Good news on infant mortality rates in China - but have the numbers been exaggerated?

by Michael Woodhead

The Economist [aka 'the Monetarist'] is impressed with China's socialist achievement in reducing rates of maternal and infant mortality over the last decade. 

The magazine this week cites a WHO report that praises China for reducing rates of infant mortality from 61  to 12 deaths per 1,000 live births since 1991 - meaning they are now one fifth of what they were in the time of Deng Xiaoping. Maternal mortality rates have also dropped by about 70% over the same period. The improvements are attributed to the introduction of universal health insurance  schemes that subsidise hospital care for maternity care - and also implementation of infant vaccination programs.

The Economist then raises a lot of questions about whether China's vaccination program is as safe and appropriate as it could be - mentioning the recent scare about hepatitis vaccine quality and the ineffectiveness of measles vaccine programs. It even makes an absurd suggestion that China should step back from blanket immunisation and instead test mothers for immunity to various diseases before vaccinating them accordingly.  The overall message, however, is that China deserves credit for a major improvement in mother and baby health.

Coincidentally this week a letter is published in The Lancet Global Health from Chinese researchers questioning whether the gains are as extensive as they seem. Dr You Hua and colleagues at the School of Public Health, Zhejiang University School of Medicine, Hangzhou, write that recent improvements in infant mortality have been confined to rural areas - with little change in urban areas despite much greater rises in standards of living. 

Like WHO, they also attribute the improvements in rural areas to the introduction of the New Cooperative Medical Scheme in 2003. The coverage of this scheme reached 97% of village hospitals in 2011 and the subsidies allowed pregnant women to access antenatal and postnatal services. The Chinese researchers note that maternal mortality rates fell from 65 to 27 per 100 000 between 2003 and 2011 in rural areas, but remained virtually unchanged in urban areas. They speculate that the lack of change in cities may be due to the influx of uninsured women from rural migrant worker families.

Dr You also questions whether the impressive reductions in maternal mortality reported by the government are authentic. She remarks that health departments are financially rewarded for achieving targets such as maternal and infant mortality - and punished for not meeting them. The officially reported figures may therefore be subject to 'inflation', she suggests.

"These reservations notwithstanding, it is important to call attention to the dramatic reduction in rural maternal mortality in China and the lack of progress in the urban maternal mortality. The levelling out of urban maternal mortality in China in the past decade calls for increased attention," the researchers conclude.

Measles resurgent in China as migrant children miss vaccinations

by Michael Woodhead
China looked like it was on track to eliminate measles until two years ago, but now the infection is making a comeback among unvaccinated young children, the World Health Organisation has warned.
In a report of the progress towards measles elimination in China a WHO surveillance study notes that China has seen dramatic reductions in rates of measles since it implemented and expanded childhood vaccination campaigns in the 1980s  and 1990s. Rates of the infection fell from 572 per 100,000 in the 1960s to below 10 per 100,000 since the 1990s. Since then, further reductions in measles have been seen as children have been given two doses of measles vaccine with uptake rates of more than 90%. There have also been additional 'catch up' measles vaccination campaigns in provinces where continuing outbreaks of measles have occurred. This resulted in the annual number of cases coming down from 140,000 per year in 2008 to under 10,000 in 2012. However, as the WHO Bulletin report notes, there has been a resurgence in 2013, with the number of cases bouncing back to around 24,000 in that year. The report says most of the measles cases occurred in young children who had missed one or all of their scheduled vaccination doses, although a few also occurred in adults. It says the resurgence is disappointing, especially as it follows intensive 'catch up' campaigns. In their report, the WHO researchers say it is likely that many of the unvaccinated children spreading measles will belong to migrant worker families who have left their hometown and thus drop out of the measles vaccination and reporting programs based in schools and local health centres.
"The resurgence of measles seen among young unvaccinated Chinese children in 2013 indicates a weakness in routine immunisation that allows some children to miss one or both of their scheduled doses of measles vaccine. Such weakness must be eliminated if a further resurgence in the next few years is to be avoided and measles is ever to be eliminated in China," they conclude.
"Improvements in the identification and location of children who are new to an area may permit marked improvements in vaccine coverage" they note.

