Monday, June 26, 2006

Controversy? New England Journal of Medicine and a bird flu letter

Wired's Bodyhack blog posts the interesting saga of a letter from Chinese authors, published in last week's NEJM, which reports a fatal human case of avian flu occurring in 2003 -- 2 years before China officially reported any human cases of avian flu to the World Health Organization.

NEJM received several emails and faxes that seemed to be from the authors of the letter, asking that it be taken out of the journal, but the issue had already gone to press and it was too late to remove it. Later, NEJM confirmed that the emails had not come from the letter's first author Wu-Chun Cao, who confirmed that the letter should be published; some of the emails and faxes, however, had the author's email address or other information and NEJM is currently in the process of contacting the other authors to see if any of the other requests were authentic.

The full-text of the letter is available on the NEJM site, and the editor notes, "We earlier reported that the Journal had received e-mail requests to withdraw the letter "Fatal Infection with Influenza A (H5N1) Virus in China." The corresponding author, Wu-Chun Cao, M.D., Ph.D., has informed us by telephone and facsimile that those e-mails were not sent by him. He has not requested withdrawal of the letter, and so it stands as published in the issue of June 22, 2006."

Disturbing for a number of reasons: from a public health perspective, what are the ramifications of China withholding information on an infectious disease of possible global significance? When a journal receives correspondence purporting to be from an author of a manuscript or letter, to what extent do they need to verify it is truly from the author?

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