Well gee... I thought I'd start some fearmongering. I could have kept it secret until confirmed. That would be the prudent thing to do under the circumstances, but what the heck. This is from a very reliable site, The Infectious Disease Society, daily e-mail alert system.** It is wise to heed their moderator's note of caution. The moderator is very wise.

What disturbs me the most will be if the reports are true about jailing medical providers. During the SARS outbreak I don't believe anyone was jailed. The government kept denying reports but the medical community was sending e-mail reports out that the IDS was passing on to everyone.

On the other hand, it is so unlikely China had only a few H5N1 cases. If their frequent exposure to precursor strains gave them a more immune population it would be possible. But it seemed odd.

Then there was the very eye opening (to me) response when SARS occurred. It was mind boggling the Chinese government officials really did have old fashioned people in power that truly either didn't understand the benefit of revealing the SARS problem or preferred to handle it internally purely for political ego. I don't mean that to stir up a political discussion. But those are the best words I can find to explain it. I can not fathom national ego when it means you cover up disasters of this nature. It's one thing to pretend your dam didn't fail, but quite another to pretend an epidemic isn't occurring.

With the SARS cases, the national government was much more forthcoming than the local guys. They even fired a mayor or two over it. The whole thing was difficult to understand from my cultural perspective.

I suppose, as here, their government leaders are not medical experts as ours aren't. That means we have non-scientists making decisions that would be much better if made by scientists.


But I digress...I suspect CNN and company will get wind of this by tonight's news. They do so love a disaster and a scandal.


**Note of caution: Don't sign up for their list serve. Instead bookmark the page and check it when you want to. The daily e-mails are constantly flooded with viruses. They seemed to take few precautions with their mailing list database.

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Ooh---good find; meanwhile, the official line remains:
November 22, 2005
"China said...a woman farmer had died...its second confirmed fatality..."

If true, it is spreading more rapidly then expected....we may be looking at a very serious problem

a very disturbing report, if true- on both levels

And of course China is saying "no way!" while the rest of the world holds out for their real information.

You know - this sounds a lot like SARS, where the first denied it, then...

then...

the...

th...

t...

...

..

.

Any news people?

UUUppssss! this is kind of scary.




Titana......

As of an hour ago, (0100am EST, 11-24-05), CNN is sticking with the official Chinese report and made no mention of the information. Not that their reporters ever read the science blogs. So CNN may be waiting for that infamous second confirming source or they haven't noticed the report yet.

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Google search on Dr. Masato Tashiro indicates he is an upstanding scientist in the virology field.

He works for the National Institute of Allergy and Infectious Diseases National Institutes of Health, Japan.

Japanese CMSP Panel/Board Members
Dr. Masato Tashiro (1996- )
Director
Department of Viral Disease and Vaccine Control
National Institute of Infectious Diseases
4-7-1 Gakuen, Musashimurayama
Tokyo 208-0011, Japan

The Mission Statement

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"Oh my God! SARS!"

...and practically nothing happened (fortunately).

--

I wouldn't put it past China to withhold information like that. Given fairly recent events it's obvious that they're very isolationist.

Yeah, heck, SARS only killed a couple hundred nurses, doctors, and other health care workers and left a few more of them disabled for life. That's practically nothing. It's so nice to know the public noticed.

SARS was indeed a VERY BIG deal and we dodged the bullet thanks to incredible advances in medical technology and some very hard work by some health care workers who were sent in before we figured out exactly how to protect them.

Had SARS happened just a few years earlier, you would not be so fortunate. Pandemic flu has some particular characteristics that will not be so easy to control as SARS. Mainly, almost all if not everyone with SARS was deathly ill. That meant they were easy to spot. Which then meant they could be isolated as well as all their contacts. Influenza will not be so consistent. In fact, there will be many people with mild symptoms that will go undetected and spread disease. Don't count on the same control as we had with SARS.

