H1N1 deaths 'tip of iceberg'

By Shan Juan (China Daily)
Updated: 2009-10-28 07:58

The death toll on the Chinese mainland and around the world from the H1N1 flu virus could be much higher than previously thought, experts warned yesterday.

The World Health Organization's representative in China, Michael O'Leary, said the number of reported H1N1 fatalities may be the "tip of the iceberg".

He made the warning yesterday, one day after the mainland reported its third official H1N1 death.

O'Leary said the fact that many deaths around the world are not being scrutinized with lab tests means most H1N1 deaths likely go unrecorded.

So far, the world has reported 5,000 H1N1 deaths.

Zeng Guang, chief epidemiologist with the Chinese Center for Disease Control and Prevention (CDC) agreed, saying lab limitations mean some flu deaths may not be followed up in the lab.

"So far, no clear evidence can prove that, but the underestimation of H1N1 deaths, if it is happening, is definitely not intended," he said.

The Hong Kong Health Department has estimated that the number of undiagnosed flu cases could be 25 times higher than the official number. The mainland has not estimated how many cases slip under the radar.

But the mainland reported a surge of flu cases and its three deaths this month as the second wave of the pandemic began.

Health experts said the outbreak will test the intensive care capacity of the mainland and warned West China was the most at risk.

"A surge in severe cases would definitely test the capacity of intensive care units and personnel, particularly in remote western and rural areas. So the priority is to avoid several outbreaks occurring at the same time," Zeng said.

It would be a disaster for a city with 100 intensive care beds to have more than 100 patients with severe symptoms at the same time, he said.

But he did not reveal the number of intensive care beds available for H1N1 treatment on the mainland.

People in the western regions are at greater risk because of the relative shortage of medical resources, the Ministry of Health said.

Experts said the western regions lack health personnel, medical supplies and expertise. In addition, the treatment of patients with respiratory diseases is more challenging in mountainous areas.

All three reported H1N1 deaths on the mainland were in West China, with the last one happening in the Xinjiang Uygur autonomous region.

The Ministry of Health has predicted the virus will infect tens of millions of people on the mainland. Several million will seek medical help. Around four in every 1,000 will die, it said.

The ministry has sent experts to West China to improve the situation. They will help with pandemic control and patient treatment. Training sessions on early detection and treatment have also been organized among local medical workers. And the ministry is building an emergency response team to help with severe cases.

He Xiong, deputy director of the Beijing CDC, urged people to practice good hygiene.

"Early detection and treatment are crucial in curbing severe cases and deaths from H1N1 flu," he said.