Wed, Jan 26, 2005 - Page 8 News List

Why quarantine is the best policy

By Chen Ching-chih 陳清池

On Jan. 15, Taiwan and China reached an agreement allowing direct charter flights across the Taiwan Strait during next month's Lunar New Year holidays. It is quite likely that direct trade, transport and postal ties -- the "three links" -- might soon follow.

Under these circumstances, the need to pay greater attention to China's threat to Taiwan's security is obvious.

In addition to military security, one must think in terms of health security: the health threat that China has historically posed to its neighbors, particularly Taiwan, must be seriously considered.

The 2002-2003 global outbreak of SARS, which resulted in the deaths of 774 people (including 43 in Taiwan), was a disease that originated in China, and experts have warned that it will not be the last.

Nowhere is the flu virus more likely to mutate the way the SARS virus has than in China, where crowded conditions prevail, traditional farming practices pack pigs, birds and people close together, and locals consume exotic wild animals.

Indeed, "China is the perfect breeding ground for new viruses," German virologist Christoph Scholtissek has said.

In addition, judging from China's long history of epidemics, public health officials must take the warning seriously and be prepared for more diseases to emerge from China.

Dating back to the 12th century BC, Chinese oracle-bone scripts have mentioned the existence of pestilence.

With their propensity for keeping records, the Chinese from the 3rd century BC began recording the occurrence of epidemics in some detail.

One can thus have a pretty reliable idea about the frequency of epidemics that have had an impact on China over the last 2,200 years.

According to a checklist of epidemics in China, two major outbreaks occurred: the first in 243BC and the second in 48BC.

In the succeeding centuries, as China became more urbanized, an average of seven epidemics were recorded each century until the 14th century, when 20 epidemics were recorded.

Another 20 epidemics then ravaged China in the 15th century. The number doubled to 41, then 38, 39 and 39 again for each of the centuries after that. On average this represented one outbreak every two-and-a-half years.

Infectious diseases did not and do not respect borders. Trade, war and other means of cross-border contact facilitated the spread of disease across the world.

Three examples, one each from the 14th, 19th and 20th centuries, should suffice in demonstrating how major epidemics that appeared to have originated in China not only caused enormous loss of life within China but also beyond its borders.

First, let us cite what many historians believe to be the most devastating epidemic in recorded history.

In the 13th and 14th centuries, Mongol movements across previously isolated locations probably brought the bubonic plague to the Eurasian steppe for the first time.

Plague-infected fleas and rats served as carriers and passed on the deadly bacteria to humans.

The 14th-century pandemic first invaded China in 1331. This plague coincided with native Chinese resistance against Mongol domination, climaxing in the overthrow of the Mongols and the establishment of a new Chinese dynasty, the Ming, in 1368.

William McNeill, the noted historian of plagues, writes, "The combination of war and pestilence wreaked havoc on China's population. The best estimates show a decrease from 123 million in about 1200 to a mere 65 million in 1393, a generation after the final expulsion of the Mongols from China."

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