Reports of a pneumonia-like illness that mainly affects children in northern China caught our attention. The last time we heard about a mysterious respiratory illness outbreak that was overwhelming hospitals was at the start of the COVID-19 pandemic, so it’s no surprise that this caused some panic.
author
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C Rainer McIntyre
Professor of Global Biosecurity, Principal Investigator, NHMRC, Biosecurity Program Leader, Kirby Institute, University of New South Wales, Sydney
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Ashley Quigley
Senior Researcher, Global Biosecurity, University of New South Wales, Sydney
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haley stone
PhD student, Biosafety Program, Kirby Institute, University of New South Wales, Sydney
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Rebecca Dawson
Research Fellow, Kirby Institute, University of New South Wales, Sydney
On November 22, the World Health Organization asked China to provide information about the incident. Chinese health authorities have since said the outbreak was caused by multiple respiratory pathogens.
So, which pathogens may be causing an increase in respiratory illnesses? Do we need to worry about any possible pandemic? let’s see.
Mycoplasma
One of them is the Mycoplasma bacterium, which has been causing an outbreak of respiratory illness in China since June.
Mycoplasma is usually treated in the community with antibiotics, and hospitalization is uncommon. It can cause a phenomenon called “walking pneumonia,” in which a chest X-ray looks much worse than the patient appears to be.
However, there are reports that mycoplasma is highly resistant to antibiotics in Taiwan, which may explain why it is causing more hospitalizations.
influenza
During the first two years of the pandemic, flu levels dropped to very low levels due to mask-wearing, social distancing and other measures. But once things start to return to “normal,” flu infections tend to rebound.
Influenza is most severe in children under five and the elderly, so it can result in children being hospitalized.
RSV and adenovirus
Respiratory syncytial virus (RSV), which can also have severe effects on children, like influenza, all but disappeared during the first two years of the pandemic. But now it’s widely circulated.
Adenoviruses can cause a range of syndromes, including gastroenteritis and influenza-like illness, and are reportedly responsible for the current outbreak in China.There are reports and photos of children vomiting receiving intravenous fluidspossibly dehydration caused by gastroenteritis.
The role of coronavirus
SARS-CoV-2, the virus that causes COVID-19, can also cause pneumonia but is less likely to affect children. Early in the pandemic, we knew that SARS-CoV-2 could show pneumonia on chest scans in asymptomatic children, so COVID-19 could also cause “walking pneumonia” in children.
SARS-CoV-2 kills more children than the flu, so it could overwhelm hospitals.
Some studies suggest that SARS-CoV-2 infection may also lead to immune dysfunction, which may explain the unexpected increase in other infections since the pandemic, including strep and mycoplasma infections.
co-infection
People can be infected with SARS-CoV-2 and other bacteria or viruses at the same time, which may also explain the severity of the current epidemic. Co-infection with SARS-CoV-2 and mycoplasma is very common and can lead to more severe complications, a study suggests.
Could this be a new epidemic?
The chart below shows outbreak reports of unknown influenza-like illness and pneumonia, as well as known causes of influenza A and B, SARS-CoV-2, RSV, pertussis, adenovirus, and mycoplasma. The report confirms that respiratory diseases have increased in China this year compared with the same period last year.
In contrast, making the same comparison globally, the incidence rate this year is down compared to last year, which tells us that China does have more respiratory diseases than expected.
It would be of greater concern if no known cause of this phenomenon was identified. But a few viruses have been discovered that give us confidence that we are not dealing with a new virus.
The virus with pandemic potential we are most concerned about is avian influenza, which may mutate and become easily transmissible among humans. China has been the epicenter of bird flu in the past, but the spread of H5N1 has moved to the Americas, Europe and Africa.
Despite this, China has reported multiple cases of human infection with various avian influenza viruses this year, including H3N8, H5N1, H5N6 and H9N2. As large-scale outbreaks in birds and mammals continue, there is a greater likelihood that avian and human influenza genetic material will mutate and mix, which could lead to new pandemic influenza viruses.
The threat from new viruses is increasing, and viruses that spread through the respiratory tract and are severe enough to cause pneumonia have the greatest potential for pandemics. The current situation in China does not show any signs of a new pandemic, but we should always identify and pay attention to undiagnosed clusters of pneumonia cases. Early warning systems give us the best chance of preventing the next pandemic.
C Raina MacIntyre receives funding from NHMRC and MRFF. She is currently receiving funding from Sanofi for research on influenza and whooping cough. She is a member of the WHO Technical Advisory Group on COVID-19 Vaccine Compositions and the WHO SAGE Ad Hoc Working Group on Monkeypox and Smallpox. She leads the EPIWATCH early warning system.
Ashley Quigley leads the EPIWATCH® Epidemiology Team at the Kirby Institute in New South Wales.
Haley Stone is a Research Officer at EPIWATCH® at the Kirby Institute in New South Wales.
Rebecca Dawson is a Research Fellow at EPIWATCH® at the Kirby Institute in New South Wales.
/ Courtesy of The Conversation. Material from the original organization/author may be of a point-in-time nature and has been edited for clarity, style and length. Mirage.News does not adopt an institutional position or position, and all views, positions, and conclusions expressed in this article are solely those of the author.