INFECTIOUS DISEASES AND RARE AND UNUSUAL ILLNESSES IN CHINA

DISEASES IN CHINA

Food or waterborne diseases include bacterial diarrhea, hepatitis A, and typhoid fever. Among the vectorborne diseases are Crimean-Congo hemorrhagic fever and Japanese encephalitis. Soil contact diseases such as hantaviral hemorrhagic fever with renal syndrome (HFRS) have been found in China.[Source: CIA World Factbook, 2022]

Before Covid-19, AIDS, tuberculosis and rabies were among the three deadliest infectious diseases in China. Hepatitis and stomach parasites are common in China. Millions of people have dysentery. Malaria is found in some rural areas in southern China, but not in the major cities or the northern and western parts of the country. Outbreaks of cholera have occurred in China. Outbreaks of bubonic plague occurred in the 80s in Yunnan and Qinghai and more recently in Inner Mongolia.

Malaria has been dramatically reduced in China. From 1950 to 2016, there were a total of 227,668,374 malaria cases reported in China, with an annualised average incidence of 337.02 per 100,000 population. The incidence decreased at an average annual percent change −11.4 percent during that time.. There were 36 085 malaria deaths, with an annualised average mortality of 0.534 per 1,000,000 population. The predicted number of malaria cases and deaths for 2020 was 2,562 and 10, respectively, and zero for indigenous cases. Though, the goal of malaria elimination is realistic by 2020 in China, routine clinical and entomological surveillance should be continually conducted, especially for the cross-border areas and imported malaria cases. [Source: Cheng Ding et, al., “Malaria in China: a longitudinal population-based surveillance study”, Epidemiol Infect. 148: madrassah. February 24, 2020]

According to the World Health Organization, cholera was reported in 10,344 individuals in 1995. In China, which accounts for 20 percent of the world's tetanus cases, over 90,000 a year die from neonatal tetanus. . Schistosomiasis has been eliminated in the vast majority of rural areas in south China but sexually transmitted diseases, especially gonorrhea, have increased markedly since the 1980s. [Source: C. Le Blanc, “Worldmark Encyclopedia of Cultures and Daily Life, ” Cengage Learning, 2009; Worldmark Encyclopedia of Nations, Thomson Gale, 2007]

Diseases in China in the Mao and Deng Eras

As a result of preventive efforts, such epidemic diseases as cholera, plague, typhoid, and scarlet fever have almost been eradicated. The mass mobilization approach proved particularly successful in the fight against syphilis, which was reportedly eliminated by the 1960s. The incidence of other infectious and parasitic diseases was reduced and controlled. Relaxation of certain sanitation and antiepidemic programs since the 1960s, however, may have resulted in some increased incidence of disease. In the early 1980s, continuing deficiencies in human-waste treatment were indicated by the persistence of such diseases as hookworm and schistosomiasis. Tuberculosis, a major health hazard in 1949, remained a problem to some extent in the 1980s, as did hepatitis, malaria, and dysentery. In the late 1980s, the need for health education and improved sanitation was still apparent, but it was more difficult to carry out the health-care campaigns because of the breakdown of the brigade system. [Source: Library of Congress]

“By the mid-1980s, China recognized the acquired immune deficiency syndrome (AIDS) virus as a serious health threat but remained relatively unaffected by the deadly disease. As of mid-1987 there was confirmation of only two deaths of Chinese citizens from AIDS, and monitoring of foreigners had begun. Following a 1987 regional World Health Organization meeting, the Chinese government announced it would join the global fight against AIDS, which would involve quarantine inspection of people entering China from abroad, medical supervision of people vulnerable to AIDS, and establishment of AIDS laboratories in coastal cities. Additionally, it was announced that China was experimenting with the use of traditional medicine to treat AIDS.

