China revealed today that its first human death from bird flu was a soldier who died of the H5N1 strain in 2003, two years before the country first publicly acknowledged a human infection.

The confirmation showed that the virus was present in China before the outbreak of the virus was disclosed elsewhere in Asia and raised questions about Beijing’s ability to detect emerging diseases, as well as its transparency.

China’s Ministry of Health began tests on samples from the People’s Liberation Army private only after Chinese researchers published a letter in the New England Journal of Medicine in June saying that a 24-year-old soldier, who was admitted to hospital in November 2003 for respiratory distress and pneumonia and later died, had been infected with H5N1.

The man, identified only by his surname, Shi, was initially thought to have severe acute respiratory syndrome, but recent tests performed with the World Health Organisation (WHO) confirmed the cause as bird flu.

The UN health agency called on Beijing to re-examine other pneumonia cases of unknown origin to ensure better transparency. But a Health Ministry spokesman said the 2003 case was not evidence of an outbreak then and said the Government had no plans to review other cases.

China publicly announced its first human case of bird flu last November, when the virus was sweeping through Vietnam and Thailand. China has reported 20 infections of humans, of whom 12 have died — not including the 2003 case.

Roy Wadia, a spokesman for the WHO in Beijing, said it was too early to pass judgment on whether the ongoing regional outbreak originated in China and declined to speculate on whether there had been a cover-up. He said: “I don’t think we can conclusively prove anything at this point in time. It just shows that the virus has been in this part of the world for a long, long time.”

However, Mr Wadia highlighted weaknesses in official reporting, saying that the Health Ministry first heard of the case when the article was published in June. Military doctors had known of the case for much longer. He said: “This actually pinpoints a challenge facing the communication mechanism within the Chinese government structure.”

He said: “It’s good that this case came to light, but the question is how many cases might there be out there?” Mao Qun’an, a spokesman for the Health Ministry, said there was no need for alarm. “People shouldn’t panic. The country’s bird flu surveillance capability is much stronger now than it was two years ago.”

The first human death from bird flu was reported in Vietnam in January 2004. Since then more than 220 people have caught the virus, resulting in about 130 fatalities.

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