# 4041
Dovetailing into my last blog, we get this report from Maria Cheng, AP Medical writer, who explores the success (or lack thereof) of China’s extraordinary efforts to keep the H1N1 virus out of their country.
Along the way we get confirmation that the number of cases, and deaths, reported by China are `minimum numbers’, and not representative of the true picture.
This is an excellent report and worth reading in its entirety.
Experts: Radical Measures Won't Stop Swine Flu
Quarantines Have Failed To Contain Disease, Health Experts Say
MARIA CHENG, AP Medical Writer
LONDON --
Health experts say extraordinary measures against swine flu -- most notably quarantines imposed by China, where entire planeloads of passengers were isolated if one traveler had symptoms -- have failed to contain the disease.
Despite initially declaring success, Beijing now acknowledges its swine flu outbreak is much larger than official numbers show.
China's official count of some 63,000 reported illnesses with 53 deaths dwarfs estimates of millions of cases with nearly 4,000 deaths in the United States, a nation with about a third of China's population.
Dr. Michael O'Leary, WHO's top representative in China, says there has been a dramatic spike in Chinese swine flu cases recently and those reported by the government are only "minimum numbers."
"We have new cases occurring all the time," he told The Associated Press last week. "There's always more deaths than we could possibly know about."
The problem of course is, between incubation periods of up to 4 days, and totally asymptomatic carriers, it is impossible to interdict everyone coming into the country who may be infected and shedding virus.
Just as India and Japan discovered, the best you can hope to do is slow down the introduction of the virus.
Areas that receive a small number of arrivals might be able to institute a quarantine system (see Can Island Nations Effectively Quarantine Against Pandemic Flu? ), but even then the ability to interdict infected travelers won’t be 100%.
The four successful quarantines during the 1918 pandemic were in American Samoa (5 days' quarantine) and Continental Australia, Tasmania, and New Caledonia (all 7 days' quarantine).
- The Spanish Flu did not reach American Samoa until 1920, and had apparently weakened, as no deaths were reported.
- Australia's quarantine kept the influenza away until January of 1919, a full 3 months after the flu has swept New Zealand with disastrous effects.
- Tasmania kept the flu at bay until August of 1919, and health officials believed they received an milder version, as their mortality rate was one of the lowest in the world.
- By strictly enforcing a 7-day quarantine, New Caledonia managed to avoid introduction of the virus until 1921.
Eventually, once the quarantines were lifted, the virus did make it to these isolated regions of the world.
Given the current level of international trade and travel, quarantines for air and sea ports that handle a substantial number of passengers really aren’t practical.
At least, not for very long.
