China is gearing up for an upward battle against an H1N1 flu pandemic, expected to peak in the autumn-winter season and infect tens of millions of people across the country.

Severe cases or even fatalities will be unavoidable, warned Liang Wannian, deputy director of the ministry's emergency office, on Friday

"Half of the patients could develop clinical symptoms and several million will seek medical help," he said at a regular press conference.

The deadly strain of the flu virus has infected about 250,000 across the world, killing 2,800.

But that is just a fraction of what the World Health Organization (WHO) has predicted.

In early May, WHO said the H1N1 virus could infect about 2 billion people, or nearly one-third of the world's population.

If that turns out to be true, it would pose a great challenge to health institutions and anti-viral drug supplies, Liang said.

The H1N1 virus is spreading faster in China, now that autumn is here, Liang said, with more than half of the nearly 7,000 cases detected between Aug 24 and Sept 10.

Cluster outbreaks are replacing isolated cases, he said, and the mainland has reported 207 cases of large-scale infections since mid-June.

As hospitals nationwide prepare to receive patients in large numbers and deal with the rise in the number of severe cases, preventive efforts, especially at the community level, will be strengthened further, Liang said.

Students across the country will soon get free preventive traditional Chinese medicines (TCM) in schools, said Liao Wenke, a division director with the Education Ministry.

Suspected and confirmed H1N1 patients in schools will be sent home or quarantined for treatment, Liao said, urging universities to set up special units to quarantine people who come in close contact with confirmed patients.

An emergency plan to deal with a pandemic - even if the number of patients exceeds hospitals' capacity - is already in place, Liang said.

"Places such as schools and hotels, which can receive patients on a mass scale, will be used as temporary treatment centers," he said. The government has been stocking antiviral drugs, including Tamiflu and some TCMs.

"So far we've prepared enough Tamiflu for 10 million people," Liang said. It is the first time the top health authority has revealed the exact number.

The drug stock is a relatively weak link in China's epidemic control efforts, said Zeng Guang, chief expert of epidemic disease research at the Chinese Center for Disease Control and Prevention. "That's part of the reason why the authorities are putting so much emphasis on preventive measures like quarantine."

The US had antiviral drug stocks for 85 million people by early May, Zeng said. "And it has not stopped adding to that stock."

Luckily, most of the H1N1 flu cases in China have been mild. "Therefore, Tamiflu has not been needed for their treatment," he said, asking hospitals across the country to use the limited stock of antiviral drugs efficiently. TCM has been used both to prevent and treat H1N1 in China, Liang said. And some of them have shown promising results.

Earlier, the State Administration of TCM recommended, lianhuaqingwen (a herbal medicine) for treatment of flu, citing its outstanding effects in killing viruses and cheaper price compared with Tamiflu.

Some experts, however, insist that for severe flu patients Tamiflu has proven to be the most effective.

(China Daily September 12, 2009)