Tuesday, August 16

Once upon a midnight dreary quoth the Raven, "The vodka is good but the meat is rotten."

A reader with a steel trap memory (Boris in Jackson Heights -- the über cynic among Pundita readers) wrote to ask if yesterday's post was the one I really intended on Sunday to put up on Monday. And if not, when would I be finished nailing the Chinese military's hide to the wall so we could return to discussing other subjects, such as Gaza, the Six-Party Non-talks, Iraq, and so on.

Boris, Pundita would be a crummy detective if we started out with the preconceived notion that the PLA was running black propaganda against the US military.

And it could be China's embattled Ministry of Health ratting out, if you'll pardon the expression, leaks in the PLA's biowar program. After all, it's the MOH that has been on the firing line, what with the slow response to SARS and the 2003 H5N1 outbreak. I'll bet Boris didn't think of that.

And there is the food fight between two factions in China. On one side is Jiang Zemin's camp. On the other side -- well, it seems to be General Cao's camp but we can't say for sure whether we're looking at a shakeout in the PLA or Chinese Communist Party.

Then again, there could actually be a very weird highly lethal disease loose in China that may or may not be strep suis and/or a combination of Ebola, plague, mutated Bird Flu and the dog ate my notes. A disease having something to do -- or maybe not -- with pigs. Don't forget the China Ebola Chicken report posted on Agonist back in April by guess who the first two guesses don't count.(1)

Running alongside the mystery disease, and perhaps entwined with it, or perhaps just a different view of it, is the dance of the brilliant A (H) virus -- sort of the Rudolf Nureyev of viruses. Pirouetting and leaping into a dazzling array of recombinations as it does a pas de deux with genes from the world's wildlife, domesticated animals and occasional human partner.

As the spring of this year wore into summer H5N1 flew from China's gorgeous Qinghai Lake then to Tibet, Central Asia, Russia and now westward, leaving sudden death in its trail.

"Educate yourself, it's coming," snapped John Batchelor to his audience last night. This was after a Wall Street Journal reporter informed him that a Harris poll found that fully half of Americans didn't have a clue about H5N1 and a solid majority had only vague or erroneous ideas about how to prepare for the visit.

At some point in this tangled tale must be decisions:

Just how hard should the US government push Beijing about their habitual foot-dragging with regard to reporting highly infectious lethal disease outbreaks?

Just how much should the US military believe that the PLA has got a supervirus bioweapon and the vaccine for it under wraps?(2)

And just how much money, if any, should the US government cough up to fund vaccine development, seeing how US pharmaceutical companies are so worried about law suits and low profit margins that they are reluctant to invest whopping amounts in vaccine R&D?

But to arrive at sound decisions we'd have to untangle the tale, or at least parts of it that can be untangled. By many twists and tangles, the plot has come to revolve around a confounding interview with a mysterious Dr. Wong -- or Wang. Reader "Liz" cautioned:
Transliterations are always tricky: listen with a mental ear to the names John Wong, John Wang (the a as in ah, not bat)...I wouldn't make too much of the difference in how the doctor's name is spelled.
All right. Still a confounding interview, riddled with enough inconsistencies (whether through the fault of transliterations or Dr. Wong) to fill up online message boards with discussions about fleas and rats, bacteria and viruses and the Black Death.

To top it off, the only complete English translation of the interview is a poor one. Another Pundita reader to the rescue. Yet with a better translation it's just like clearing away underbrush: now the technical inconsistencies show up in sharper relief. A MD general practitioner reads the cleaned up translation and comments with poorly concealed contempt for Dr. Wong's -- or "Mr." as she pointedly lapses into calling him -- medical knowledge.

Regarding the Dr. Wong Pig Sickness interview you published [yesterday].

First, the issue of Bubonic Plague and the research posted at the BBC, which you included in the second footnote of the new translation.

Plague is caused by Yersinia Pestis, a bacterium. The symptoms -- formation of bubos, which are grossly inflamed, black-colored lymph nodes filled with pus -- is to my knowledge unique to this illness. The description of bubos in the accounts from the black death are what give the diagnosis of this disease.

The bubonic form is acquired primarily from rats or their fleas, but may be found in other rodents as well, and may be passed between people via fleas or contact. [3] This form of plague generally kills on a time-scale of days.

In addition, humans infected with bubonic plague who develop significant numbers of the bacteria in the lungs during a disseminated infection (possibly also a genetic switch in the bacteria) can cough and sneeze bacteria-containing droplets. This is what is known as pneumonic plague; people who acquire plague by breathing it in understandably develop infection in their lungs first, thus continue to pass it on person to person pneumonically without need of fleas or rats, for sustained chains of transmission. This form of plague has a 90% mortality rate due to the afflicted losing their ability to breathe, and can kill within a day or two.

Thus the English researchers' observations [at BBC link] are in fact explicable by known behavior of Y. Pestis; a virus need not be implicated in the historical outbreak they studied.

The symptoms observed in China are not consistent with those usually observed for Yersinia Pestis. They do, however, vaguely resemble the symptoms of Yersinia Enterocolitica, which tends to manifest as vomiting and bloody diarrhea.

Y. enterolytica is usually self-limited, resolving in most cases without treatment in about three weeks, and is most commonly acquired by exposure to undercooked pork, especially pork intestines.

Severe cases may be treated with antibiotics. If a more dangerous mutation of Y. enterolytica is the cause of the illness, then it is possible that Mr. Wong mistook the discussion or diagnosis of Yersinia for Y. Pestis when in fact Y. enterolytica was meant.

