- Outbreak Cover-Up?
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- The website that first broke news of the Sars
virus in China is now warning of a bird flu epidemic that has claimed more
than 100 lives, but can it be believed.
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- By Chris Taylor
- South China Morning Post
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- A US-based Chinese-language news website known as Boxun,
or "Abundant News", has riveted the online medical community
over the past month with a series of reports from China's Qinghai province
about an alleged bird flu cover-up. One report - said to be leaked by a
Chinese official - claimed that 121 people were dead from avian influenza,
or H5N1.
- China has denied the claims, but for anyone who follows
both Chinese-language underground news agencies and the medical organisations
that obsessively monitor emerging viruses, the Boxun reports and the international
online response to them recalls early 2003, when news emerged of a killer
virus in Guangdong. The virus was Sars, which became a menace overnight
after a Boxun report interrupted a long media clampdown by Beijing.
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- Boxun's Sars story was translated into English and repeated
by ProMED-mail, an online reporting system that keeps subscribers informed
of outbreaks of new diseases. Now Boxun is either leading the pack again,
or leading it astray - and Boxun's founder doesn't rule out the latter.
Nevertheless, ProMED picked up the story once again and the world's online
community of virus watchers has been discussing it since.
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- "We've been following the reports very closely for
several weeks," said Peter Cordingley, a public information officer
for the WHO Regional Office for the Western Pacific in Manila. "We
have no independent confirmation of them."
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- Boxun's founder, who goes by the pseudonym of Wei Shi
and describes himself as a businessman, said from the US that he could
not verify the web-posted stories from Qinghai that Boxun had run.
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- Nor could he vouch for the alleged whistleblower's credentials.
All Boxun's non-secondary source reports are posted anonymously. But he
said he hoped that by putting the stories in the public domain, somebody
would prove them true or false.
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- "We put out the stories like these and on Sars because
we believe anything like this can happen in China," he said. "The
government doesn't want to confirm anything."
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- Mr Cordingley said the WHO was wary of Boxun, because
it was seen as a "dissident website", adding: "Some of the
stuff they publish has a political agenda."
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- According to Wei, Boxun runs a broad range of news from
secondary sources including state-controlled Xinhua items, which count
for the majority of China news content. He said that he and his team of
US-based volunteers had no political affiliations. "People in China
cannot express themselves freely, and Boxun is an opportunity for alternative
points of view to be expressed," he said.
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- But even if Boxun does have a political agenda, when
it comes to the threat avian influenza poses to world health, alternative
views - if they are really coming from the ground level - must be taken
into consideration as an alternative to China's state-controlled media.
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- One of the posts on the website includes the only known
photographs of the dead bar-headed geese at Qinghai Lake that sparked the
controversy. Wei is convinced the photographs are authentic.
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- One grainy, wide-angled shot shows a sandy foreground
with what seem to be masses of lifeless birds stretching away to a sliver
of a turquoise lake under an arching blue sky. If the anonymous poster
of the pictures is to be believed, the birds are bar-headed geese struck
down by H5N1 at the end of their 1,000km migration from the northern plains
of India to China's remote western Qinghai.
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- The photographs were posted on May 24, one day after
the Chinese authorities told official media that wild geese were dying
of H5N1 in Qinghai, marking China's first outbreak of avian influenza since
last August.
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- It was news that generated great interest in scientific
circles. The report ended a nine-month clean bill of health in a nation
that is home to about 13 billion poultry. But more importantly it was evidence
that H5N1, a scourge to domestic birds in Asia, was now killing wild species
of birds. This suggested a possible mutation in the virus that simultaneously
made it much more mobile and a greater threat to other species, including
humans.
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- Boxun confirmed that threat the day after the Xinhua
report, with an anonymous story headlined: "Acute bird flu in Qinghai
leads to multiple deaths, officials impose news blackout and strict prevention."
The report, which was datelined Xining - Qinghai's provincial capital,
claimed that "large-scale deaths of birds" began in early April,
and that tight monitoring of the news had kept it from the outside world.
