China probing report of 2003 human H5N1 case

Jun 28, 2006 (CIDRAP News) – The Chinese Ministry of Health is conducting its own investigation into the report of a man who died of H5N1 avian influenza in late 2003, according to a report today by Agence France-Presse (AFP). The case was first described by eight Chinese researchers in the Jun 22 issue of the New England Journal of Medicine (NEJM).

The Chinese Ministry of Health said it was conducting its own tests to try to confirm the case, Roy Wadia, World Health Organization (WHO) spokesman in China, told AFP. The date given for the case, November 2003, was 2 years before China officially reported any human H5N1 cases to the WHO.

The Ministry of Health said it was unaware of the case until the researchers' report appeared in NEJM, Wadia told AFP. He said the WHO has asked the health ministry to determine where the man caught the H5N1 virus and whether there were other deaths. He also said it was unclear why the scientists, who work at state institutions, did not report their findings to the health ministry.

Adding to confusion about the case, the NEJM reported last week that the authors had e-mailed the journal requesting that the report be withdrawn, but the request was too late. Karen Pederson, NEJM spokeswoman, told CIDRAP News today that the journal then asked the researchers to explain the rationale for their withdrawal request.

The journal took the withdrawal request seriously, Pederson said, because one of the e-mail messages requesting withdrawal came from the real address of one of the researchers. She said the authors responded that they stood by their report and none of them said they had e-mailed a request to withdraw it.

In the AFP article, Wadia declined to speculate about a cover-up by the Chinese government. "We are just waiting for further information as to when exactly it was confirmed and why was it not conveyed to the Ministry of Health," Wadia told AFP.

The November 2003 death of a 24-year-old Beijing man attributed last week to avian influenza was originally thought to be from severe acute respiratory syndrome (SARS), according to the authors of the NEJM report. The case is significant because, if confirmed, it revises the timeline and geographic pattern of human cases of avian flu (see link to Jun 22 CIDRAP News story below).

See also:

Zhu Q-Y, Qin E-D, Wang W, et al. Fatal infection with influenza A (H5N1) virus in China (letter). N Engl J Med 2006 Jun 22;354(25):2731-2 [Full text]

Jun 22, 2006 CIDRAP News story "Report: China had human H5N1 case in late 2003"

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