Deaths in China After Flu Shot
November 16, 2009
TIME.com
By Alice Park
Chinese health officials reported on Nov. 13 the first deaths in people who received the H1N1 vaccine. The Ministry of Health announced that the two people, including a teacher from Hunan province, died hours after receiving their inoculations. Since September, when the ministry began its H1N1 immunization program, 12 million Chinese have received the pandemic flu shot.
A preliminary autopsy revealed that the teacher died of an apparent heart attack while playing basketball, and a ministry spokesperson told the China Daily newspaper that the death was a “coincidental medical incident” and not related to the vaccine. No details on the second victim have been released thus far. (See pictures: “Soccer in the Time of Swine Flu.”)
As they conduct an autopsy investigation into the second death, Chinese health officials have pulled all vaccines that were manufactured in the same batch used to inoculate the teacher. Although the H1N1 vaccine has been rigorously tested and vetted for safety, no inoculation can be considered 100% safe, and some may cause adverse events, including death, in some people.
Taking an aggressive approach to the pandemic flu, the Chinese government in June asked 11 biotech companies to develop a pandemic H1N1 vaccine. Beijing-based Sinovac succeeded in developing the world’s first approved swine flu shot. The company raced to conduct clinical trials and was the first to report that a single dose of vaccine, instead of the two doses that most flu experts believed would be necessary, was sufficient to protect against 2009 H1N1. In early September, China became the first country to begin swine flu inoculations.
But by the end of October, 54% of Chinese residents reported in a China Daily survey that they would not get the H1N1 vaccine because of concerns about the shot’s safety. That prompted the director of the World Health Organization’s Beijing office, Dr. Michael O’Leary, to tell the newspaper, “The H1N1 vaccine is one of the safest vaccines being used. When it’s available to me, I would not hesitate to get the vaccine developed and produced by China.” (Read “H1N1: Hitting the Young, Riskier for the Old.”)
Three vaccine manufacturers in China, including Sinovac, have received orders from the government for more than 34 million doses. Among the 12 million people inoculated so far, 1,235 have complained of side effects, ranging from sore arms, rashes and headaches to anaphylactic shock and sudden drops in blood pressure.
While the Chinese government has been criticized for its draconian public-health response to swine flu — using quarantines, canceling school and detaining entire planeloads of people when a single passenger appears to have flulike symptoms — the country’s officials say the strict measures helped stem the spread of flu. So far, China reports about 36 deaths and 62,800 H1N1 cases — compared with U.S. government estimates of 4,000 American deaths and 22 million infections. China plans to immunize 65 million citizens, or 5% of the country’s population, by the end of the year. As in the U.S., health officials are targeting high-priority groups first, including the military, police, health care workers, teachers, students and those with chronic diseases.
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Plague Death Toll Reaches 3 in Northwestern China
August 4, 2009
Bloomberg
By Jason Gale and Simeon Bennett
Pneumonic plague claimed the life of a third man in northwestern China as global health officials said the disease was unlikely to cause mass fatalities.
A 64-year-old man died in the remote town of Ziketan in Qinghai province, the official Xinhua News Agency reported late yesterday, citing local health authorities. The town has been sealed off, and nine people are in quarantine with symptoms, the news service said.
“The Ministry of Health has said no new cases have been found,” Vivian Tan, a World Health Organization spokeswoman in Beijing, said in an e-mail today.
While plague is one of the most deadly infectious diseases, early diagnosis and treatment with generic antibiotics such as streptomycin and tetracycline cuts patients’ mortality rate to less than 15 percent, the WHO said on its Web site. The disease can kill 60 percent of its victims if left unchecked, the Geneva-based United Nations agency said. The agency is monitoring the situation, it said.
“The fact that this area is so remote is definitely a good thing because it makes it a little harder than say an urban setting for this disease to spread,” Tan said in a telephone interview yesterday.
Plague cases have been increasing in 19 provinces of China since the 1990s, Xinhua reported yesterday. The country had 206 cases between 2001 and 2005, with 24 deaths, according to the Ministry of Health. Two cases were reported last year, both of them fatal. There were two cases in 2007, of which one was fatal, and one non-fatal case in 2006, according to ministry statistics.
“This is the first time in recent years that they have made an official report to us, so there’s nothing to compare it to,” the WHO’s Tan said today.
Most Serious Form
Pneumonic plague is the most serious of three forms of plague and occurs when the Yersinia pestis bacteria infect the lungs and cause pneumonia.
The previous victims in the latest outbreak were a 37-year- old man, who died Aug. 2, and a 32-year-old man who died earlier, Xinhua said.
One of the nine patients in quarantine is in serious condition and another has developed symptoms of coughing and chest pain, Xinhua reported. Most of the affected townspeople are relatives of the first dead man, according to the report.
The WHO was notified of the cases late on Aug. 1, Tan said. Local authorities traced contacts of the infected people and are observing them closely, she said.
The agency opened a Collaborating Centre for Surveillance, Research and Training on Emerging Infectious Diseases in Guangzhou, in the southern province of Guangdong, three years ago to monitor and respond to outbreaks.
Previous Outbreaks
The H5N1 bird flu strain, which has spread worldwide and killed at least 262 people, was first detected in a farmed goose more than a decade ago in Guangdong, where severe acute respiratory syndrome, or SARS, is thought to have jumped to humans in 2002.
The plague-affected area, situated northeast of Tibet, is adequately supplied with necessities and people’s lives are “normal,” the local health authority said in a statement three days ago. Ziketan, in the eastern part of Qinghai, has a population of about 10,000 people.
The local health department said anyone who has visited Ziketan and the surrounding areas since July 16 and has developed a fever or a cough should seek treatment at a hospital. Ziketan is 144 kilometers (89 miles) southwest of the Qinghai provincial capital of Xining, which in turn is almost a 3-hour flight west of Beijing.
Airborne Germ
Pneumonic plague is spread through the air and can be passed from person to person through coughing and contaminated articles, according to the WHO. It is caused by the same bacteria that occur in bubonic plague — the Black Death that killed an estimated 25 million people in Europe during the Middle Ages.
Yersinia pestis bacteria are found mainly in rodents, particularly rats, and in the fleas that feed on them. In almost all cases, only the pneumonic form of plague can be passed from person to person.
In the mid-1800s, plague killed 12 million people in China. Better living conditions, antibiotics and improved sanitation have reduced its prevalence, with more than 2,000 plague cases reported worldwide in 2003.
“These things do happen sporadically in different countries,” Tan said. “It’s not something we’re very worried about, but we are keeping an eye on it.”
The last urban outbreak of plague in the U.S. occurred in Los Angeles during 1924 and 1925, according to the Atlanta-based U.S. Centers for Disease Control and Prevention. Since then, there have been about 10 to 15 cases a year in the U.S., mostly in rural areas, the CDC said on its Web site.
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