The potential spread of suspicious pneumonia cases and any cover ups or delays in quickly reporting any concerns could lead to the spread of infectious diseases, China's Ministry of Health warned Tuesday. They restated the need for timely reporting of cases.

Respiratory diseases were common at this time of year and heightened awareness was needed to prevent and control SARS and infections of the highly pathogenic bird flu, said a statement on the ministry website.

However, some medical institutes were failing to quickly report on "pneumonia cases with unknown causes" or avoided using the term by diagnosing them as severe pneumonia, it said.

Local health authorities had failed to respond quickly to reports and some pneumonia patients who had been in contact with sick or dead poultry were moved to other hospitals without guidance, risking the spread of infectious diseases.

The ministry reiterated that medical institutes must make direct reports of suspicious pneumonia cases through the national network and inform local health authorities immediately.

It instructed local health authorities to use experts to investigate cases as soon as they received reports. Centers for disease control (CDC) were ordered to carry out epidemiological research and laboratory testing and provide the results quickly.

CDCs without the facilities and expertise for testing must deliver samples to CDCs at higher levels, and positive samples and those required by the ministry must be sent to the national CDC for verification without delay.

Careful screening was necessary for possible human cases of bird flu, said the ministry, noting that suspicious pneumonia cases must be verified jointly by epidemiological history, lab testing and clinical studies.

Samples testing negative for the H5N1 strain of bird flu, but with an epidemiological history, were required with two antibody tests being taken in the acute and recovery periods.

Pneumonia cases with no clear epidemiological history required further tests and medical observation before the possibility of acute infectious respiratory diseases like bird flu could be ruled out.

Suspicious pneumonia fatalities were required to undergo autopsies, the ministry said, adding that investigation of each case with an unknown cause should be reported.

China has reported 17 human bird flu infections, 12 of which resulted in fatalities. The Ministry of Health has urged local medical institutes and health authorities to improve surveillance, staff training and laboratory capacity as well as to educate the public to avoid all contact with sick and dead poultry.

The World Health Organization had recorded 204 human cases of bird flu involving 113 deaths by April 21. Experts have warned the virus could mutate into a form which may be able pass between people and cause a pandemic.

(Xinhua News Agency April 26, 2006)