Cancer in China: don't be distracted by the smog

by Michael Woodhead
Forget about the smog scare - if you want to tackle cancer in China, you need to focus on smoking, diet and physical activity. That's the message from the Asian regional representatives for the World Health Organisation in the Lancet this week. Cherian Varghese and Shin Hai-Rim urge China to act on the obvious causes of cancer and implement practical programs that will achieve the greatest change with the least resources.
In their commentary they note that China has a huge burden of cancer, but there is still a lot that is not known about the causes of cancer and the types of cancer in China.  They note  there is a lot of concern about very evident environmental factors such as air pollution, but they say this is a minor contributory factor compared to factors such as infectious diseases, smoking, poor diet, alcohol consumption and lack of physical activity. Therefore they say much could immediately be done to prevent and reduce cancers by implementing policies such as smoking cessation and vaccinating against hepatitis B and HPV. They also stress the need for a more skilled health workforce and system to deal with cancer, such as by identification of early-stage disease, referral, and palliative care. They warn against the temptation to put resources into expensive new cancer drugs, which would probably have only minimal effect on cancer survival rates.
"A set of very cost-effective interventions are provided in the [WHO] Global Action Plan to reduce tobacco and harmful alcohol use, improve unhealthy diets, and increase physical activity. These measures are mostly regulatory, legal, and fiscal interventions, and will affect rates of non-communicable diseases (including cancer) in large populations," they say.

China has learned the lessons from SARS, praised by WHO for H7N9 reponse

China's response to the H7N9 influenza outbreaks has been praised the World Health Organisation for the sound preparedness, prompt communication and collaboration with international groups. In the latest WHO Bulletin the agency says China has learned the right lessons from the mistakes made with SARS and now has a robust and open system for dealing with infectious disease outbreaks that can be a model for other countries. After SARS, China reformed its systems to improve disease surveillance and make the country’s response to future disease outbreaks both swift and effective, WHO says. The improvements to the system were evident when H7N9 influenza emerged in March 2013. The Chinese surveillance system based on Centres for Disease Control and Prevention allowed the problem to be quickly identified, and there was a good response in terms of follow up testing and identification of new cases. prompt moves were taken to reduce risk by closing poultry markets, and appropriate risk information was disseminated quickly to the public, the report says. It also welcomes the close cooperation between the National Health and Family Planning Commission and WHO in responding to the H7N9 threat. China was praised for being open about the sharing of information about H7N9 to the public and with the wider scientific community, with no barriers to publishing the results of virological and epidemiological investigations in scientific journals "China’s prompt response to the emergence of the A(H7N9) virus as a human pathogen – which spanned multiple governmental departments and ministries at national, provincial and municipal level – was mainly the result of strong leadership in a critical situation." the WHO report concludes.

Chinese leaders affirm commitment to Hangzhou Resolution on ethical organ donation and transplantation

