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'No need' to extend test capacity for H1N1 virus

By Shan Juan (China Daily)
Updated: 2009-11-10 08:28

A health official yesterday rejected the need for grassroots clinics - unlike their counterparts at city, provincial and national levels - to test for the H1N1 virus.

"The primary significance of H1N1 testing lies in tracking the general pandemic situation in the country, and thus guiding future countermeasures rather than treating individual cases," said Feng Zijian, director of the emergency response department of the China Center of Disease Control and Prevention, which is in charge of the pandemic's surveillance.

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"That's also in line with international practice," he said. "Testing every patient with flu-like symptoms for the H1N1 strain is not necessary and is a waste of limited resources."

Some grassroots hospitals have urged central health administrations to equip them with H1N1 testing capacity, saying that would allow them to give more timely and proper treatment once they confirm a patient has H1N1.

The Chinese mainland now has 411 laboratories testing, confirming and monitoring H1N1 flu cases, which can only be done at the city level or higher.

On Oct 7, a 14-year-old secondary school boy surnamed Yi was rushed to the First Affiliated Hospital of Nanhua University in Hengyang, Hunan province, in critical condition. There he tested positive for the H1N1 virus and later died from complications including multi-organ dysfunction.

But the boy first developed flu-like symptoms on Oct 2 and was treated for the common flu at a local hospital in Changning, which has no lab to confirm H1N1 flu cases.

Zhan Nonggao, director of the traditional Chinese medicine department of Changning People's Hospital, which Yi first visited, said it is impossible for the hospital to administer H1N1 flu medications, as they don't have H1N1 testing capacity at all.

Complications that kill many H1N1 flu patients worldwide usually begin to develop three to five days after the patients show flu symptoms, according to Lu Hongzhou, who heads Shanghai's expert team for H1N1 flu control and prevention.

"Without a timely diagnosis, effective treatment might be delayed," he said.

Fan Yishan, director of the Yunnan Infectious Disease Hospital, said that distributing the H1N1 testing chemicals to grassroots-level health institutions would allow doctors there to provide quicker treatments.

In response, Feng said virus testing involves more aspects than just the chemicals, like staff training.

"Grassroots clinical health workers should be trained better in clinical diagnosis," Feng said.

"The doctor should give right and timely medication according to the patient's condition," he said. "That actually requires no viral testing results."

As of yesterday, the Chinese mainland has reported 59,478 H1N1 cases, including 30 deaths.

Beijing vaccinations

Beijing health officials said yesterday they would consider giving free H1N1 vaccinations to residents without hukou, or permanent residency.

The response came after online criticism about the alleged "unfair vaccine distribution in Beijing, which only favors residents with hukou".

However, municipal health bureau officials didn't give a timetable to vaccinate the capital's five million migrants.

The municipal health bureau announced on Friday it will be the first city in China to roll out an inoculation program to include all registered residents. This means that 12 million people will receive the vaccine between Nov 16 and Dec 13.

"Actually we've already given the shot to non-Beijingers like college students in Beijing who come from outside of the city," said Ma Yanming, spokesman of the bureau.