. (See related article.)
In the few months since formation of the partnership, acting Assistant Secretary of State for Oceans, Environment and Science Anthony “Bud” Rock says there has been “a dramatic difference in heightened awareness” about pandemic in other nations.
Testifying at a congressional hearing December 7, Rock said the international discussion of pandemic also has brought on more dialogue between ministries of public and animal health in many countries. A key action to prevent pandemic will be greater surveillance of disease among animals and humans with recognition of how their close contact can result in an exchange of viruses and exposure to previously unknown diseases. (See related article.)
For ongoing coverage of U.S. and international efforts to combat avian influenza, see Bird Flu.
