Strange Things Afoot at the NEJM

On Tuesday, I received an email from the New England Journal of Medicine with the subject line: "URGENT NOTICE REGARDING CONTENT IN TOMORROW'S ISSUE." It said one the authors of a letter to the editor describing a fatal bird flu case in China wanted to withdraw the letter. But it was too late for the print issue, so it appeared yesterday.

Then today I received another email from NEJM saying the correspondence regarding the withdrawal had not actually been from the author. In fact, that author, Wu-Chun Cao, had confirmed with an email and a fax that he did not wish to withdraw the letter.

Weird, no? But it starts to make some sense when you find out the letter described a 2003 case of fatal bird flu in China, which would have occurred a full two years before the country officially reported a case of bird flu to the World Health Organization.

From the CBC in Canada:

Influenza experts outside China have long believed the country has hidden or missed human cases of H5N1, but they hadn't anticipated seeing proof in the pages of one of the world's most prestigious medical journals. China has officially reported 19 cases and 12 deaths.

A spokesperson for the New England Journal of Medicine said the journal had received "multiple" e-mails asking to withdraw the report. From the e-mail addresses, some seemed to be from Cao; others claimed to be from all eight authors.

"It seemed very clear that they were coming from Dr. Cao and/or that institution," Karen Pedersen said from Boston. Copies of the e-mails were also faxed to the journal.

The CBC also reported that NEJM editors are trying to contact the rest of the eight authors on the paper to confirm no one wanted the letter withdrawn.