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Sunday, August 14

A new translation of the Boxun interview about the Sichuan disease outbreak

August 17 Update
I received a second opinon about whether Dr. Wong/Wang referred to bubonic plague as a virus; the second translator maintains he never did. Readers who have been closely following this story know much turns on the issue of that one word. For the second translator's additional (brief) comments about the original text, see today's Pundita post at:
http://pundita.blogspot.com/2005/08/dr-wongs-fan-club-rejoice.html
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A Pundita reader who does not have a biomedical background but who is fluent in Mandarin offered to translate the text posted July 29 on Boxun.com, and which has been the subject of so much discussion on this blog and elsewhere. The translation result is below. Many thanks to the reader for dedicating a weekend to the task of translation!

For other readers fluent in Mandarin who would like to read the original text for comparison, it can be found at:

http://www.peacehall.com/news/
gb/china/2005/07/200507281438.shtml

For readers who want to compare this translation with the one found on the Agonist website, the Agonist translation can be found at:

http://discuss.agonist.org/yabbse/index.php?
board=6;action=display;threadid=22611

The Agonist translation is accompanied by extensive discussion about confusing and erroneous comments made during the interview with regard to bubonic plague.

I have made very minor edits to the text; e.g., replacing commas with semi-colons and beginning a new sentence when such could improve ease of reading, but only when I was sure this would not change the meaning of a sentence. I placed in brackets word substitutions or suggestions for a word.
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Transcript of a recording of an interview of a doctor who had participated in the analysis of the Sichuan disease

Interviewer (I): Greetings, Dr. Wong, thank you for accepting our interview. [1]

Dr. Wong (W): Greetings to you.

(I): What is your work in the health department system?

(W): My main task is the identification and analysis of viruses.

(I): Like the genetic researchers featured in the movies?

(W): Kind of similar, yet not that exaggerated; that’s the movies.

(I): Dr. Wong, have you participated in the disease examination (or studies) of the Sichuan disease?

(W): I have.

(I): How do you evaluate the results of the viral examination?

(W): My answer is that the results of this study are more complicated than imagined. This also would explain why the study team leader has been replaced three times, each test yielded different results.

(I): You’ve mentioned the change of team leaders, why was that?

(W): There were three different examination results for each test, each result always overthrew the last, causing the removal of the team leader.

(I): Was it because of corruption?

(W): I could not understand whether or not it was because of administrative reasons; regarding corruption, it’s quite normal.

(I): Can you tell me more about the details of the Sichuan outbreak?

(W): On June 2nd we received a called from the Sichuan health department, they said that there [was] an appearance of unusual deaths in the local area and [would] send samples of the virus over for analysis.

(I): (Interrupts) So you are saying that, according to the report in July, the local disease prevention mechanism is sound?

(W): It is not sound. This process is not controlled by political systems. It’s a medical procedure, with regards to unusual deaths due to diseases must be reported, the responsibilities of the local leaders cannot be investigated; moreover, the concealment of truth will be punished -- where was I? Yes, we’d received the sample

(I): Sorry.

(W): It’s all right. After we had received the sample, we quickly examined the virus. From the sample we isolated the SZ77++A3231 virus.

(I): What sort of virus is SZ77++A3231?

(W): It is a type of Ebola virus.

(I): Can you explain it in a more simplistic way?

(W): This virus does not suit the concrete description.

(I): That’s understandable, but why is it that the Chinese Ebola virus [was] claimed to be low-infectious?

(W): That’s a good question, the reasons for the claim that the virus is low-infectious are that: the first is to reduce societal panic, the second is that the Ebola virus has evolved in China. Recombination of genetic material has appeared. The most prominent characteristic is that the positions to which the virus manifests itself are mostly in the Kleinen property [?]; there are also abrupt breaks in the genetic sequencing of the virus, leading to the endless changes in the incubation period.

(I): How were the viruses classified?

(W): Previously, categorization of the China Ebola virus was made by the model of EBO prefixes. Then for some unknown reasons, the news of the virus leaked, thus the method of classification was changed. The EBO prefixes were cancelled, with the increase of the speed of infection and intensity, such as the SZ777++A3231. Sometimes we don’t even use the name of the place of the discovery of the virus; instead we directly use the name of ++A3231.

(I): So that no one would even think of the Ebola virus?

(W): Correct. The classification of the Ebola virus is a national secret.

(I): So the previous information leak was --

(W): I don’t understand the main reason, but those in charge of information security have been segregated and questioned.

(I): You started to participate in the June investigation of the virus outbreak in Sichuan; did you participate in subsequent investigations?

(W): I need to point out that I was not the only one who participated in the investigational work in Sichuan. There were others from all over the country who had participated in the investigation, the country had specially set up three departments to process the examinational work.

(I): Can you tell me about the current situation regarding the outbreak of the virus in Sichuan?