by Michael Woodhead
Chinese health officials and hospital leaders have committed to upholding the new ethical framework for organ donation and transplantation as outlined in the recently signed Hangzhou Resolution.
In a update statement, officials and transplant surgeons affirmed the new five point plan that will outlaw practices such as use of organs from executed prisoners and the 'sale' of organs to foreign buyers.
The new statement also includes a list of 38 Chinese transplant centres that have already confirmed  to have stopped using organs from prisoners, with others "anticipated in the days ahead".
The statement published in Hepatobiliary Pancreatic Diseases International is co-authored by China's leading transplant specialist Professor Huang Jiefu  and international transplant specialists including Dr Francis Delmonico, President of the Transplantation Society.
It notes that the Hangzhou Declaration commits China to adopting  a new organ transplantation system overseen by the National Health and Family Planning Commission (NHFPC) and the Red Cross. The new system will set up a national voluntary organ donation scheme and a new organ procurement and allocation system that is based on clinical needs and which is "open and transparent". China will set up a human organ transplant clinical network based on 169 authorised transplant centres, an organ registry system and an organ donation regulatory system.
"The NHFPC expressed the resolution of the government of China that the dependence upon organs from executed prisoners must be terminated. The government of China has affirmed its commitment to prohibit transplant tourism and to shut down organ trafficking and transplant commercialism," the statement says.
The move to the new organ donation system will also mean that China is no longer the subject of an academic boycott on organ transplantation.
Health minister Li Bin also pledged her commitment "to bring China back to the international community and to promote an academic exchange based upon the five-point NHFPC plan elaborated."
The next step will be to implement the agreement in all China's provinces. The statement says China will also host a meeting this year with leaders of the major international transplantation societies and WHO representatives.
"The meeting will affirm the new resolution in the practice of organ donation and transplantation in China. The meeting will be a milestone for China transplant professionals to practice according to the international standards set by WHO Guiding Principles."
Meanwhile, in a public show of support for the new organ transplant system, senior Chinese leaders have registered to donate their organs.
Officials including Chen Zhu, vice-chairman of the Standing Committee of the National People's Congress and a former minister of health; and Hua Jianmin, head of the Red Cross Society of China added their names to the new online organ registry at the Beijing Union Medical College Hospital .
The registry, overseen by the society's China Organ Donation Administrative Center, is available for people aged 18 and over who are willing to be organ donors after their death.
In December, the State Council issued a guideline related to funeral reform, encouraging Party members and officials to register to donate their organs after their death, according to China Daily.

New organ transplant network launched, transplants for foreigners banned

by Michael Woodhead
China's leading organ transplant specialist Professor Huang Jiefu has launched a new national network of  Organ Procurment Organisations to try clean up the organ transplant system in China.
Professor Huang also launched a new national voluntary organ donation registry, in a bid to move away from the corrupt 'organs for sale' system that has operated in the past.
Under the new system, organs will be assigned according to clinical need rather than according to payment or connections, and there will be severe penalties for doctors and transplant clinics that are found to be flouting the rules.
At an official launch by the National Health and Family Planning Commission in Beijing attended by representatives from WHO and the Red Cross, Professor Huang said that about 160 hospitals had now been approved to carry out organ transplants. In the past about 600 clinics had offered transplants for money, but under the new system any clinic that operates outside the official donor network will lose its license and doctors will be suspended. There is a ban on private organ donations for money and also a ban on procuring and giving organs from Chinese to foreigners.
However, Professor Huang said some provinces had been slow to join the new network and to play an active role in the new organ donor sharing system. He urged them to work more closely with the new system, noting that there were about 30,000 critically ill people in China who urgently needed an organ transplant. He also encouraged Chinese people to sign up for the new national organ donor registry, saying it was possible to amend or withdraw from the scheme at any time.

WHO says H7N9 flu situation changing but still not high risk

A WHO analysis of China’s latest H7N9 avian influenza outbreak shows that that cases are trending slightly younger, with a lower case fatality rate, according to CIDRAP News.
The latest risk assessment by WHO found that the average age in the latest surge of H7N9 was slightly lower than the first wave: 52 years compared with 58 years. H7N9 is still striking males more frequently than females, and the case fatality rate is not as high as the outbreak's first wave, but H7N9 infections are still marked by rapidly progressing severe pneumonia. Tests on the H7N9 virus have not shown resistance to neuraminidase inhibitors such as oseltamivir (Tamiflu). And while most cases are linked to exposure to infected live poultry, the recent death of the doctor from Shanghai shows that continued vigilance is needed, the WHO said.

