A recent rise in the number of human cases of avian influenza reported in cities is a dangerous sign of things to come, Zhong Nanshan said yesterday in Beijing.

In Vietnam, Thailand and Indonesia the main cause of the virus spreading was through dead poultry, said Zhong, who is president of the Chinese Medical Association. He was speaking at an international conference on respiratory diseases.

However, in China he noted that 16 human cases of bird flu had been identified without any direct contact with dead poultry, he noted. Eleven of the victims had died.

There was no evidence that human cases diagnosed in Sanming of east China's Fujian Province, Guangzhou of south China's Guangdong Province and Shanghai came from eating or coming into contact with diseased poultry.

But the two cases reported in Shanghai and Guangdong had been linked to poultry markets.

"People don't just contract the virus through contact with dead poultry," Zhong said. "They can also get the virus from contact with live poultry and migratory birds."

"Some poultry, especially ducks, are possibly virus carriers and might transmit the virus to humans," he explained. He added that the government should only allow licensed poultry to be sold in markets in the cities.

Zhong indicated that more stringent monitoring of poultry, wild birds and humans should be undertaken to control any further spread of the virus.

He warned it was a dangerous sign that the virus had been found in animals like cats. He expressed concern that avian flu might combine in other animals like pigs and this would allow the avian influenza virus to spread more easily to humans. In China the virus had only been found in poultry and humans. No mammals have been reported as carriers, he said.

He added that the people who died in Guangzhou and Shanghai may have survived if they'd been given early medical attention

The victims were aged 29 and 32 but despite their relatively young ages they succumbed to the disease. So it was important to educate the public to go and see the doctor as soon as they got any of the symptoms such as a high fever, he explained.

"The epidemic has affected 10 provinces but individual cases only so it's not a pandemic," Zhoing said. "There's no evidence to suggest there is human-to-human transmission of the virus in China."

Zhong continued, "We can't say the SARS virus, which was around in the spring of 2003 and 2004, has disappeared because it's still here -- at least in bats."

"I can say we have controlled the key point of the infection which is in the animal market," Zhong said.

Global alliance

Zhong was interviewed by media at a ceremony to launch the Global Alliance against Chronic Respiratory Diseases (GARD) project in Beijing.

The Alliance is a global voluntary grouping of 41 organizations from around the world focused on reducing the burden of chronic respiratory diseases by integrating and strengthening diagnosis,  prevention and treatment. .

The World Health Organization estimated that some four million people died of chronic respiratory diseases (CRD) in 2005 and that total deaths would increase by 30 percent in the next 10 years if immediate action was not taken.

Zhong also signed an agreement yesterday with AstraZeneca who donated six million yuan (US$720,000) to China for doctors to do clinical research into CRD.

CRD are chronic diseases of the airways and lungs. Two of the most common are asthma and chronic obstructive pulmonary diseases.

Major risk factors for chronic respiratory diseases are air pollution and occupational substances.

In 2002 around 74 percent of Chinese urban areas had poor air quality. In the same year 1.3 million people died of lung diseases.

(China Daily March 29, 2006)