Pundita, one of my favorite correspondents, has a long, detailed, thoughtful response to my email to her last night on her recent series on avian flu. There’s one clarification that I’d like to make: I continue to think that China is a special case from an epidemiological standpoint. There are a number of factors which have led to high population densities over long periods of time there including partible inheritance, rice cultivation, Confucian practice, and so on.
Look at the development of a new strain of a disease as the results of rolling a pair of dice. Look at infection of each new person as a roll of the dice. If you roll the dice more often, more combinations show up. If you keep rolling the dice long enough, all possible combinations will show up eventually.
I’m not saying that Chinese people are dirtier or have more disease or anything of the sort. I wouldn’t be at all surprised if they were cleaner and less disease-prone than us Westerners. I’m just saying that the conditions there—particularly in rural China with large numbers of people living in close proximity to domestic livestock—may make the development of new strains of diseases more likely.
Pundita is on my blogroll for a reason: she takes serious subjects seriously (but maintains a light touch). She’s grabbed ahold of the issue of avian flu lately, it’s one of the most serious subjects around, and she’s taking it seriously. Go over and take a look.
Dave, although I am not the expert in such matters, I consider your reasons for citing rural China as a ‘special’ lab for emerging diseases to be worthy of consideration. Thus, I am adding quotes from your comments in this post as an ‘update’ to the dialogue I posted today.