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Zhong Nanshan is on his soapbox again.  And the world would do well to listen to him.

For the uninitiated:  Zhong Nanshan is Director of the Guangzhou Institute of Respiratory Diseases.  Guangzhou is located in the Cradle of Global Infectious Respiratory Disease, Guangdong province, China.  Guangdong is just north of Hong Kong.  Guangzhou is a dynamic city to work in if you are a public health professional.  That is because they pretty much see everything there is to see in Guangdong.  Bird flu. SARS.  TB.  You name it, it either starts there or winds up there. 

Zhong is at the center of the storm, and that is metaphorical.  Not only is he at the center of the disease storm, but his outspoken nature also creates a bit of a storm when he gets his dander up.  I point to Karl Taro Greenfield's seminal work on the history of SARS, the book China Syndrome.  If you have never read that book, hit Amazon now and pick one up.  His work in the early stages of the disease, as well as his antagonizing of the old-guard ChiCom political leadership put him doubly in harm's way.  His ability to end (at least temporarily) the truth embargo may have helped facilitate the demise of that old guard.  For a brief history of Zhong Nanshan, you can read this article: Uncompromising doctor - Zhong Nanshan.

Now for today's news:  The same flu epidemic that is strangling American emergency rooms is apparently also choking its Chinese counterpart facilities.  This H3N2 derivative, which we suspect is Brisbane, has caused several deaths among Chinese children and led to the closure and decontamination of at least one Hong Kong school. 

Zhong has issued a stern warning to the Chinese people in particular (and to the world in general) that H5N1 is mutating (again) at a time when traditional, seasonal influenza is about to reach a peak this month in China.  His concern is straightforward:  These may be the most favorable pandemic conditions in southern China since the original Hong Kong outbreak of human H5N1 in 1997.

Here is the Reuters story:

Bird flu shows signs of mutation - China expert

Tue Mar 11, 2008 9:38am GMT

(Adds closure of Hong Kong school)

HONG KONG, March 11 (Reuters) - A Chinese expert on respiratory diseases says the H5N1 bird flu virus has shown signs of mutation and urged vigilance at a time when seasonal human influenza is at a peak, newspapers reported on Tuesday.

"When avian flu is around and human flu appears, this will raise the chances of avian flu turning into a human flu. We have to be very alert and careful in March," Zhong Nanshan was quoted by the Ming Pao newspaper as saying.

"People who were killed by bird flu last year and this year were too poor to seek treatment. If you happen to have high fever and pneumonia, you must seek treatment fast," said Zhong, director of the Guangzhou Institute of Respiratory Diseases in China's southern Guangdong province.

Experts are worried about seasonal flu, because it could get mixed up with a deadly novel strain, such as the H5N1 bird flu virus. Such a hybrid would not only become easily transmissible between people, but packed with great killing power.

"The bird flu virus has shown signs of mutation. If infected people don't get treatment in a timely manner, they can die easily," Zhong was quoted as telling reporters on the sidelines of the Chinese parliament's annual meeting.

Three Chinese have died this year of H5N1 bird flu and they were infected probably through contact with sick poultry. The World Health Organisation said there was no evidence of transmission between humans in all three cases.

In Hong Kong, the government shut a primary school early ahead of the Easter holidays after one of its students, a 7-year-old boy, died at noon on Tuesday. The boy was admitted to hospital last week with flu-like symptoms and authorities are still trying to determine the cause of his illness.

Thomas Tsang, controller of the Centre for Health Protection, said five other pupils at the school have been admitted to hospital for respiratory infection and their conditions were stable. Three samples have tested positive for influenza A, Tsang said, without specifying the strain.

"The school will close early for Easter from tomorrow ... to facilitate disinfection," Tsang told a news conference. But he said there was no reason to close all schools in Hong Kong, although they would monitor the situation closely.

Hong Kong, which lies at the south of China, is in the grip of a seasonal flu peak, with outbreaks reported in a growing number of schools.

A 3-year-old girl died last week of human H3N2 flu and authorities have ordered schools to conduct fever checks and advise those who are unwell to stay home.

Although the H5N1 virus has infected only 368 people around the world since 2003, its mortality rate has been high, killing 234 of them. (Reporting by Tan Ee Lyn and Donny Kwok; Editing by Jeremy Laurence)