“In the mid-1980s the leading causes of death in China were similar to those in the industrialized world: cancer, cerebrovascular disease, and heart disease. Some of the more prevalent forms of fatal cancers included cancer of the stomach, esophagus, liver, lung, and colon-rectum. The frequency of these diseases was greater for men than for women, and lung cancer mortality was much greater in higher income areas. The degree of risk for the different kinds of cancers varied widely by region. For example, nasopharyngeal cancer was found primarily in south China, while the incidence of esophageal cancer was higher in the north.

Unusual Diseases in China

In May 2018, China's first national list of rare diseases referred to as the Chinese Rare Diseases List, CRDL) was issued jointly by five national bodies, including the National Health Commission, Ministry of Science and Technology, Ministry of Industry and Information Technology, State Drug Administration, and State Administration of Traditional Chinese Medicine. The CRDL gives priority to rare diseases with a relatively high prevalence, that pose a heavy burden, and that are highly treatable. The CRDL includes a total of 121 rare diseases such as albinism, Lysosomal Acid Lipase Deficiency, Atypical Hemolytic Uremic Syndrome,Maple Syrup Urine Disease, amyotrophic lateral sclerosis, Multiple Acyl-CoA Dehydrogenase Deficiency, Charcot-Marie-Tooth Disease, Multiple SclerosisGaucher's disease, Kallmann syndrome, Marfan syndrome, Fabry disease, and hemophilia.

Reuters reported: An estimated 16 million Chinese have rare diseases, though there is scant data and even less financial support. Only a fraction receive treatment. "China, with the largest population in the world, should also have the largest population of rare diseases," said Peter Fang, head of Asia Pacific for Shire, which has a focus on rare illnesses.“He estimated, however, that for some rare illnesses, like Fabry disease, caused by the build-up of fat-like substances, fewer than five percent of patients in China are diagnosed. In China's broad but shallow healthcare system, rare illnesses have been largely ignored, leaving patients outside the safety net. Drugs they need are hard to get hold of or are expensive, with no reimbursement under public insurance policies. [Source: Jackie Cai and Adam Jourdan, Reuters, May 19, 2017]

The 2017 national list of rare diseases aimed to guide policymakers as part of a broader overhaul to improve diagnoses and speed up drug approvals in China, the world's second-largest drugs market. Reuters reported: “Rare illnesses, by definition affecting only a small group of people, are often genetic and costly to treat or control. But they are an increasingly significant segment of the market, and of big pharmaceutical firms' profits. Global sales of so-called 'orphan' drugs to treat rare diseases are set to increase to $209 billion in the next five years from $124 billion this year.[Source: Jackie Cai and Adam Jourdan, Reuters, May 19, 2017]

“One such medical 'orphan' is 8-year-old Hu Yizhuo from the eastern city of Nanjing, who has tuberous sclerosis complex (TSC), a rare genetic disorder that causes benign tumors to grow in the brain and around the body. To control his symptoms, including frequent seizures, he takes daily doses of Sabril, made by Sanofi SA, and Pfizer Inc's Rapamune. But there's a catch. The two drugs are not easily available in China, where a focus on cost control and long approval backlogs means many specialist drugs are often out of reach. Instead, Hu's parents get the drugs smuggled from Turkey, Taiwan and Hong Kong via agents or from local doctors prescribing them for off-label use.

Pfizer said Rapamune was available in China through a joint venture firm, though not with preferential 'orphan' drug status. "My son needs his medicine, without it he could die," said his mother Fang Liuyan, 39, a former accountant, adding there was no way to buy them via regular, approved channels in China. "We don't care (about the legality), any risks are secondary to being able to control his condition. This disease can mean a lifetime of taking medicines, which we now pay for ourselves. Emotionally and financially it's a huge strain. I hope in future the drugs could go on the insurance list and help relieve some of the pressure on us."