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The German weekly Die Zeit has an interview with WHO's flu coordinator Klaus Stöhr on the subject.
http://www.zeit.de/online/2005/47/stoehr_interview (in German)
He assumes, that Tashiro was misquoted, that he talked about hoax sites on the web and used an example. The WHO is permanently scanning the web for new information related to diseases and the figures attributed to Tashiro have been known to be a hoax source before.
The big difference to SARS is, that now the WHO is in China. And I think, the Chinese government has learnt in a positive way from the information disaster with SARS.

Harald

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Here's the original source of information which I cannot read. If anyone can read it I'd appreciate being filled in where this translation leaves off. (Go to the Google link and click on translate this page.)

It looks like of the 300 cases, 7 might have been person to person. It also looks like the source confided in the good doctor and he vouches for that source. Since the expert likely had contact with colleagues, I do find the report somewhat credible. If the IDS moderator didn't think it was a credible story, he/she would have said so. They post news reports all the time with comments about the report's lack of credibility.

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I await your help reading the source I posted. In the mean time, IDS is very good about posting corrections. If the doctor was mis-quoted or a hoax occurred there will be many folks who know and will notify the moderator. Chances are high the doctor himself will respond.

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And we have the answer, so nevermind kucharek.

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http://www.masternewmedia.org/2003/0...om_fiction.htm

Well, debunk THIS! Let's see if your debunk-fu is greater than mine... er, this guy's!

HIYA!

(Note: I just found this on google, so I don't really know if it's a reliable source. So be warned. Reading it over, it seems pretty biased and "anti-establishment"... still, are the figures wrong?)

I can´t understand how come such an explosive rumor like this hasn´t made its way onto the tabloid headlines.

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There is no mad cow in China ! . . . er . . . there is no mad cow in America ! Only bird flue in China !

Hey don't misunderstand me ! There is no mad cow in France too !

And when Chernobyl exploded, radiations completely controled by our government , just stay behind the Border !

Poor , poor chineses can't you see , how happy we are , living in democratic countries !

I'm very sceptical about this. For all we know that Japanese guy could be trying to create an atmosphere of fear which will drive up the share price of the anti-viral drug manufacturing company that he is heavily invested in. Japan has enough of its own bird flu problems. They shouldn't be pointing the finger just yet...

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If I understand correctly, he confirms what was said by the interviewee in the "Die Zeit", that he just showed examples for unconfirmed rumours?

Harald

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I think we know enough about this reputable person who has a very long public track record that you paranoia is misplaced here.

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Thanks.

I think that is becoming the clearer picture. It doesn't make the numbers true or false. Judging from the SARS events I'd conclude tentatively that the numbers are possible but rather than government cover up, it is lack of diagnostic capability in rural China combined with a few 'old school cover up believing' local officials and a few farmers covering up for economic reasons.

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First, these numbers were very early on in the epidemic, and second, the news is a secondary source of information. It's best to try to find original sources of information.

There is a common misconception that since the SARS epidemic was controlled that it never was as bad as first feared. Had the SARS outbreak occurred even a decade earlier, this misconception would not be the case. The world would know what those of us in infectious disease specialties know, we didn't dodge a bullet, we dodged the A-bomb.

The means of control was the world's public heath systems that were able to find every case and every contact of every case and isolate them until there were no more cases. We've had this capability in Western countries for decades but in the third world it is a new development.

No, you weren't at risk traveling to Toronto. That response was unnecessary. But you were at risk, had we failed to contain the outbreak, of being one of the millions that could have been infected eventually. Remember, one guy spread the infection to 9 others by passing them in a hotel elevator. Those nine subsequently flew off to multiple countries.

Had there been very many of such cases people could have been exposed randomly who had casual but close contact with the infected persons. For example, handing a clerk some change in a store, sitting next to the person on the plane, opening the door to the bathroom the guy just walked into ahead of you and so on could have been sources of transmission had the epidemic gotten out of control.