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- "In mid-April, the phenomenon of widespread infection
of humans, domestic animals, etc. appeared ... but because the area is
so sparsely populated, the large extent of the infection of humans and
domestic animals was not readily apparent," the report said.
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- The alleged deaths later came to include six Chinese
tourists, who reportedly contracted bird flu during the May Day holiday
week. The report named three of the dead tourists as from Sichuan province:
Li Tianlei, male and Dai Jing, female, both from Chengdu, and Li Tianhai,
male, from Chongqing.
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- A report the next day stepped up the charges, claiming
that an official leak had revealed 121 people had died of bird flu. Of
those, 11 were health workers, the report said.
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- "At present, Chinese officials are still maintaining
their position that as of yet there are no human infections and have increased
the suppression of news," the website said. According to sources the
report does not name, about 1,300 people were quarantined, but it was not
reported where.
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- On May 25, a report provides a list of 18 villages with
a total of a 120 deaths. It also provides some unscientific musings on
whether the disease was pure H5N1, or a new viral concoction, before concluding
"it is definitely contagious".
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- One of the few western media outlets to publicise the
reports has been recombinomics.com. Henry Niman, founder and president
of Recombinomics Inc - a private viral gene and predictive viral change
research centre - posted English translations of the reports as they appeared,
using Alta Vista's Babelfish translator.
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- Some reports are touching, such as one dated May 26.
After complaining about news restrictions on China's media, the writer
says: "The reports of the past few days have been made by the nine
of us from around Gangcha county and Qilian county, because we wanted to
really understand the avian influenza situation in Qinghai. We came disguised
as tourists to carry out on-the-spot interviews ... only by coming to this
place can you realise just how poor China can be. Anyone with a conscience
would shed tears."
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- The reports end abruptly - and have not resumed - on
June 5, with a report on the website the same day announcing that eight
of the nine had been arrested. The ninth, according to Boxun, was cut off
mid-transmission and has not been heard of since. The first eight names,
ages, places of birth and place and time of arrest were all provided.
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- Mr Cordingley gave the WHO's official response to the
reports: "We have been assured by China's Ministry of Health that
there have been no human deaths from the bird flu, and we have no reason
to disbelieve them."
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- But Dr Niman is less certain. "It's pretty clear
that H5N1 is more abundant now, and yet we had no reports [from China]
between August last year and Qinghai," he said. "In other words,
they got through the whole season without any outbreaks, and that seems
suspect.
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- "There was one ProMED-mail report from Fujian [in
April this year] that said that there was an outbreak in domestic geese,
and the striking thing about that report is that the animals were not even
being tested."
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- Wei Shi, of Boxun, may hope that unverified reports on
his website will prompt reporters and health officials to do the footwork
required to prove or disprove them, but it has taken the WHO until this
week to get approval from the central government to go to Qinghai. That's
about six weeks since the May 4 date provided by Xinhua for the mass deaths
of bar-headed geese at Qinghai Lake.
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- There are now many unanswered questions. Mr Cordingley
said the WHO was now in Qinghai with a team that also comprised the Chinese
Ministry of Health and the Ministry of Agriculture. Perhaps they will discover
that migratory geese infected with H5N1 became sick at the end of a grueling
1,000km journey and died.
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- Perhaps the WHO will see evidence that the authorities
moved in and mopped up afterwards, cleared away the carcasses and keeping
some specimens for analysis.
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- But perhaps something else happened. After all, the WHO
visit comes less than a week after Xinhua vaguely reported the first-ever
"joint medical and logistic support exercise" between the mainland's
army and air force, including "on-the-spot treatment, field hygiene
and epidemic prevention".
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- If Boxun, ProMED-mail and the Sars experience can teach
us anything, it is that every detail counts. In the case of a possible
human-to-human transmissible and a H5N1 pandemic, too much is at stake
to demand anything less.
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- http://www.scmp.com
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