Outbreaks of Rare Diseases in China

In August 2005, an outbreak of anthrax killed one person and infected 12 others near Shenyang in the northeastern province of Liaoning. Anthrax is a bacterial disease usually associated with farm animals. People rarely get unless they have handled or eaten infected animals. Those who get it usually get cutaneous anthrax, which us caused when the bacteria is absorbed through cuts in the skin. See Anthrax Under BIOLOGICAL WEAPONS factsanddetails.com

Hanta virus, which is carried by East Asian rodents, has infected Russia, China, Taiwan and South Korea. In the late 1980s two epidemics of an Ebola-like hemorrhagic fever were blamed on an accident at secret biological weapons plant in a remote area near a nuclear testing site. in China Hemorrhagic fever (DHF) occurs when capillaries leak and the circulatory system collapses.. Those that die of dengue fever often get DHF hemorrhaging in the final stage of the sickness. Failing to realize they are infected, they don’t get treatment soon enough and lose blood plasma and go into shock after the initial fever passes. Some victims die within 10 hours of developing serious symptoms if they don’t get appropriate treatment.

In 2005, an unidentified illness killed 17 farmers and sickened 41 others around the cities of Ziyang and Neijiang in China's southwestern Sichuan province after they butchered sick pigs or sheep. Those affected had symptoms including high fever, fatigue, nausea and vomiting, and "became comatose later with bruises under the skin," Xinhua news agency said. “The report said that medical experts believe the illness "is not spreading further among humans," and that there were "no obvious signs of (an) epidemic." [Source: Associated Press, July 24, 2005]

Associated Press reported: “The report did not cite a suspected cause of the sickness, but authorities in Hong Kong said that Chinese authorities believe a bacterial infection might be responsible for the deaths. The World Health Organization said the cases did not appear to be related to bird flu. The son of one of the victims told Hong Kong's Cable TV his father fell ill after slaughtering and eating part of a sick pig. Pigs in the area had been infected with streptococcus bacteria, which is common in domestic animals, a hospital worker treating the patients told Cable TV. It was unclear if the sick sheep in the area were infected with the same bacteria.

In May 2021, a man in China died after contracting Monkey B virus, a rare infectious disease from primates. The victim, a 53-year-old veterinarian based in Beijing, was the first documented human case of the virus in China. According to the Chinese Center for Disease Control and Prevention, the man worked in a research institute that specialized in nonhuman primate breeding and dissected two dead monkeys in March. He experienced nausea, vomiting and fever a month later, and died May 27. His blood and saliva samples were sent to the center in April, where researchers found evidence of the Monkey B virus. Two of his close contacts, a male doctor and a female nurse, tested negative for the virus, officials said. [Source: Rebecca Tan, Washington Post, July 19, 2021]

According to the Washington Post: The Monkey B virus, or herpes B virus, is prevalent among macaque monkeys, but extremely rare — and often deadly — when it spreads to humans. In humans, it tends to attack the central nervous system and cause inflammation to the brain, leading to a loss of consciousness, said Kentaro Iwata, an infectious disease expert at Kobe University in Tokyo. If untreated, there's about an 80 percent fatality rate.

Parasites and Worms in China

According to one survey 700 million Chinese (62 percent of the population) are infected with at least one kind of parasite, and up to 90 percent of the children in some rural areas suffer from chronic worm infections — roundworm, whipworm and hookworm — which can stunt growth and cause deficiencies in mental ability. An estimated 200 million people in China have hookworms — sharp-toothed parasites that attach themselves to intestinal walls and suck blood. They can stunt growth and cause anemia and lethargy. Hookworm enter the body through the skin, often bare feet, and travel through the blood to the lungs and reach they stomach when they are coughed up and swallowed. From the stomach they move to the intestines, where they can reach lengths of four inches (most are less than a half inch). People can be infected by a thousand worms that can live for or five years and can collectively suck up to a cup of blood a day. Hookworm is treatable but people who live in areas where it is found tend to get it repeatedly. The parasites favor damp, cool environments and are particularly common in cotton, rapeseed and tobacco fields.

