China Closes Lab
Isolating, Sequencing
H5N1 Bird Flu
Dr. Henry L. Niman, PhD
Recombinomics Commentary
A laboratory jointly run by universities in Hong and China said on Tuesday it had suspended studies into the H5N1 bird flu virus after Beijing issued new guidelines which triggered fears of a crackdown on academic freedom and independent research into the deadly disease.
The new rules were issued on May 30, five days after the Joint Influenza Research Centre sent an article to the international journal Nature which said that infected wild birds in western China might have picked up the virus from poultry farms in southern China.
A day after the article was published, Jia Youling, director general of the Ministry of Agriculture's Veterinary Bureau, criticised the findings and said no bird flu had broken out in southern China this year.
The closing of an independent lab in China is cause for concern. The lab has been doing H5N1 research in collaboration with Yi Guan's lab at Hong Kong University. The publication in Nature clearly demonstrated that H5N1 was present in 2005 in eastern China, even though China had filed no OIE reports in 2005 prior to the May 21 report on Qinghai Lake. Subsequent reports were filed on outbreaks in Xinjiang province, but there are still no reports of H5N1 in China in 2005 east of Qinhai Lake.
The 2005 isolates from Shantou in Guangdong Province were of particular interest, because five of the eight genes were virtually identical to the corresponding genes from Qinghai Lake isolates, clearly demonstrating a relationship between the H5N1 tarnsmitted betaeween two regions in China. The lack of the PB2 mutation E627K in isolates outside of Qinghai Lake supports the notion that the isolates in Shantou may be from earlier Qinghai Lake infections instead of precursors of the Qinghai Lake isolates. However, the relationship demands more study.
China's actions strongly suggest they want to control and withhold vital information regarding H5N1 in China. The sequences will like be appearing throughout Asia and Europe via migratory birds wintering in China and Russia, but samples collected as the H5N1 evolves this season will be particularly important because of the lethality associated with Qinghai isolates and the H5N1 endemic to much of Asia, including China in general and Guangdong Province in particular.
The Qinghai isolates, as well as isolates from Vietnam, share many polymorphisms with isolates from Guangdong province. Independent studies of this region should be increased not decreased.
The timing of the new announcement, in view of the 20 isolates deposited at GenBank and Los Alamos (which included all 12 isolates collected at Qinghai Lake), as well as the virulence of the Qinghai isolates, increases concerns that there is a raging pandemic in China and information on H5N1 is being withheld.
It is doubtful that s. suis is the etiologic agent.
China - Strange Disease Kills 17 In Sichuan Province
From Patricia Doyle, PhD
ProMed Mail
China View - Xinhua News Agency
Investigations are under way after a mysterious disease killed 17 farm workers and left at least 12 in a critical condition in hospital in Southwest China's Sichuan Province.
Zeng Huajin, a senior official with the provincial health department, said the deadly illness was "probably" caused by _Streptococcus suis_, a bacterium usually spread among pigs. "I can assure you that the disease is absolutely not SARS (severe acute respiratory syndrome), anthrax or avian influenza," the official said last night. "If it is caused by _Streptococcus suis_, we still need further research," he added.
An initial 20 farm workers who handled sick or dead pigs and sheep in 12 towns and 15 villages in Jianyang city and Ziyang city's Yanjiang district suffered from high fever, nausea, vomiting and haemorrhaging. But more cases were reported as health workers began to search villages for the sick. "By noon on Saturday [23 Jul 2005], 58 people suspected of having the disease had been reported in Ziyang and (neighbouring) Neijiang," according to a statement last night from the provincial health department. "2 people (of those 58) have been released from hospital while 27 of them are recovering," the statement said.
The statement said that the patients were from 49 villages of 23 townships in Sichuan and they were not related to each other. Zeng said the disease could not spread among humans, and normally only those with a weak immune system became ill. The Ministry of Health and Ministry of Agriculture last week sent a special team to Sichuan to assist in the investigation, treatment and control of the outbreak. The 2 departments were not available for comment yesterday. "This is a good job of disease surveillance, and shows China has vastly improved its system since the SARS period in 2003," World Health Organization spokesman Bob Dietz was quoted by Bloomberg as saying.
A physician with Ziyang No 1 People's Hospital said yesterday that people could quickly become ill and doctors were busy carrying out emergency treatment. All patients were reportedly being treated at 3 hospitals in Ziyang. Yesterday, Hong Kong put out an alert relating to the disease. Frozen pork from Sichuan is safe to eat, the Secretary for Health, Welfare and Food York Chow told the Hong Kong public. He confirmed that no live pigs are imported from the province into the territory. He said frozen pork imports come via designated companies with permits from the Hong Kong health authorities.
This outbreak appears to be more extensive than originally reported, with another 58 people under observation with similar symptoms. Our previous suggestion that the common factors of the sporadic nature of the cases, the limitation to farmers tending pigs and sheep, and the late development of haemorrhagic symptoms might suggest involvement of Crimean-Congo haemorrhagic fever (CCHF) virus probably no longer applies. This suggestion is not compatible with the reported sickness and death of the pigs and sheep in the care of the affected farmers. CCHF virus infection does not normally produce symptoms in domestic animals. The disease bears no resemblance to avian influenza and a bacterial infection is now the locally preferred diagnosis. - Mod.CP
_Streptoccossus suis_ is a commensal organism in pigs that can cause invasive disease. The Gram-positive coccus can also cause disease in man. Usually individuals at risk are those with exposure to pigs or pork (pig farmers, slaughterhouse personnel, butchers). The most common manifestation of human _S. suis_ infection is meningitis, and although _S. suis_ infection is relatively rare in the West, it has been reported to be the 2nd most common cause of pyogenic meningitis in Hong Kong (1). Although most reports are from Asia, the infection in humans has been reported in many countries in Europe as well. Early hearing loss in these cases is a common feature (2). Additionally the infection may be more virulent and recurrent in those who are asplenic or functionally hyposplenic (3). Primary bacteremia, septic arthritis, pneumonia, and endocarditis have also been reported (4).
The infection is generally sporadic in man, and since overt meningitis is not described in the current cases, it appears that _S. suis_ is less likely to be the etiology of this outbreak in China.
1. Gui ACF, Ng KC, Tong PY, et al: Bacterial meningitis in Hong Kong:10-years' experience. Clin Neurol Neurosurg 2005;107:366-70.
2. Donsakul DK, Dejthevaporn C, Witoonpanich R: Southeast Asian J Trop Med Public Health 2003; 34:154-58.
3. Francois B, Gissot V, Ploy MC, Vignon P: Recurrent septic shock due to _Streptococcus suis_. J Clin Microbiol 1998; 36:2395.
4. Kay R, Cheng AF, Tse CY: _Streptococcus suis_ infection in Hong Kong. QJM 1995p;88:39-47. - Mod.LL] ...cp/pg/dk
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