Mr. Wong uses the word 'virus' to refer to two bacteria (Yersinia pestis and streptococcus suis), which severely undercuts his credibility, as does his claim to some kind of cross between "ebola" (a virus) and "plague" (a bacteria). If he was referring to a co-infection by two agents, then he should have explicitly said so.

The word translated as 'ebola' may in fact be a more generic word meaning 'filovirus'. You should find out if this is the case. So far as I know, Ebola has never been found in pigs. While it is possible the Chinese illness is due to a filovirus, I doubt that it is a form of Ebola. Also, the pig illness does not appear to be transmissible between people, whereas Ebola is transmissible in this fashion.

[Quoting interviewer's question to Dr Wong:]

"But how do you account for the 'bleeding under the skin' reported in this

Hemorrhagic symptoms can occur in a variety of severe illnesses, via a syndrome of inappropriate clotting called 'disseminated intravascular coagulation.'

In DIC, people's clotting factors are activated by a strong ongoing immune response, and they form microscopic clots throughout the bloodstream. The result is infarcts --'strokes' in the brain and other organs as the tiny clots occlude small blood vessels.

And along with these clots there is bleeding, because the formation of the clots depletes the blood stream of the factors needed for clotting, so that abraded mucous membranes and small recent wounds or bruises leak blood continuously.

Thus the hemorrhagic symptoms seen in the pig sickness do not necessarily mean that a Hemorrhagic Fever (filovirus) is involved.

I don't know what the cause of the pig sickness is. But because of the multiple imprecisions and unlikely claims in the interview I do not believe Mr/Dr Wong is a reliable source for that information.
[Signed] Lisa the GP"

The heroic translator was unable to help with the filovirus word in Mandarin and more-or-less stood by the machine translation of virus as versus bacteria. My time wrestling with three different online English-Chinese medical dictionaries came up dry, except I learned that the Mandarin pictographs for "virus" and "bacteria" are very different.

I wrote Liz to ask if anything about the improved translation jumped out at her, which is how I learned Liz knew some Chinese in addition to Russian.
Pundita: I noticed a definite political slant to the translation up today. It reads like part-technical/part-political (spin) statement.

As for the question about repeated reference to "plague virus" -- yes, plague is a bacterium. I don't know enough Chinese to know how clear the Occidental distinction is in an Oriental language.

Different fundamental referents can lead to surprising mis-translations. I recall a machine (and therefore literal) English-to-Russian translation of "The spirit is willing but the flesh is weak." It became, "The vodka is good but the meat is rotten."

And "Out of sight, out of mind" became "Invisible idiot."
Well, we still have two strands of the tale firmly in hand:

One: Taiwan suffered greatly because of Beijing's foot-dragging and cover-ups with regard to the SARS and 2003 H5N1 outbreaks. Taiwan's military is watching China very, very carefully. Yet since the outbreak of the mystery disease and through all the reports about the disease, Taiwan has not suspended travel to and from China's mainland.

Two: There is no way Dr. Wong could have defined his role in the examination of the mystery "virus" sample as clearly as he did in the interview without giving away his identity to China's authorities. The improved translation makes this crystal clear.

Therefore, Dr. Wong gave the interview at the instruction of China's Ministry of Health. Of that much I think we can be certain.

But remember that Wong indicated to the interviewer that the person(s) who had earlier leaked the information about Ebola loose in China would be found and punished:

"(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."

The question is why the MOH wanted to publicly admit that highly sensitive classified information had been leaked, thereby giving credence to the reports about deaths in China from Ebola infection.

Liz warned I should not ask that question.
"Why?" The question, of course. Like the Soviet Union before Gorbachev opened Pandora's Box (from a Party perspective), every piece of public information serves a political purpose. Whose, of course, is always open to question.
But Pundita is interested in open-ended questions only up to a point, which is decision time. Reader Bruce Kesler suggests a guideline for decision analysis:

"When confused by menu in Chinese restaurant choose from Column B."

All right. Here is what Pundita sees in B Column:

NIH should lobby Congress to throw a couple $100m at Henry Niman's vaccine development company so he'll stop publishing machine translations of anonymous Chinese reports on Boxun that scare us silly.

The US Department of State should ask Taiwan's leading bankers, who are keeping China's banking system afloat, to tell the PLA to make sure that whatever really weird happens in China stays in China.

Make sure to fully cook all pork and chicken dishes.

"Ebola China Chickens: From Agonist
Posted by Dr. Niman
Report from the 17th of April, and suggests--according to the key paragraph--that in late march a driver called Zhong became sick at a chicken farm and was taken away and not heard of again. By early April the chickens at the same place (Baoan in Mandarin, Po An in Cantonese) began to lose their feathers, develop red spots, and bleed from the eyes and the anus. Many of the dead birds were cleaned up and sold to markets in Shenzhen and nearby Dongguan. Some workers at the chicken farm have also gone missing. It alleges that chickens sent to Hong Kong for testing were not from the farm, which exports some 1.6 million chickens to HK annually.

This confirms that the authorities did indeed tell the authorities in HK about the dying chickens:

This report alleges that a man called Zhou Zhengbei was executed on June 28 in Fujian for leaking information about the Shenzhen incident:
(2) The Epoch Times August 8
War Is Not Far from Us...Leading CCP official argues for exterminating U.S. population

(3) Dr. Lisa clarified for Pundita that plague could also be transmitted by rat bite, thus giving Dr. Wong's fan club some hope to cling to. (See Footnote 2 in yesterday's post)

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