Schistosomiasis(bilharziasis) has become a serous problem in China, particularly in southern China, after it was almost eradicated under Mao. The Three Gorges Dam project is expected to increase the spread of the disease. Schistosomiasis is caused by a blood fluke (tiny worm also called a flatworm) that goes through a complicated life cycle utilizing a species of freshwater snail. After maturing inside a human host, adult flukes pair for life and produce thousands of eggs that damage organs and are discharged in urine and feces. The larvae that hatch from the eggs work their way into the snails that in turn produce large number of larvae capable of penetrating human skin. The flukes lives in the veins, bladder and large intestine of their human hosts and borrow molecules form their hosts to wear on their surfaces so the hosts’ immune system can't recognize them as alien.

Visceral leishmaniasis has been reported in Xinjiang. Leishmaniasis is a parasitic disease found in tropical and subtropical areas of the world. Transmitted by the bite of some species of sand fly, it comes in cutaneous (skin) and visceral (internal organ) forms. Cutaneous leishmaniasis is characterized by open or closed skin sores. Visceral leishmaniasis typically develops over several months and is characterized by fever, enlargement of the liver and spleen and anemia.

Dengue Fever and Encephalitis in China

In 2003, 211 cases of encephalitis and 13 deaths attributed to the disease were reported in Guangdong Province. Japanese encephalitis is a mosquito-born viral disease that usually infects people in rural areas in the summer and autumn in temperate regions and some parts of Asia It is transmitted chiefly by the “Culex vishui” and “Culex tritaeniorhyncus” mosquitos, which bite mainly in the afternoon and evening and develop from larvae found mainly in cultivated rice fields and marshes. People traveling in rural areas have a stronger likelihood of contacting the disease than those who stay in urban areas. Most people who are infected display no symptoms, but the fatality rate is as high as 30 percent among victims who are hospitalized. Severe swelling in the head and central nervous system are manifestations of severe cases of the disease.

In 2014, dengue fever killed six people and infected more than 23,000 in southern China's worst outbreak of the mosquito-transmitted disease in about two decades. Associated Press reported Authorities in worst-affected Guangdong province attribute the severity of this year's outbreak to exceptionally hot and wet weather, plus increasing travel by residents to regions where dengue is endemic, especially Southeast Asia. The Guangdong health agency said on its website that 19,631 of the 23,146 cases reported as of October were in the provincial capital of Guangzhou, a sprawling city in China's manufacturing heartland near the border with Hong Kong. It said more than 1,000 new infections were being registered in Guangdong every day, with other provinces reporting a few dozen cases. Authorities have dispatched teams around Guangzhou to spray insecticide to kill the mosquitoes that spread the virus, China's official Xinhua News Agency said. [Source: Associated Press, October 7, 2014]

There was a surge in the number of dengue fever cases reported in southern China in the summer of 2006. Dengue fever is a nasty, viral disease transmitted by the “Aedes” mosquito, usually the Aedes aegypti, the same mosquito that often carries yellow fever. Sometimes called "breakbone fever" or "break-heart" because of the intense pain it can produce, the disease is characterized by sudden onset of fever; intense pounding, frontal headaches; aching bones and joints; nausea and vomiting; and a feeling of being too sick to eat anything. Other symptoms include severe sweats, chills, and excruciating chest pains. Tests foe dengue rely on the presence of antibodies, which can take up up to a week to develop.”

Meningitis in China

In January 2005, a meningitis outbreak in Anhui province killed at least 16 people and infected 258. There were shortage of the meningitis vaccine. Xinhua news agency said local authorities were ordered to report cases promptly, keep public places clean, and prepare enough vaccines. The BBC reported: “Correspondents say China's unusually prompt and sweeping orders reflect a new sensitivity to public health following the outbreak of Severe Acute Respiratory Syndrome (SARS) in the country in 2003, when Beijing was criticised for a slow response. “The Ministry of Health warned the public that infectious diseases spread more easily during Chinese New Year, which starts next week, when thousands of people travel round the country to visit their families. The number of reported cases of meningitis in January was 94 more than over the same period last year, Xinhua said. Eight of the deaths occurred in central Anhui province, but state media said cases had been reported in all regions of China except for Tibet, the island of Hainan and southern Fujian province. [Source: BBC, February 1, 2005]

China has a relatively high rate of the disease compared to industrialised countries. In February 2005, there were reports of bacterial meningitis in Anhui Province, In the summer of 2006, 160 people contacted meningitis from eating undercooked giant Amazonian snails at a Beijing restaurant. All the victims recovered.