WHO defends China's hepatitis B vaccination programme

China's vaccines are produced and regulated in accordance with international standards, and the hepatitis B vaccination program is vital in safeguarding children against the illness, according to the World Health Organization.
Bernhard Schwartlander, China representative for the international health body, made these points during an interview with China Daily on Thursday.
"Given that the hepatitis B virus is still around, it's important for babies to get vaccinated," he said.
The WHO Beijing office met with the National Health and Family Planning Commission on Thursday to discuss the latest developments surrounding incidents in which 11 newborns have died after being inoculated against hepatitis B.
According to Schwartlander, it's difficult to establish a causal link between the vaccines and the babies' deaths since nearly all infants in China receive the vaccine as part of a very successful vaccination program.

Smoking cessation drugs are not available in China

Clinics to help smokers kick the habit are facing medication shortages.
A combination of behavioral intervention and medication can significantly increase the chances of a person quitting cigarettes, health experts said.
"Many can quit through just intervention, such as consulting a doctor or calling a hotline," said Fu Dongbo, a specialist with the World Health Organization.
"But for those heavily dependant, medication is an option, including nicotine replacement therapy."
Not many opt for the latter, though, judging by the 2010 Global Adult Tobacco Survey of China.
Based on 13,354 interviews nationwide, the study found 36.4 percent had tried to stop smoking in the previous 12 months, but less than 9 percent of them had used assistance, such as medication.
Part of the reason could be that Chinese smokers do not fully understand cessation therapy, according to a report by the WHO Collaborating Center for Tobacco or Health, based at Beijing's Chaoyang Hospital.

China ahead of Canada in treatment of HIV: experts

British Columbia’s partnership with China in the fight against HIV/AIDS highlights not only the progress being made overseas, but also the lack of foresight shown by the Canadian federal government at home, says an acclaimed B.C. researcher.

Julio Montaner, director of the B.C. Centre for Excellence in HIV/AIDS (BC-CfE), accompanied Premier Christy Clark in Beijing Tuesday as she signed a memorandum of understanding between the Chinese Centre for Disease Control and Prevention and the B.C. organization during a trade mission.

In 2011, China became the first country to adopt the BC-CfE’s “treatment as prevention” (TasP) strategy, which involves widespread HIV testing and the immediate offer of highly active antiretroviral therapy to those who test positive. This treatment has been shown to virtually eliminate progression of the disease to AIDS and reduce transmission of the virus by 96 per cent.

The United States, France and Brazil have since adopted the World Health Organization-backed treatment as well, each hailing it as a progressive strategy backed by abundant scientific evidence. Canada, however, has not.

China medical news roundup for Thursday 14 November

Beijing cardiologist uses microblog to educate a wider audience

On the walls of the inpatient wards of Beijing Anzhen Hospital, a large sign reads, "Please follow Yu Zhenqiu's micro blog for hypertension intervention".

Yu, the director of the hypertension department, said the micro blog helps him reach as many sufferers of high blood pressure as possible. Within his working hours, he can see no more than 30 patients even if he skips lunch.

"For the great majority who cannot see top specialty doctors like me at the country's large key hospitals, micro blogs might offer help."

His frequent postings on high blood pressure prevention and intervention tips, and answers to frequently asked questions, have brought Yu about 70,000 followers on Sina Weibo, a popular micro-blogging website.

Apart from information on free-hypertension consultation sessions, he also replies to questions online.

"Many of my postings have been forwarded thousands of times, a result that could never be achieved by treating patients in the hospital," he said.

Writing posts is now a daily routine for him, such as washing his face and brushing his teeth, he said.

Yu, who is also deputy director of the China Hypertension Association, used traditional media first to share prevention and treatment tips and educational items about the disease, before moving online.

Full article at: China Daily

Chinese parents won't take sick kids to small hospitals

With a shortage of pediatricians and inadequate medical facilities, bringing children to hospital can cause a lot of stress to parents. Some experts have suggested a change in parents' attitude and adoption of an alternative medical model. Liu Zhihua reports.

There is a shortage of at least 200,000 pediatricians in China currently, according to K. K. Cheng, a professor with University of Birmingham, who specializes in epidemiology and the development of primary care in China.

Yang Dan, a Chongqing resident and mother to a 3-year-old boy says she detests taking her child to the hospital.

