WHO Asks China for Information on Initial Human Bird Flu Case

The case occurred in a 24-year-old man in November 2003, according to a letter in yesterday's New England Journal of Medicine written by eight Chinese scientists. The first human case reported to the WHO during the current avian flu outbreak occurred in Vietnam in December 2003 and China reported its initial case to the WHO in November 2005.

``We have seen this letter and we have asked formally for clarification from the Ministry of Health,'' Roy Wadia, a WHO spokesman in Beijing, said today. ``It's a very important issue that needs to be clarified urgently. It raises questions as to how many other cases may not have been found at the time or may have been found retrospectively in testing.''

World health authorities are tracking cases of the H5N1 avian flu strain, which has infected at least 228 people in 10 countries since late 2003, killing 130 of them, the WHO said on June 20. Human H5N1 cases provide opportunity for the virus to mutate into a pandemic form that may kill millions of people.

International health agencies are trying to work more closely with China to detect and prevent infectious diseases faster, particularly in the densely populated southern region.

The H5N1 virus, which has spread in birds across Asia, Europe and Africa this year, was first detected in a farmed goose a decade ago in Guangdong, where severe acute respiratory syndrome, or SARS, may have first jumped to humans in 2002.

Lung Disease

SARS infected more than 8,000 people between 2002 and 2003, killing 774. The lung virus was originally suspected by doctors as the cause of disease in the 24-year-old man. The letter written by the Chinese scientists, didn't say when samples from the man were analyzed.

The authors of the letter asked editors at the New England Journal to allow them to withdraw it yesterday. Since the report was already printed in this week's issue, a withdrawal wasn't possible. The editors are still trying to uncover the problem and a future correction or retraction is possible, said Karen Pederson, a spokeswoman for the journal.

Qing-Yu Zhu, from the State Key Laboratory of Pathogens and Biosecurity in Beijing, was the first author on the letter. The work was funded by grants from the National Task Force of China and the 973 High-Tech Projects Plan.