An outbreak of meningitis in China in 1966-1967, at the beginning of the Cultural Revolution, led to a CIA epidemic prediction system. A 1972 CIA document titled, “Intelligence Implications of Disease” described the meningitis outbreak in China is the 1960s. The CIA’s Office of Scientific Intelligence (OSI) responded to the outbreak with Project IMPACT, which devised a methodology for predicting epidemics and understand how epidemics affect the military and civilian services. The Project IMPACT report released under the Freedom of Information Act (FOIA) said that the political chaos of the time was “one of the best ingredients for a successful epidemic”. The interaction of people and unchecked movement of people led to the spread of the disease.[Source: Before It's News, Monday, June 3, 2013]

Polio Outbreak in Xinjiang

In September 2011, CNN reported: “An outbreak of polio has been confirmed in China for the first time since 1999, leaving one person dead and hospitalizing another nine, according to the World Health Organization (WHO). The disease broke out in the prefectures of Hotan and Bazhou in the country's western Xinjiang province. Among the ten cases confirmed, six are in children under three years old and four are young adults. [Source: Jaime FlorCruz and Haolan Hong, CNN, September 21, 2011]

The WHO said evidence indicates the virus is genetically linked to polio cases currently circulating in Pakistan, which borders Xinjiang. Pakistan has been affected by the nationwide transmission of the same WPV1 strain.It also warned the virus could spread beyond the current affected area. The polio virus can travel great distances and find susceptible populations, no matter where they live. "Although other areas in China or other countries are not immediately at risk due to the geographic distance to the affected province, the polio virus can travel great distances and find susceptible populations, no matter where they live," Helen Yu, from the WHO's Beijing office told CNN.

According to China's Center for Disease Control and Prevention, the Ministry of Health has dispatched a group of public health experts to the affected region to help treat the virus. It said the local government had launched a mass vaccination campaign starting in early September. WHO confirmed initial vaccination campaigns carried out by mid-September had reached over 3.5 million children -- children being particularly vulnerable to polio. Further vaccination campaigns will be conducted in the near future to ensure this outbreak is brought completely under control, according to the health ministry. "No matter how long a country has been polio-free, as long as global polio eradication has not yet been achieved, the risk for importation remains and constant vigilance is required." said Yu. The polio outbreak in China in 1999 was reportedly caused by a case brought into the country from India.

Rabies

Rabies has become a serious problem in China. It kills more than 2,000 Chinese a year. In the late 2000s it killed more than 2,400 people died of rabies, up from 2,245 people in 2045 and a steep increase from less than 200 in 1996. In the late 2000s, only 3 percent of China’s dogs were vaccinated against the disease. Experts blame the high rate of rabies on the breakdown of the rural health care system. Dog owners in rural areas generally don’t vaccinate their animals because of the expense. A rabies expert at Guangxi University told the New York Times, “Many farmers are reluctant to get shots for their dogs because it’s not always free... The veterinary system at the township level has become very inadequate. There isn’t much investment into the system."

Geoffrey Cain wrote in Time magazine: “ Making the virus more tragic is that the victims tend be very young and very poor. Half of all human rabies deaths occur in children under the age of 15, says WHO, and more than 90 percent of human rabies victims in China are low-income farmers living in poor provinces, according to a study published in 2006 in the Chinese Journal of Epidemiology. [Source: Geoffrey Cain, Time magazine, October 12, 2010]

“Health officials point to a variety of reasons for the surge in rabies. In remote provinces in countries such as China, India and Bangladesh, many rabies infections go undocumented, making it difficult to swiftly pinpoint outbreaks and deliver the necessary post-exposure treatments. Meanwhile, over the past decade public health experts have been fighting urgent outbreaks such as swine flu, bird flu and SARS, overshadowing the gradual rise in the human rabies cases. The fact that poor people are most susceptible to rabies puts initiatives against the virus even further under the radar, says Dr. François-Xavier Meslin, the Geneva-based team leader for neglected zoonotic diseases at the WHO.

