China

The news from China is that it is news in China. Everyone who comes here almost certainly already knows China is reporting its "first" human cases of bird flu. Two are a brother and sister in Hunan, the brother recovered and with laboratory confirmed diagnosis (reportedly a rise in antibody titer), the sister deceased with no lab confirmation but a presumptive diagnosis. A farmer in Anhui province is also reported to have died after chickens on ducks on her farm died (Bloomberg) (note that another report from Reuters says that no outbreak of among birds was reported in her village). Another suspected case in Liaoning province in the far north is under investigation and WHO is "seeking further information." Rather than downplaying the cases, as they have in the past, the Chinese press is printing pictures of distraught relatives and giving it blanket coverage (Reuters).

All live poultry markets were shut down in Beijing earlier this month (ChannelNewsAsia) and the government is instituting strict measures in poultry farms. But it is estimated there are 14 billion poultry in China, 70% in backyard settings. The potential degree of human contact with a panzootic (pandemic among animals) is perhaps unprecedented.

Almost certainly these aren't really the first cases in China. They are only the first officially recorded cases. The current outbreak in humans was heralded in February of 2003 when tow members of a family returning to Hong Kong from Fujian province were found to have H5N1 infection. The father died, the young boy survived. His sister was reported to have died in China before their return home. Human cases have probably been occurring years before 2003 and also since, either not reported and/or not detected. Thus the reported cases in China may not signal a new phase of the disease but only a situation whereby international attention has forced existing cases to stick their head above water and be seen.

But maybe not.