On May 19, 2007, the Ministry of Agriculture confirmed that an H5N1 outbreak had occurred in Hunan province, leading to the slaughter of more than 11,000 head of poultry. The provincial government immediately implemented an emergency plan, culling an additional 52,800 birds to prevent the spread of the disease. This was the first reported outbreak in the country in three months. In this vast country, millions of farmers live in close proximity to billions of chickens. With the environmental conditions across China, it should come as no surprise that birds and humans continue to get sick.

Throughout history, the people of China have depended on the waters supplied by its seven major rivers to live. But over the last 20 years, the quality of the water has deteriorated to a serious state. The Yellow River, long considered by the Chinese to be the birthplace of their civilization, has been so overused for consumption, irrigation and industrial production that the amount of water flowing through this once mighty river occasionally it has been reduced to a trickle. According to the World Bank report published in 2001, “China: Air, Land, and Water: Environmental Priorities for a New Millennium,” 40 percent of the water in large sections of the Yellow River has been classified as “unsuitable for human contact, irrigation and agriculture.”(1)

The long and disgusting list of river pollutants includes industrial chemicals, heavy metals, dead animals and untreated human excrement. Add to this the nuclear waste coming from the headwaters of the river in Tibet and the millions of dead chickens contaminating the groundwater, it is only a matter of time before there are more human outbreaks in China.

China’s State Environmental Protection Administration reports that factory animal farms have become a major source of pollution. In 1995, more than 1.7 billion metric tons of raw manure was dumped into rivers that serve as a water supply.(2) In China’s second largest river, the Yangtze, conditions are much the same. More than 23.4 billion tons of sewage and industrial waste are dumped into the Yangtze every year. More than 15 percent of the water samples taken in 2001 from the Yangtze were classified as “unfit for human contact.” That percentage has certainly increased since 2001 and will continue to increase with the westernization of Chinese culture.

The influx of rural peasants into the cities has stretched the sewage infrastructure beyond its capacity. Operators of most new buildings report that the structures are connected to sewers, but none of the waste is being treated; up to 80 percent of raw sewage is still discharged directly into the water supply.(3)

In Northeast China, the Liao He River is the main waterway that flows into the Yellow Sea from Shenyang, the capital of Liaoning Province. In 1999, this river was classified as “only suitable for industrial purposes that do not involve direct human contact with the water.”(4) Surely, it is much more polluted in 2007. It should not be surprising that Liaoning province was the location of many reported human cases of bird flu and many large outbreaks among poultry in the past three years.

Beyond the serious problems of polluted water, China is home to nine of the ten cities identified as having the worst air pollution in the world. Respiratory illnesses related to air pollution are the leading cause of death among children and adults throughout China, according to a November 1999 World Resources Institute report, Urban Air Pollution Risks to Children: An Indicator of Health overall environmental. Chronic obstructive pulmonary disease (COPD) and pneumonia are the leading causes of death in adults and children, respectively.(5)

Air pollution has been blamed for health problems among millions of Chinese residents, including lung cancer and decreased immune function. The air is so bad throughout southern China that women in Yunnan province were found to have the highest rates of lung cancer ever recorded: 125.6 cases per 100,000 women. Compare this to national averages for lung cancer among US women that top out at 6.3 people per 100,000.(6)

The symptoms and diagnoses of hospitalized and later confirmed avian influenza patients have been cataloged by the WHO. All patients developed symptoms of fever, cough, shortness of breath, and pneumonia. Conditions for developing pneumonia can include inhalation of fumes and other toxic particles in the air. To expel the congestion, an overabundance of mucus must be produced, creating the perfect environment for the rapid replication of invading organisms. If the mucus contains a mix of dioxin and other chemicals, the chance of death from influenza could be exponential.

Considering that chronic lung disease and pneumonia are among the most common causes of death in China, the identification of H5N1 may have had little to do with its demise. Perhaps the cause of his pneumonia was environmental toxicities complicated by the presence of H5N1.

Hundreds of millions of birds and ducks have died in the last four years, yet outbreaks continue in China and Southeast Asia. Until the underlying causes are addressed and a massive environmental cleanup is carried out, outbreaks in birds and humans will undoubtedly continue to occur.

_____________________________________

REFERENCES

(1) Outbreak of bird flu in a village in central China. http://www.chinaview.cn

(2) Dooley, Erin E. “Reviving China’s Ruined Rivers,” Environmental Health Perspectives 110 (2002)

(3) Nierenberg, Danielle. “Industrial Animal Agriculture: The Next Global Health Crisis?” World Society for the Protection of Animals, November 2004.

(4) Schmidt, Charles W. “Economy and Environment: China Seeks a Balance,” Environmental Health Perspectives 110 (2002).

(5) Table: Changhua, Wu, et al. “Water Pollution and Human Health in China,” Environmental Health Perspectives 107 (1999).

(6) O’Neill, Marie S, et al. “Health, Wealth, and Air Pollution: Advanced Theory and Methods,” Environmental Health Perspectives 111 (2003).

(7) Schmidt, Charles W. “Economics and the Environment: China Seeks a Balance,” Environmental Health Perspectives 110 (2002)