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Three "Pneumonia" Deaths Being Re-Investigated for Bird Flu in China

Posted on: Sunday, 6 November 2005, 09:00 CST

Text of report by Zhu Tu and Zhou Tinguy entitled: "Ministry of health notice on three cases of pneumonia of unknown origin in Hunan", carried by official Chinese news agency Xinhua (New China News Agency)

Beijing, 6 November: A news spokesperson at the Ministry of Health issued a notice on 6 November regarding three cases of pneumonia of unknown origin in Xiangtan County, Hunan Province. Since 27 October, the Ministry of Health has received reports from the Health Department of Hunan Province saying that a total of three cases of pneumonia of unknown origin have occurred in that province.

Case No 1 was a 12-year-old girl with the surname He, who was a middle school student in Shebu Township in Xiangtan County. She was received at the Xiangtan County Women's and Children's Health Clinic with "severe pneumonia" on the morning of 16 October. At noon that day she was transferred to the Xiangtan County Children's Hospital. Emergency treatment was ineffective and she died on the morning of the 17th from "double pneumonia and acute respiratory distress syndrome (ARDS)." Samples taken after the patient became ill tested negative both for H5N1 avian influenza and for infectious atypical pneumonia (SARS).

Case No 2 is the 9 year old younger brother of the girl who was case No 1. He is a third year elementary school student in Shebu Township in Xiangtan County. He was admitted to the Xiangtan County Women's and Children's Health Clinic on 17 October, and was transferred to the Xiangtan County Children's Hospital and put in isolation there on the evening of 18 October. On 22 October, his temperature began to return to normal, and his clinical symptoms and all tests showed him returning to normal. His throat swab samples and blood serum samples all tested negative for the H5N1 avian influenza virus, except for one sample suspected positive for H5. All his samples tested negative for SARS.

Epidemiological investigation revealed that avian influenza had broken out in the village of Wantang in Shebu Township in Xiangtan County where this brother and sister lived, and that the two of them had close contact with dead household fowl.

Case No 3 is a 36 year old ethnic Han Chinese man surnamed Song who is a middle school teacher in Xiangtan County. He lives in a community in Yisu River Township in Xiangtan County. On 24 October he sought treatment at the Xiangtan County Chinese Medicine Hospital. Chest X-ray showed "pneumonia in the lower left lung." That afternoon he was admitted to Xiangtan City Central Hospital. Following treatment with antibiotics, his temperature returned to normal and his condition steadily improved. His throat swabs and blood serum samples all tested negative for the H5N1 avian influenza virus. Tests for SARS were also negative.

In light of the recent outbreak of H5N1 avian influenza in the village of Wantang in Shebu Township in Xiangtan County, it is the overall analysis of experts that the diagnosis in these three cases is pneumonia of unknown origin, but the possibility of human cases of H5N1 avian influenza has not been ruled out. Determination of the exact cause of these cases requires further laboratory tests. Those tests are being conducted now by the concerned laboratory of China's Centre for Disease Prevention and Control.

When the Ministry of Health received the disease reports, it immediately sent a team consisting of experts in epidemiology, clinical medicine, and laboratory work to Hunan Province to direct the investigation of the outbreak, medical observation, and treatment of the sick. The number of people under medical observation who had direct contact with the patients in these cases or close contact with dead household fowl in the village of Wantang is 192. Nothing unusual has been observed in any of them, except for one person suffering from "acute bronchitis."

The Ministry of Health reported the cases of the He family brother and sister to the World Health Organization on 28 October. On 3 November, the Ministry of Health explained to WHO the details of the three cases of pneumonia of unknown origin in Hunan Province, and the preventive measures taken. In light of the fact that the exact cause of these cases could not be determined right away, the Ministry of Health invited WHO to arrange for experts to come to China to investigate the cause along with Chinese experts.

Source: BBC Monitoring Asia Pacific

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