Swine Flu Infection in China Raises Fears

Posted by: Dexter Roberts on May 11, 2009

Just when fears of a pandemic seemed to be abating, China has reported its first case. On May 11, the government announced that it had quarantined a 30-year-old man suspected of having swine flu, or A(H1N1), in Chengdu, Sichuan, as well as some 200 people that were on two air flights with him on May 9.

The man apparently became infected with the virus while studying in St. Louis, Missouri, and returned to China over the weekend on a Northwest Airlines flight through Tokyo to Beijing, before transferring to a different flight for the final leg to the southwestern capital of Sichuan province. “We are taking [appropriate] measures including quarantining the patient himself,” said Li Dexin, director of the Institute for Viral Disease Control and Prevention at the Chinese Centre for Disease Control and Prevention, in Beijing. “Up to now, we have not discovered any secondary infections. The whole situation is under our control,” he told reporters in Beijing.

Even before the discovery, Chinese authorities had taken precautions to prevent a potential outbreak of the virus. China’s Ministry of Health, which has led the effort in coordinating disease experts, agricultural and quality inspectors, scientists and foreign ministry officials, had ordered several earlier quarantines around China, strengthened health inspections at all borders, stepped up monitoring at pig farms and slaughterhouses, and disinfected vehicles and cargo from affected countries. (Other mainland organizations taking part are the China Centre for Disease Control, the General Administration of Quality Supervision, Inspection and Quarantine, and the agricultural, foreign affairs, and science and technology ministries.) At a May 5 emergency meeting, China’s premier, Wen Jiabao, announced spending of $725 million to fight the virus.

China knows firsthand what can happen when the response to a new virus is delayed: It learned a harsh lesson during the 2003 outbreak of the severe acute respiratory syndrome, or SARS, virus. The government’s initial slow response to that epidemic ultimately led to the infection of more than 5,300 people and 349 deaths in China. Only after weeks of claiming SARS infections were under control did authorities admit, in a shocking about-face, to having a major crisis on their hands. Both the country’s health minister and the mayor of Beijing were fired for their roles in that cover-up.

This time, WHO officials praised Beijing’s response. Says Beijing-based Vivian Tan, spokesperson for the World Health Organization in China: “Now, health workers and officials at all levels have been instructed to detect cases and report them as soon as possible. The Ministry of Health has also been very good about sharing information with WHO.”

Even so, China’s aggressive moves to combat the spread of the flu have upset some. The Canadian government questioned Beijing’s decision to quarantine a group of 25 visiting Canadian students for five days who did not show flu symptoms. And when Beijing cancelled all flights to Mexico and quarantined dozens of Mexicans, including some who had not gone back to their home country in years, Mexican officials reacted angrily. The Mexican government dispatched a special flight to China on May 5 that picked up its citizens in Shanghai, Beijing and Guangzhou, and flew them home. In a television broadcast on May 4, Mexican president Felipe Calderon referred to discriminatory practices of some countries as based on “ignorance and misinformation,” an apparent reference to China.

China, with its vast area and huge population, is particularly vulnerable to the virus, which has already infected some 4,700 people in 30 countries, killing 48. Throw in the fact that the mainland has a migrant population of workers numbering well over 100 million, and China’s challenge in controlling any infectious disease outbreaks is even more daunting. “First, there’s the sheer dimension of its huge population. Second, there’s the immense diversity across the country – some provinces are more developed, with better resources. Other areas have a lot less,” says WHO’s Tan. And “China has a huge migrant population that is constantly on the move and who sometimes fall through the cracks of basic healthcare.”