(W): As I’ve mentioned earlier, the Sichuan outbreak is a very complicated matter. I will try to summarize it. How should I say it? Currently, there are many factors in the outbreak. There are three different diseases plus an industrial pollution incident and incidence of medical malpractice

(I): Are you saying that it is not completely the pig-strain streptococcus claimed by the officials?

(W): Pig-strain streptococcus can also infect humans, it can also cause death, but the level of impact is not at all dramatic. There are elements of pig-strain streptococcus in the Sichuan outbreak, but that’s not the main cause.

(I): Then why did the officials blame the outbreak on pig-strain streptococcus virus?

(W): You can understand that locally the residents, merchants, even the local private business sector rely heavily on the domestic animals. Pig-strain streptococcus virus is the most common virus in that region, and it will remain that way for a long period of time. Where there are pigs, there will definitely be pig-strain streptococcus virus.

(I): So you are saying that pig-strain streptococcus virus is one way to explain what is happening?

(W): You could explain it like that. Also, let’s look at it this way, not just saying that the deceased have the pig-strain streptococcus virus in their bodies. Even the healthy local population in the region has the same virus in their systems due to prolonged exposure to domesticated animals, pigs, goats, and the like. These animals also have within them the pig-strain streptococcus virus. Just because there are no symptoms doesn’t mean that the virus does not exist; I need to state that this is a characteristic of the virus, that it cannot be avoided.

(I): Can pig-strain streptococcus virus be infectious on a broad scale?

(W): You can reference information on the pig-strain streptococcus on the Internet.

(I): Some authorities have indicated that this outbreak may be due to mutations of the pig-strain streptococcus virus.

(W): The streptococcus is known to commonly exist amongst humans and domestic animals, pig-strain streptococcus virus II’s ability to infect is very weak. The criteria for the appearance of the virus is also very complicated; the rate of mutation is very low, because this virus’s structure is very stable unlike the rapid speed of mutation of the flu virus.

(I): How do you explain the qualitative nature of the human/pig strain streptococcus virus?

(W): I have stated that there is an element of this virus, but it’s not the main cause for the outbreak. Humans can be infected with the pig-strain streptococcus virus, but the strain is not sufficient to cause the kind of outbreak that we’ve seen. While pig-strain streptococcus virus can cause death in humans, it is not that serious.

(I): Then can you talk about the other factors surrounding the outbreak?

(W): I need to announce that I had participated in one part of the virus analysis and investigation. There are other departments at work in the investigations also. The result of my analysis is that in the samples there are the A3231 virus, or collectively, the SZ77++A3231.

(I): Are there many variants (strains) of the SZ77 virus?

(W): SZ77 is a set of sequence, basically including this model of the Ebola virus and the combination of Ebola viruses; it is a biggest classification in the country’s virus studies.

(I): That’s really very confidential information. What about the unending developing behind the letter A?

(W): About the last two digits, can be developed, as a marker; basically it stops at the 57th place.

(I): That means the sequence stops at A3257. Why?

(W): Correct, because anything above the numerical sequence of 57 [is] reserved for another type of virus. From next year on, we might stop classifying viruses by the location that they were discovered in, thus, canceling the SZ series.

(I): We’ve got the A3231. What about the other viruses?

(W): I don’t understand a lot of them; three of the viruses contain the A3231 bubonic plague. I don’t yet understand the other one.

(I): You mentioned the bubonic plague; why did that not involve widespread transmission?

(W): It was not that strange. Chinese have already been inoculated against the bubonic plague. Actually a lot of humans have immunity to the plague, but the living conditions in Sichuan was quite adverse, prompting decrease in immunity in some of the population, thus losing the desired effect of the plague vaccine.

(I): Yet why we did not see any reports from the officials and the local press about the outbreak of the bubonic plague?

(W): The bubonic plague that I am talking about is the sample in which we had detected the bubonic plague [as well as] the A3231 virus, the pig-strain streptococcus, and other germs.

(I): That’s scary.

(W): I’ve mentioned that the living conditions in the Sichuan region are very adverse.

(I): Why did all these viruses break out simultaneously? The officials said that there are no connections between them, and that they are not infectious.

(W): There was not a simultaneous outbreak; rather, they broke out consecutively. The timing of the breakout was more centralized. All viruses have incubation periods, at the end of the incubation period, the disease will break out. With regard to how the viruses are related and their transmissibility: if we define the transmission mechanism of a virus to be its ability to infect, via a medium, other humans or animals and cause them to develop similar symptoms, then, yes, essentially we have an infectious disease.

(I): The report from the affected area was that pigs are the vectors of the disease. What do you think?

(W): Pigs can be the vectors of the disease. Humans can also be the vectors of the disease; these possibilities cannot be eliminated. From what we know, there are distances between the herds of pigs, and that would create a lot of questions as to how the virus was transmitted.