Plague in China

Plague cases are not uncommon in China, but outbreaks have become increasingly rare. From 2009 to 2018, China reported 26 cases and 11 deaths. Most of the outbreaks occur in Inner Mongolia and northwest China. Rodent populations have risen there after persistent droughts, worsened by climate change. An area the size of the Netherlands was hit by a "rat plague" in 2019 causing$86 million of damages. Cases of the plague occurred in Colorado in 2013 and 2014. [Source: Reuters, July 5, 2020; November 17, 2019]]

In July 2020, Authorities in Bayan Nur, a city in Inner Mongolia, issued a third-level alert, the second lowest in a four-level system, one day after a hospital reported a case of suspected bubonic plague. The alert forbids the hunting and eating of animals that could carry plague and asks the public to report any suspected cases of plague or fever with no clear causes, and to report any sick or dead marmots.

In November 2019, there were four reported cases of plague in people from Inner Mongolia, including two of pneumonic plague. Reuters reported: Inner Mongolia reported a fresh, confirmed case of bubonic plague despite an earlier declaration by the country's health officials that the risk of an outbreak was minimal. The health commission of the autonomous region said a 55-year-old man was diagnosed with the disease after he ate wild rabbit meat on November 5. The man was isolated and treated at a hospital in Ulanqab. A total of 28 people who had close contact with the patient are now isolated and under observation, and the commission said there are no abnormal symptoms found in them.

“The Inner Mongolia case follows two that were confirmed earlier in November in Beijing. In both cases, the two patients from Inner Mongolia were quarantined at a facility in the capital after being diagnosed with pneumonic plague, health authorities said at the time. The Inner Mongolia health commission said it found no evidence so far to link the most recent case to the earlier two cases in Beijing.

Large parts of the northwestern city of Yumen in Gansu province were sealed off in July 2014 after a 38-year-old resident died of bubonic plague. A total of 151 people were put under observation after it was determined they had come in contact with a man who died of the plague. None of them had reported symptoms of the disease. Associated Press reported: “Investigators believe the 38-year-old man contracted the bacterial infection after contact with a marmot. During the quarantine, authorities in the city of about 180,000 carried out disinfection and rat extermination, according to Xinhua. [Source: Associated Press, July 24, 2014]

In 2004, two people were infected with bubonic plague in Gansu and Qinghai Provinces. One died. Outbreaks of the disease occurred in the 80s in Yunnan and Qinghai.

2009 Plague Outbreak in Qinghai

In 2009, thousands of people were placed under quarantine, including the entire town of Ziketan, in Qinghai Province after three men — a 32-year-old herder, 37-year-old farmer and 62-year-old man — died of pneumonic plague and 11 others were infected. Medical teams were sent to the area to disinfect buildings and kill rats. [Source: VOA News, November 2, 2009]

In November 2009, VOA News reported: “Authorities are disinfecting the sealed-off town of Ziketan in northwest China, after a third person died of pneumonic plague. Medical staff also are killing rats, insects and fleas that can carry the disease. The local health bureau says at least nine more people are infected, mostly relatives of the first victim. Police set up checkpoints on the roads around the farming community in Qinghai province when the outbreak was discovered on Thursday. Ziketan is an ethnically Tibetan town of 10,000 people in one of China's least populated regions.

“An American student traveling in the area, who asked to remain anonymous, says drivers are accepting about $300 to take people out of the town. "I think people are scared and actually fleeing the disease," she said. She says most of the restaurants and Internet cafes in town are closed because people do not feel safe eating out. Many who do go out wear medical masks. Usually there are nightly traditional Tibetan dancing sessions, but those stopped at the beginning of the outbreak.

