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Earliest human case of bird flu disclosed

Beijing scientists said in a medical journal Wednesday that a man in mainland China died of bird flu in November 2003 — two years before the communist country reported any human infections to the World Health Organization.

At the last minute, however, the scientists asked without explanation to withdraw the journal report. But it was already in print.

The man's death was initially thought to have been caused by SARS, the scientists wrote. That raises the possibility that other cases attributed to SARS may have actually been the deadly H5N1 flu.

"It's hard to believe that this is the only person in all of China who developed H5N1" that year, said Dr. John Treanor, a flu expert at the University of Rochester.

WHO was surprised by the report, which came not from the Chinese government but from eight scientists in a research letter in the New England Journal of Medicine.

"We will formally request the Ministry of Health to clarify this," and why it has taken more than two years to come to light, said Roy Wadia, a WHO spokesman in China.

[...] The SARS outbreak began in China in November 2002 but was not recognized until the following spring. More than 1,450 cases of severe acute respiratory syndrome were confirmed, the vast majority in Asia. However, some were diagnosed not by lab tests but based on symptoms, which are very similar to those of bird flu.

The New England Journal report raises the possibility that the two dangerous viruses emerged simultaneously.

The patient, a 24-year-old man with pneumonia and respiratory distress, died four days after he was hospitalized in 2003, they reported. The main outbreak of SARS, occurred earlier that year and sporadic cases were still happening. Doctors initially diagnosed that as his cause of death. But tests failed to find the SARS virus.

Further tests of the man's lung tissue yielded fragments of a flu virus, the Chinese scientists reported. Genetic sequencing revealed it to be a mixed virus, with genes similar to two distinct types of bird flu seen in northern and southern China.

"It suggests to me that H5N1 infections were occurring in China probably not recognized or not detected maybe in the background of the SARS epidemic," Treanor said. "I don't know how you could interpret it any other way."

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A Legacy of the Storm: Depression and Suicide

New Orleans is experiencing what appears to be a near epidemic of depression and post-traumatic stress disorders, one that mental health experts say is of an intensity rarely seen in this country. It is contributing to a suicide rate that state and local officials describe as close to triple what it was before Hurricane Katrina struck and the levees broke 10 months ago.

Compounding the challenge, the local mental health system has suffered a near total collapse, heaping a great deal of the work to be done with emotionally disturbed residents onto the Police Department and people like Sergeant Glaudi, who has sharp crisis management skills but no medical background. He says his unit handles 150 to 180 such distress calls a month.

Dr. Jeffrey Rouse, the deputy New Orleans coroner dealing with psychiatric cases, said the suicide rate in the city was less than nine a year per 100,000 residents before the storm and increased to an annualized rate of more than 26 per 100,000 in the four months afterward, to the end of 2005.