(I): Pardon the interruption, but the explanation by the officials stated that the mode of transmission was human exposure to slaughtered diseased pigs, and not because of different humans being exposed to different pigs resulting in infection.

(W): That’s a method of propaganda, but looking from the angle of infection by pig- strain streptococcus virus, then that claim can be established.

(I): Do you not agree with the official explanation?

(W): From what I understood, the disease spread amongst the pigs is independent, as far as humans being infected by pigs --

(I): It seems there are discrepancies from our perspective [respective?] sources of information.

(W): I don’t really want to try to explain the phenomenon reported by the news media, since phenomena are just phenomena; the discovery of the virus is the most convincing.

(I): Agreed. You’ve mentioned before about the problems of medical malpractice and industrial pollution. Can you explain them to us?

(W): These are very important questions. I don’t really want to comment too much about them. In the beginning of the disease outbreak, the local medical authorities used various medications to treat the disease and instead of curing it, they instead sped up the worsening of the disease, leading to deaths. To try to control the spread of the disease, the local officials had stated that the disease does not have any effective medications [which] prompted the speedy cremation of the affected corpses.

In the process of medical treatment, some were also affected by environmental pollution, as were the patients who were affected by the virus seem to have very similar symptoms, also died because in part due to medical malpractices. [sic] Naming the [disease] as pig strain streptococcus was not the intention of the health department; it was the local government officials who had the control in handling this matter.

(I): We did not see anything in the media which mentioned the bubonic plague or the Ebola virus, and the officials stated that the symptoms of the deceased all matched each other.

(W): Propaganda is propaganda.

(I): How do you determine the disease of the Sichuan outbreak -- from your personal perspective?

(W): (Laughs) You’ve got me there! Since I do not have access to all the disease samples, my statement may be biased. I can only comment from what I had come to understand from the information available to me. I believe that this is a blood-borne virus with the Ebola and the bubonic plague virus as its main constituents. [2] I had arrived at this according to my research results.

The reason why I had arrived at this conclusion was that in the samples I analyzed there was a special strain of bubonic plague; it was drug resistant and can only be transmitted by blood. It can only be transmitted at a certain blood density; otherwise, the virus would not survive. The Ebola virus is one of the main components of the virus but not the main cause of deaths. I thought the Ebola virus sped up the worsening of the symptoms of the disease.

I need to make one thing clear, and that is I did not personally participate in the study which studied the combined effects of the Ebola and the bubonic plague viruses, so I don’t really understand the combined effects of those two viruses. Regarding the medical malpractice, it has to do with usage of expired medications as well as improper treatment of the disease.

(I): Can you reiterate that your explanation placed focus on the fact that there was bubonic plague virus in the sample? Will this prompt a greater transmission of this disease?

(W): The bubonic plague in this outbreak has taken on a certain mutation; it can be accounted for [the outbreak’s] widespread transmission. However, it would not be impossible for this strain to be passed from rats to humans. Since this mutation can only be blood borne. While rats are the carriers of the virus, they can only infect others by biting humans or other domestic animals, passing along a certain set amount of virus (the mutated virus), thus enabling the transmission of the virus to other humans and domestic animals.

However, there is something which we should take note of here regarding the infection of domestic animals by infected rats. When the virus is transmitted to other animals it mutates, and there is a distinct difference between this strain and the original strain found in the rat. Whether or not a greater outbreak will follow is actually within control. Keep in mind that there are three conditions that must be met. First, the body’s immunity to the bubonic plague must be lowered; second, there must be direct exchange or the contact of blood; and third, the virus must be present in sufficient quantities, otherwise, infection would be unlikely.

(I): The international communities have offered technical assistance yet it was rejected, what is your thought about it?

(W): We cannot accept any international assistance. With our participation in the World Health Organization, our national secret would be revealed. It would not be beneficial for the reputation of China in the international communities. Not only would problems in scientific research be exposed but also the local medical, living conditions, environmental pollution, and corruptions.

We have been slaughtering pigs on a large scale, but not the extermination of rats and one seldom reads of reports of humans being bitten by rats. Although rats and men live in the same environment, rats have always been scared of humans; therefore, the incidents of humans being directly bitten by rats are minimal. Even if humans are bitten by rats, the rats must carry a certain amount of the virus in order for it to fully become a transmittable disease.

Yet pigs are different; pigs are an integral part of the human diet, and when pork are being processed, it is inevitable that there are contacts with pig blood, and their contact period is significantly longer. Thus, if the infected pigs were slaughtered, the chances of infection would greatly increase. That is not saying that infection is a certainty, but the odds do shorten considerably. We also cannot determine which rats are infected, so we can only exterminate them all.