Vivian Tan, the spokeswoman for the World Health Organization in China, said:“"I think it's important to note that this is not the first time this appeared in that region, because this bacteria is actually quite endemic in some rodents in that region," she said. Tan says this is the first time the Chinese government officially notified the WHO of pneumonic plague cases, but there were two reported in Qinghai in 2001 and in 2004.

“The American student says fliers in Mandarin and Tibetan were handed out at a public health meeting in Ziketan on Friday, and notices about the disease are posted in the center of town. "They put up fliers that basically had pictures of the rodent on the grasslands. Everyone knew that it started with the rodent," she said. "Everyone I spoke with knew it was airborne and knew roughly the symptoms like fever, that sort of thing." She confirms official Chinese reports that say the sealed-off town is not running out of supplies. She says about half the supermarkets are still open and seem to have enough food and water for the population.

Scientist Say Plague Originated in China, 2600 Years Ago

In November 2010, researchers announced that the first outbreak of plague occurred in China more than 2,600 years ago before reaching Europe via Central Asia's "Silk Road" trade route, according to a study of the disease's DNA signature. The findings flesh out long-held suspicions about the Chinese origins of the plague, which killed an estimated third of Europe's population in the Middle Ages. [Source: AFP, November 1, 2011]

An international team of scientists sequenced 17 strains of Y. pestis, building a genetic "family tree" of pathogens that mutated from a common ancestor. "The results indicate that plague appeared in China more than 2,600 years ago," France's Museum of Natural History, which took part in the research, said. It then spread towards Western Europe along the Silk Road, starting more than 600 years ago, and then to Africa, probably by an expedition led by Chinese seafarer Zhang He in the 15th century, it said. Plague came to the United States from China via Hawaii in the late 19th century, according to the molecular evidence. It arrived in California through the ports of San Francisco and Los Angeles before heading inland.

"The work highlights specific mutations in the bacterium showing how the germ evolved within given geographical regions," the museum said in a press release. "But it demonstrates in particular that successive epidemic waves originated as a whole in Central Asia and China." The study, published online on Sunday by the journal Nature Genetics, was led by Mark Achtman of University College Cork in Ireland. Scientists from Britain, China, France, Germany, Madagascar and the United States also took part.

Sexually Transmitted Diseases in China

Venereal disease was nearly eradicated in China by the Communists. When the Communists took power in 1949 China was suffering from one of the largest syphilis epidemics ever. The disease was largely eliminated by the 1960s thanks to a decades-long effort led by doctor from Buffalo, New York named George Hater, who later renamed himself the Ma Haiteh.

Since the 1980s, there had been a dissemination of sexually transmitted diseases to every province and all the major cities in China. Statistics show that in sixteen major cities, the average incidence of STDs was 21.02 per 100,000 in 1987. In some cities, the incidence was as high as 336 per 100,000, resembling that in some Western countries. In Helongjiang province alone, the incidence of STDs increased at the rate of 8.9 times/per year from 1982 to 1988. By the end of 1988, when this province had the fourth highest incidence in the country, 4,558 cases had been reported; and it was estimated that reported cases represented only 20 percent of the total incidence. Nationwide, the number of STD cases reported from 1980 through the end of 1988 was 140,648, with more than 56,000, over 39 percent of these, occurring in 1988 alone. In 1992, the figure of 45,996 new reported STDs cases was 4.86 percent higher than in 1991.

In recent years sexually-transmitted diseases have returned at alarming levels. In 2006, there were 174,596 reported case of syphilis, up 31 percent from 2005. Some think the true number is 10 times higher.The incidents of syphilis increased from 0.2 cases per 100,000 in 1993 to 6.5 cases per 100,000 in 1999. According to one report sexually transmitted diseases increased 170 times between 1984 and 1994 and continue to grow at a rate of 20 percent a year and have contributed to the small but growing HIV problem.

According to researchers at the University of North Carolina sexually-transmitted diseases are increasing in part because economic reforms and globalization “have led to income gaps and a cultural climate that favors re-emergence of prostitution due to a substantial majority of men and large migrant population of male workers.” The report also blames the fact that youth are experimenting with sex before marriage at increasingly younger and younger ages.