The air circulation is poor. The area is noisy. It is so overcrowded that parents have to hold their children in their arms for intravenous infusion procedures. There have been cases of parents losing their children in the disorganized environment.

Yet sending their children to small hospitals is out of the question, because they cannot provide quality healthcare, Yang believes. She says once her son was misdiagnosed even in the largest hospital in Ya'an, a medium-size city in Sichuan province.

With the disparity in healthcare quality between rural and urban regions, between a top-level hospital and a less-privileged one, most Chinese parents share the belief that small hospitals are incompetent.

Read more at China Daily

China lags on preventive health, says WHO

China should do more to curb a rise in non-communicable diseases like heart disease and diabetes that have long been neglected and now pose a risk to its economy, global health experts warned.

Non-communicable diseases challenge China’s economic development and cause a burden on society, said Bernhard Schwartländer, the World Health Organization’s representative in China, in a press briefing on Tuesday. “The cost of inaction, of doing nothing—in lives lost and social and economic prosperity foregone—is too great a price to pay,” he said.

He was joined by representatives of China’s National Health and Family Planning Commission and China’s Centers for Disease Control and Prevention.

Dr. Schwartländer said that high rates of smoking, lack of exercise and unhealthy diets have contributed to diseases. He said that the Chinese government should adopt policies to address problems, which have been overlooked and underfunded.

By 2015, the burden of death and health complications related to non-communicable disease will have cost $500 billion in the last decade, Dr. Schwartlander said. Reducing mortality only by addressing cardiovascular disease, reducing rates 1% per year in by 2040, would generate $10.7 trillion, he said.

Health care was largely left out of a reform agenda Chinese leaders revealed on Tuesday, though it briefly mentioned improving people’s welfare and strengthening reform of the medical and health system. China launched in 2009 an overhaul of its health-care system, establishing a universal insurance system to provide citizens more access to medical care.

China is struggling to deal with a population that is urbanizing, aging and is afflicted with chronic disease. Migration of millions of Chinese citizens to big cities from rural regions has spurred use of cigarettes, higher alcohol intake and increasingly sedentary lifestyles—all habits that lend to illness.

Now China is home to the world’s largest diabetes population, with the prevalence of 11.6% of the population-surpassing Russia’s population, said Li Guangwei, a professor at the Chinese Academy of Medical Sciences. Chronic disease is the cause of 85% of deaths in China, according to China’s Ministry of Health. By comparison, the U.S. Centers for Disease Control and Prevention says the rate is 70 per 100 in the U.S., while the World Health Organization says they represent 63% of deaths world-wide.

Funding remains a major issue, experts said. China’s health spending as a percent of GDP totaled 2.3% in 2011, compared to U.S. spending of 9.7%, according to the most recent data available from the World Bank.

Community clinics are overrun with patients and lack resources needed to address health problems, said Wang Bin, the deputy director the Disease Control and Prevention department of China’s National Health and Family Planning Commission.

Tobacco control remains underfunded, said Jiang Yuan, deputy director of the Tobacco Control Office of China’s CDC. The government allocated only 20 million yuan (about $3.3 million) last year for tobacco control, Ms. Jiang said.

Dr. Schwartländer said it isn’t likely that the China will reach the target set for it by the WHO to cut smoking rates in China by at least 30% by 2025. Currently 28% of people older than 15—301 million people—are smokers in China and smoking-related sickness kills more than one million Chinese citizens each year, according to WHO data. That compares to 43.8 million smokers in the U.S., according to the U.S. Centers for Disease Control and Prevention.

Experts said that the government should not shoulder all the responsibilities to improve health conditions and that citizens should adopt healthier lifestyles by eating less salt, exercising more and cutting bad habits like smoking and drinking . “People are the owners of their own health,” said Dr. Wang, adding, “We’re at an important window in China.”

Source: WSJ

MSG may protect against diabetes: Nanjing study

A Jiangsu nutrition study has made the intriguing finding that MSG intake is inversely related to risk of hyperglycaemia.