So what are the reasons I say this? Here are the facts from primary sources.

CDC's website
WHO table
1706 of the 8096 were health care workers, with 9.6% fatality rate that is ~162 deaths from 1 November 2002 to 31 July 2003, only 9 months! Canada had 43 deaths of which 43% of the cases were health care workers. I haven't found the exact number of health care worker deaths, but I do know in addition to one worker, their spouse also died. Taking an infection home to a loved one is particularly frightening.

And in addition to the fatalities, most of the survivors have permanent serious complications like lung damage from SARS and bone pain and loss from large amounts of steroids used to save them. Many spent weeks to months in intensive care units and on ventilators.

Toronto report
(emphasis mine)

CLUSTER OF SEVERE ACUTE RESPIRATORY SYNDROME CASES AMONG PROTECTED HEALTH CARE WORKERS - TORONTO, APRIL 2003 report
How would you feel if 40% of the people an your job site come down with a deadly disease? In modern times there has never been anything like this in health care. If we can't protect ourselves even with strict isolation procedures, then one is talking about a disease that is extremely contagious at least some of the time.

Another consideration is this epidemic killed at least 8,000 in only 9 months time and with extreme control measures such as sealing a Taiwan hospital with staff and patients alike inside until no new cases were occurring. You have to consider what the attack rate is over what amount of time to compare risks of infectious diseases. Who gets it, where, what percentage of those exposed, and what percent is fatal. Rabies is 100% fatal but only a few people are ever exposed. The 1918 flu may have killed as few as 3% in the USA but as many as 50% of the population was exposed. (rough guess numbers for example only)

In addition to all this there were a few thousand unreported cases that occurred before the disease was recognized and patients counted. I first heard about SARS from my IDS site a few months earlier than the hotel elevator event. Doctors were e-mailing the reports of a very serious respiratory disease with a high death rate in Guandong Province in China that was "killing health care workers".

In Taiwan there was an unusual outbreak incident in a 38 story apartment complex that wasn't understood until long after the epidemic was over. SARS virus was being aerosolized and spreading through a subsequently contaminated sewer system that ran through the building. The virus was entering people's apartments via contaminated pipes. When you see a deadly infection spreading and you can't figure out the source, 'concern' is an understatement.


In summary, we had a highly infectious disease (even if it wasn't so in all cases), with a high attack rate, it had a very high morbidity and mortality rate (who got very sick and/or died), it was infecting the people who were using isolation procedures (meaning it was going to be very hard to control), and it had many many unknowns. That is a very serious situation. Just because we did a very good job of controlling it doesn't mean the initial warnings were overkill.

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And a further clarification:

IDS siteIt is amazing how the news reporting really is so much like the game of telephone. Apparently this guy's little talk raised quite the stir. The following post on the site included a denial by China of hiding any cases, and a note about where the information had been published.

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Your debunk-fu is strong. I admit defeat.

Thank you. I'm sensitive about health care workers' infectious disease risks. We've been short changed on protection for years.

"Here, put on this surgical mask that was never designed to protect workers and go in that room where that patient has a deadly airborne infectious disease."

and

"Of course we don't need to make those simple changes to those needles to make them safer. You need to be more careful with those needles that are contaminated with a deadly blood borne disease."

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I'm sorry, man. I didn't mean to short-change what happens to the health care workers. I'm all for reducing the risk that workers have to go through.

Oh, it may interest you to know that recently there's been some pressure up here for the provincial government to make safety needles mandatory in all cases. I'm all for it.

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Gotta love China. They deserve whatever fate befalls them over this mess. This one ranks right up there with denying the WHO permission to treat SARS in Taiwan because they were all bent because it would be allowing the UN to acknowledge their independence.

Utterly irresponsible.

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Wait. Do you mean the countless deaths that will probably result? Wouldn't that be the people of a land paying for the decisions of politicians? The people deserve to die because of the decisions of the higher ups?