Have a friend who returned from Europe 2 weeks ago and fell ill approx 5 days after returning - now hospitalized with an elevated white count - general bug/infection or anything else? (Doc asked if travel had included Russia, btw)

what? nobody travels out of the county?

Experts question cause of Chinese outbreak

By Steve Mitchell
Published 8/5/2005 5:21 PM

WASHINGTON, Aug. 5 (UPI) -- Chinese officials maintain that a mysterious disease in pigs that has also infected and killed humans is an outbreak of swine flu, but the World Health Organization has recommended that further testing be conducted to identify the pathogen more precisely, and at least one U.S. scientist thinks it is possible a strain of Ebola virus could be involved.

The disease, which has occurred predominately in China's Sichuan province, has infected 206 people, of which 38 have died and another 18 are critically ill.

The Chinese Ministry of Health has said the disease is swine flu, which is not actually a flu but an illness caused by the bacteria Streptococcus suis. This disease, however, generally does not cause more than a few cases of human illness and it usually does not cause death in people.

"I don't think it's the bacteria," Henry Niman, a molecular biologist, told United Press International. "The bacteria usually doesn't infect humans and when it does it usually isn't fatal," said Niman, who is president of Recombonomics, a firm in Pittsburgh, Pa., that studies molecular evolution and the emergence of new diseases.

Niman thinks it is likely the outbreak is due to a virulent form of the avian flu strain H5N1 that has struck southeast Asia and killed more than 50 people.

"It's hard to tell what it is without further testing," Niman said.

So far, Chinese authorities have been reluctant to allow outside parties access to samples from patients.

Another possibility is Ebola, a deadly virus that kills 50 percent to 90 percent of those it infects, Niman said. He bases this on a report put out by a Chinese Web site Boxun.com, which claimed to be an interview with a Chinese physician who helped investigate the Sichuan outbreak.

The physician, identified only as Dr. Wang, said a strain of Ebola virus had been detected in samples from several patients in the Sichuan outbreak. This would be unusual, because Ebola has not been reported outside of Africa, but Wang said Chinese officials had attempted to prevent any information getting out about Ebola and the fact that the disease has occurred in China is a national secret.

On Monday, the Epoch Times reported, "The Chinese Communist Party (CCP) has prohibited news coverage, and has forbidden the use of the words 'Ebola virus' in reports, instead requiring the use of alternate wording."

Chinese officials previously denied rumors in late March that an Ebola outbreak had occurred in Guangdong Province. The pig disease outbreak did not begin until June.

The first human case associated with the pig disease occurred June 24, but Chinese officials did not make this known until late July, and reporters have been prohibited from entering the Sichuan region.

Wang said in the interview with the publication that swine flu may play a role in the Sichuan situation, but "it isn't the main cause of the outbreak." The doctor also said bubonic plague had been detected in some samples while others tested positive for three diseases: Ebola, plague and swine flu.

"I believe that this is basically a bloodborne virus with the Ebola and bubonic plague as its main constituents," Wang said.

Whether China may have been developing Ebola as a biological weapon is uncertain, but the U.S. State Department said as recently as 2002 it was possible China was maintaining a biological-weapons program.

In addition, Ken Alibek, the former deputy chief of the Soviet biological-weapons program who now resides in the United States, previously said Soviet officials had detected a biological-weapons facility in China. Alibek also said two epidemics of hemorrhagic fever --a class that includes Ebola-- occurred in that area in the late 1980's that Soviet analysts presumed to be due to an accidental release from a lab where Chinese scientists were weaponizing viral diseases.

The WHO issued a summary of its analysis of the pig-disease outbreak Wednesday, but the possibility of Ebola was not cited. WHO officials noted the symptoms reported in humans are "unusual" and recommended "diagnostic testing to further characterize the causative agent."

Most cases have occurred in adult male farmers who had close contact with diseases or dead pigs, and symptoms have included high fever, fatigue and vomiting. This is followed by meningitis, bleeding under the skin and coma in some cases.

Officials at the Centers for Disease Control and Prevention in Atlanta said the agency had not been privy to any samples from China and did not know if Ebola could be involved.

CDC spokesman Dave Daigle told UPI the agency has not participated in investigating the pig disease because it has not been invited to do so by China or the WHO.

"We don't know" if Ebola is involved, Daigle said. "We haven't had anything to test and we don't have anybody there on the ground so it's difficult to comment on."

Daigle noted that some CDC scientists "are wondering whether it might be (Crimean Congo Hemorrhagic Fever)." This is a viral disease that can have a fatality rate as high as 30 percent.

If the outbreak is due to a strain of bird flu, its still vital to get samples for testing, Niman said. This is because those will be needed to manufacture a vaccine in case this flu strain spreads.

Researchers at the National Institutes of Health are investigating a vaccine that might prevent infection with the avian flu that is based on a 2004 sample from Vietnam.

"The problem is if this is H5N1 in China, that's probably a bigger threat than the strain out of Vietnam, because it's moving so rapidly and its more fatal," Niman said. The NIH vaccine might not work against the China strain, he added.

Daigle said the flu strain does not appear to have changed much since 2004, but he acknowledged the CDC has not obtained samples from China yet and the samples scientists have tested so far have been from Vietnam and Thailand.

I did think it was interesting that the Doc asked if she had traveled through Russia (she hadn't although who knows where the plane was (or fellow travelers) before it left Stockholm) - especially in light of the goings on with H5N1 (map)

Anybody else hear of anything? Onset was about 5 days after returning stateside.

After returning from Beijing, I developed the "squirts" pretty bad. After a visit to the docs office, I was told that it was "travellers diarrhea".

Apparently it is running pretty rampant (no pun intended).

I thought I was being good at drinking bottled water only. Then I remembered brushing my teeth and rinsing with hotel tap water....DUH.

Everytime people leave for R&R here in Kuwait they always get sick when they get back. Usually a few days after they return the dreaded "Kuwaiti Crud" kicks in.