Researchers from the Jiangsu Provincial Center for Disease Control and Prevention in Nanjing conducted a prospective dietary study of 1056 healthy adults from 2002 to 2007. Fasting blood samples were collected at baseline and follow up. Hyperglycemia was defined as fasting plasma glucose >5.6 mmol/l.

During the follow-up they identified 125 cases of hyperglycemia and found that people with the highest intakes of MSG had a lower risk of hyperglycemia. People with a high MSG intake, had only one third the risk of hyperglycemia compared with people with a low intake of MSG, they found. There was a linear inverse association between MSG intake and change in blood glucose.

The researchers noted that MSG stimulates insulin secretion by acting on glutamate receptors and is especially likely to decrease the risk of hyperglycemia in overweight-related insulin resistance.

“However, based on this single study we do not recommend people increase MSG intake in order to prevent diabetes,” they commented.

Read the full study at: Clinical Nutrition

Anhui man on trial for urologist stabbing

An Anhui Province man has been accused of stabbing a doctor at a Songjiang district hospital that he believed had cheated him, district prosecutors said Tuesday.
The suspect, surnamed Huang, visited a military-run hospital in the district in 2012 to see a urologist, according to a press release from the Songjiang District People's Prosecutor's Office. The doctor found a cyst and advised Huang that he would need to have surgery to remove it or face potential health problems in the future.
Huang agreed, though reluctantly. The surgery cost him more than 20,000 yuan ($3,283), including the four-day hospital stay afterward. Several months later, Huang had recovered from the surgery, but still doubted whether it had been necessary, prosecutors said. He suspected that the urologist only suggested the surgery to help the hospital make money.
In April, Huang returned to the hospital seeking treatment for stomach pain. Another doctor prescribed him medication, but it failed to relieve his discomfort after more than 10 days. When Huang went back to complain, the doctor said that it might take more time for the medication to take effect.
Huang believed that the doctor was lying to him and only wanted his money, prosecutors said. He complained to the local health authority and to police, but nothing came of it.
In May, Huang returned to the hospital with a knife and stabbed the urologist, prosecutors said. He then went looking for the other doctor who treated him, but was stopped by hospital security guards. The urologist suffered minor injuries.
Huang confessed to stabbing the doctor and admitted that he had been unhappy with the hospital's care. 

Source: Global Times

China tells WHO that traditional medicine will help overcome antibiotic resistance problem


China's position at WHO meeting on antibiotic resistance:
"Every person alive today has benefited from the development of antimicrobial drugs but their effectiveness is under threat. Studies in China show a  frightening increase in antibiotic-resistant bacteria such as MRSA. In 
China, 6.8 percent of tuberculosis cases detected are  multi-drug-resistant, far higher than the 2 percent average in most developed countries.
Chinese doctors routinely hand out multiple doses of antibiotics for simple maladies like the sore throats which increase the chance of bacteria becoming resistant to antibiotics. China's Ministry of Health has 
enforced strict rules to curb the widespread overuse of antibiotics in hospitals. Antibiotics will now be classified into three categories for restricted, unrestricted and special use, based on factors such as safety, efficacy, price and drug resistance. All the patients using antibiotics must complete their course to prevent bacteria to become 
resistant. All antibiotics should be made under high standards so that they are effective against the bacteria.
Hospitals are usually known as the sources of all diseases .Codes of practice have been drawn up for doctors, nurses and health care workers to prevent the spread of Hospital acquired infections. Good hygiene within 
hospitals can have a major impact on HAIs such as doctors washing their hands.Guidelines about the clothing the doctors and other staff should wear also prevent spreading of diseases.
China believes that using Chinese herbs is an alternative to antibiotics as it has the same aim as antibiotics to cure the patient. The proper use of Chinese herbal formulas can not only inhibit bacterial, viral and 
fungal infections, but also minimize the need for antibiotics with their adverse side effects.Scientist are still carrying out tests to know exactly how effective they are at destroying bacteria.
The delegate of China believes that if all these precautionary measures are  taken less number of bacteria’s will become resistant to antibiotics and reduced  number of people will be affected by these diseases 
reducing the threat to humanity."
Source: Admun