Once the bubonic plague has been ascertained to be the primary component of the virus, the appropriate prophylaxis can be found. Thus, even if this sort of outbreak happens again, there will not be any more need to worry, as the appropriate treatment would be available.

(I): This virus developed very rapidly; the victims die within 19 hours after the initial exposure.

(W): The virus does not develop very rapidly. What happened was that [the victims] were, in fact, infected much earlier than [19 hours prior]. [There] was the incubation period [during] which the virus developed quietly without presenting any symptoms; you did not mention the incubation period.

(I): Will we be infected by eating pork?

(W): (Laughs) Of course not, because after cooking the pork at high temperature, the virus would have been killed and the genetic sequence of the disease broken. Think about it -- the virus is blood borne, and if the blood has changed under heat, then how can the virus survive?

(I): Besides pigs, are other domesticated fowls susceptible?

(W): I am considering this question also. Yet from what I had understood, we found that it has a lot to do with the nature of the environment. There is a lot of rearing, slaughtering and processing of pigs and pork products in the area. The pork processing industry is a mainstay of their economy. Other animals might have been infected, but their numbers will be small in comparison. Infection of these animals can occur while being raised or from environmental factors. As to why there were no infections in large factories but rather in smaller households -- that can be easily explained.

(I): Do you think that the outbreak will come to an end?

(W): After we’ve isolated and ascertained the virus, the rest will be the manufacturing of the appropriate antiviral drugs and to start a vaccination program.

(I): We often see related reports of analysis and explanation for the outbreak.

(W): Medical reports and analysis can be easily organized, tampered, or falsified for the sake of economic concerns; that’s not unusual. We must keep in mind that the lead agency for this investigation is the Sichuan Provincial government, and not the Chinese Ministry of Health. The Ministry of Health is playing a supporting role, so we must follow the wishes of the provincial government. As to why the Ministry of Health is [only] playing a supporting role, I cannot explain

(I): You had mentioned about the third virus in the outbreak; what is it?

(W): I’m sorry; I cannot explain this because it’s beyond my knowledge. This was the result of the wrong treatment administered followed by the environmental pollution accidents. So I could not fully understand it. Also I have never been involved in the analysis of the Ebola and the plague virus synthesis and I don’t have any more ebola samples. I can only say that the Ebola and the third virus do play a part in this particular virus involved in this outbreak. Those killed by the third virus have since been cremated; we only have samples now, but it’s understandably very dangerous.

(I): Thank you so much for your time. Sorry for wasting your precious time.

(W): It’s not a problem.

(I): Good-bye.

(W): Good-bye.
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Pundita’s notes:

(1) Clearly, according to this translator, the person is using the name of Wong, not Wang, as had been stated in other places.

(2) Bubonic plague is a bacterial infection not a viral one and the transmission of bubonic plague from humans to rats was via fleas, according to a dicussion thread on Agonist:

"[...] The person appears not to know that plague is a bacteria, the vector from rodents to humans is fleas, and plague is curable with cheap antibiotics."

Yet there is no mention of fleas in the interview. And throughout the interview both the interviewer and Dr. Wang refer to bubonic plague as a virus. This anomaly received much discussion on the Agonist discussion board and has led to various speculations. See Friday’s post.

There is one fascinating speculation presented during the Agonist discussion thread, which I missed during the first reading:

http://www.bbc.co.uk/worldservice/
sci_tech/highlights/010801_blackdeath.shtml

"I found several links [see BBC link above] that say the Black Death and subsequent plagues were caused by an Ebola like filovirus and not bubonic plague bacteria. Maybe the person is referring to this virus, i.e. the virus is the one believed to cause 'bubonic plague.' [...]"

I was hoping a better translation might clear up the confusion about the word, yet this translation of the Mandarin word accords with the one by the “peter pan” translator on Agonist.

I learned from the translator that an online machine translation tool was used to help with medical terminology. In the effort to resolve the confusion once and for all, I have emailed the translator a link to an online English-"Chinese" dictionary, which shows two very different pictographs for the words "virus" and "bacteria," and asked for a comparison of these with the pictograph used in the text. I hope to hear back this evening or tomorrow and will edit this footnote according to the verdict.

However, because the pictographs are clearly very different, and because the word "virus" is used throughout the text in other contexts, right now I am leaning toward the machine translation of "virus" in reference to bubonic plague as the correct one.

If the word used to describe bubonic plague is indeed "virus," one is left to wonder. If the interview is a hoax then considering the highly technical discussion in parts, most likely a hoax carried about by someone with basic medical knowledge. So one would think a hoaxer would know enough to use the correct word. Yet there it is: the bubonic plague is repeatedly referred to as a “virus,” at least according to the translation posted here and on Agonist.

A possibility is that “Dr. Wong” is a lab technician who is not knowledgeable about bubonic plague. But of course that speculation grasps at a straw.

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