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November 26, 2009

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Danger signals: H1N1 mutation found in China

CHINA has detected eight cases of swine-flu mutation on the mainland, a health official said yesterday, backing up concerns among scientists that the virus could change into a more dangerous form.

Last week, the World Health Organization said it was investigating samples of variant swine flu linked to two deaths in Norway.

But Shu Yuelong, director of the Chinese National Influenza Center, told Xinhua News Agency that the mutated swine-flu virus found in China had shown an "isolated" spread on the mainland, is not resistant to drugs and can be prevented by vaccines.

The Xinhua report did not provide any more details, such as when the cases were detected and if they were linked to any deaths.

Swine flu has triggered a global pandemic, and scientists are also worried that it could swap genes with seasonal or other types of flu.

China must be alert to any mutation or changes in the behavior of the H1N1 swine flu virus because the far deadlier H5N1 bird flu virus is endemic in the country, a leading Chinese disease expert said.

Zhong Nanshan, director of the Guangzhou Institute of Respiratory Diseases in south China's Guangdong Province, said the presence of both viruses in China meant they could mix and become a monstrous hybrid - a bug packed with strong killing power that could transmit efficiently among people.

"China is different from other countries," Zhong told Reuters. "Inside China, H5N1 has been existing for some time, so if there is really a 'reassortment' between H1N1 and H5N1, it will be a disaster."

"This is something we need to monitor, the change, the mutation of the virus. This is why reporting of the death rate must be really transparent."

The WHO warned on Tuesday that H5N1 had erupted in poultry in Egypt, Indonesia, Thailand and Vietnam, again posing a threat to humans.

Last Friday, the WHO said it was looking into two deaths and one severe case linked to variant swine flu in Norway, after that country's Institute of Public Health announced that the mutation could cause more severe disease because it infected tissue deeper in the airways.

The same mutation has been found in both fatal and mild cases in Brazil, Japan, Mexico, Ukraine, and the United States.

WHO's spokeswoman in Beijing, Vivian Tan, told The Associated Press it knew of three such cases in China that occurred in June and July that were similar to the cases being investigated in Norway.

Tan said the WHO had no data on the cases mentioned in the Xinhua report yesterday.

There was no evidence the mutated H1N1 virus was circulating widely in the world, Tan said, but since it had been linked to deaths in Norway and elsewhere, investigators were focusing on whether this mutation could be a marker for more severe disease.

"We are concerned, but realize that influenza viruses, including H1N1, are relatively unstable and change easily, especially as they infectmore people," Tan said.

"Some mutations can have minimal effects on how a virus functions, while other mutations can create important changes with significant public health impact."

China's Ministry of Health said yesterday that 51 swine- flu deaths were reported last week, bringing the total number of fatalities on the Chinese mainland to 104.

Zhong said last week that China may have had more H1N1 deaths than it had reported, with some local governments possibly concealing suspect cases.

While some regions simply lack the technology to test for H1N1, other areas had been treating deaths as cases of ordinary pneumonia without a question, Zhong said.

"Some local health-care authorities are reluctant or unwilling to test patients with severe pneumonia because there's some latent rule which says the more H1N1 deaths, the less effective the control and prevention work in your area," the doctor said.

The WHO reported more than 526,060 laboratory confirmed cases of H1N1 worldwide on November 15, with at least 6,770 deaths.

It has stressed for months the figures were only the tip of the iceberg. It urged countries to place more resources on mitigating the disease rather then on costly prevention measures or testing everyone.

All the WHO and US officials will say is that "millions" have been infected.


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