Beijing on new SARS alert after five coronavirus deaths in Middle East

Beijing hospitals are monitoring for severe respiratory infections after five deaths caused by a novel coronavirus

translation by Michael Woodhead
The Beijing Municipal Centre for Disease Control (CDC) says the city has started monitor in city hospitals for a new coronavirus infection that has caused five deaths in the Middle East.
The WHO recently confirmed laboratory reports that a novel coronavirus infection has caused nine cases of serious infection, including five deaths increased. There are now concerns that this will trigger a new"atypical pneumonia (SARS) epidemic. To date, WHO has received nine new coronavirus infection confirmed cases, five cases (including three deaths) from Saudi Arabia , two cases from Qatar , the other two cases (all deaths) from Jordan. 　　
WHO has called on all members to continue to monitor for severe acute respiratory infections, and to consider the novel coronavirus as a possible cause of any unexplained pulmonary infections in patients. The WHO stressed that monitoring should take place worldwide and any countries or regions that see any cluster of severe acute respiratory infection should conduct a thorough investigation. 　　
In response, the director of the Beijing CDC Dr Ying Rendeng said the city has already begun to monitor for coronavirus, with a careful history taken of unexplained pneumonia cases required at all medical institutions at all levels. This aims to be a 'dragnet' for monitoring suspected cases of coronavirus. All emergency doctors have received training in coronavirus characteristics and patient symptoms. Meanwhile, laboratory tests have also been prepared, so that if cases do occur, doctors and laboratories will be able to detect and diagnose them rapidly. Currently, the city has no case reports of any novel coronavirus infection.
WHO says that it is best not to assume that the new coronavirus spread is limited to the above-mentioned Middle Eastern countries. No matter which country a cluster of severe acute respiratory infection is seen, or if these infections occur among health workers, there should be a thorough investigation. 　　The reason why the new virus has caused great concern is because "atypical pneumonia" (SARS) virus that killed hundreds in 2003 was due to coronavirus. However, genetic analysis shows the closest match to the novel coronavirus is a bat coronavirus found in the Netherlands in 2008, rather than the SARS virus of 2003. The cause of the novel coronavirus infections is unclear, with most infected people having severe acute respiratory syndrome associated with acute renal failure.
Source: Hexun

Half of pregnant women affected by passive smoking

According to reports released by the World Health Organization in Beijing on November 6, Global Adult Tobacco Survey (referred to as "GATS") data show that more than half of women of childbearing age are often exposed to passive smoking. The GATS survey results from the WHO in China and the United States Center for Disease Control showed that more than 50% of Chinese women of childbearing age  often inhale secondhand smoke in the workplace. In the home, passive smoking is more serious, with nearly three-quarters of the rural women exposed to  smoking at home, while more than half of urban women are exposed to  smoking at home.The data also show that among 14 developing countries, China's 15-49year-old female passive smoking rate is highest. Lan Ruiming, WHO representative in China, said, "for women of childbearing age, passive smoking can harm reproductive health, such as the emergence of symptoms of pregnancy complications, premature fetus and infant death."

Read more: Southern Weekend

WHO calls on China to increase tax on cigarettes

A 1 yuan increase in the price of each pack of cigarettes could decrease the consumption of cigarettes in China by 3 billion packs a year, reduce the number of smokers in the country by 3.42 million and increase the government's annual revenue by 97.5 billion yuan to 129 billion yuan. That is billions of dollars of additional revenue that could be reinvested for the benefit of the people of China.
A tobacco tax increase that raises the retail price of cigarettes would be a "win-win" for China, not least for those millions of boys and young men whose lives will otherwise be lost because of this killer.
(Michael O'Leary  is WHO representative in China)

Read more: China Daily