Pig-Bourne Disease in China

In 2005, there was an outbreak of a pig-bourne disease in southern and southwest China that killed one out of five people who became infected with it. The disease, caused by “Streptococcus suis”, a bacteria usually associated with pigs, killed 38 and infected more than 206 and left hundreds of pigs dead as of August 2005.

Most of those who got sick were young male farmers who had eaten raw pork or pig products or who had handled pigs infected with the bacteria. Disease-infected pork that made one man critically ill was later sold at a local market by his wife. Symptoms included nausea, fever, vomiting and bleeding under the skin. One of the biggest problems in fighting the disease was that doctors could not find the right drugs to treat it. Many patients developed meningitis, a swelling of the brain covering and spinal chord, and experienced severe respiratory problems and had to be put on respirators.

Outbreaks of the pig-borne disease were reported mainly around the Ziyang and Neijang areas between Chengdu and Chongqing. in Sichuan Province, and to a lesser extent in Guangzhou Province. The disease was first detected in June 2005 among farmers in Sichuan who butchered or handled infected pigs. Cases of the disease among humans had occurred before but they were mainly people who had slaughter infected pigs and had cut themselves and had been infected with the blood of an infected animal. What was unusual about the 2005 outbreak was that the death rate was so high and the outbreak was so large.

Beijing was anxious not to repeat mistakes made during the SARS outbreak. Pigs were killed, farms were disinfected and shipments of pork from infected areas were blocked. There was no evidence that disease had been passed from humans to humans.

The Chinese government was quite open about the outbreak. The state-controlled media said that the government’s practice of hiding information about epidemics was over. An editorial on the China Daily praised local authorities for their “timely response and thorough disclosure of the truth to the public” in regard to the disease.

Hand, Foot and Mouth Disease in China

A nasty form of hand, foot and mouth disease killed dozens in central China in 2009. Tens of thousands caught the disease, almost of them children under five. In June 2007, more than 200 cases of hand, foot and mouth disease — a viral infection common among children — was reported in Beijing. About 90 percent of the victims were under five.

As of late May 2008, 42 young children died and 25,000 people had fallen ill in China in an outbreak of a lethal form of hand, foot and mouth disease, a common childhood illness caused by an intestinal virus that is not related to foot and mouth disease that affects livestock. The disease is highly infectious and is especially dangerous to young children. All the fatalities occurred to children under six, with most of children under two.

The virus behind the outbreak was identified as enterovirus 71, or EV71, a particularly nasty strain of hand, foot and mouth disease, which causes high fever, meningitis, encephalitis, pulmonary edema and paralysis in a small number of children. Symptoms included fever, blisters, mouth ulcers or rashes on the hands and feet. Some victims had brain, heart and lung damage, There is no known treatment for the virus. Patients with the usual strains of the disease recover in a week to 10 days. But the symptoms with EV71 were more severe. The disease thrives in warm weather and the chance of getting it can be dramatically reduced with rigorous hygiene.

Hospitals in Fuyang in the eastern province of Anhui first reported the disease in late March 2008 but the outbreak was not made public until late April, mainly due to problems identifying the disease not because of a cover up. As of late April 2008, 19 young children had died and 800 others had fallen ill in Funyang. Schools and day care centers there were closed. Rumors spread that a local river was the source of the infection.

A doctor in Funyang — Liu Xiaolin — alerted experts when children began dying of disease that her colleagues insisted were merely suffering from colds and the flu. She is credited with developing effective treatments to fight the disease. Many of the children who died did so because their parents thought they only had the flu and did not them get them treated quickly enough.

In May 2008, and 8-month-old girl and three others from Guangdong and an 18-month-old boy and one other child from Guangxi died of the hand, foot and mouth disease, indicating the disease was spreading south. By the end of May there were 42 deaths of children attributed to the disease, including two in Beijing, nationwide. An additional 11 people had died and 3,000 had contacted the disease in Vietnam.

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Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated September 2022


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