WHO calls for information on pneumonia epidemic in China

On Tuesday evening, the ProMED monitoring system issued an alert saying, Undiagnosed pneumonia cases have increased significantly in China. The focus is on the child population in the north of the country, but not only. Now, the World Health Organization (WHO) has formally asked China to provide detailed information on the rise in cases of respiratory diseases and pneumonia, which has been reported by local media.but from increasing Infect This matter has been discussed in China for several weeks.

Now, the latest news about pneumonia cases in China focuses on the World Health Organization: As reported on Thursday, it is unclear whether these cases are related to a general increase in respiratory infections that authorities have previously reported, and not just pneumonia in children. Therefore, the organization is trying to find out whether the pneumonia outbreak occurred in China. correspond to a new phenomenon If it follows a pattern or is part of a rebound in cold-related respiratory illness, it’s linked to a specific bacteria or virus. There are currently more questions than answers.

ProMED map with latest alerts for Liaoning Province and Beijing, China

The Beijing Center for Disease Control and Prevention announced earlier this month that there were 3,500 boys and girls suffering from respiratory infections in children’s hospitals. Mycoplasma pneumoniae, Bacteria that cause lung disease. The new pneumonia epidemic seems to be concentrated in the following areas: Beijing, Liaoning (700 kilometers further northeast) and other places, Quite a distance. Main impact of the epidemic childhoodbut cases of illness have been recorded collegeat least in Liaoning.

Are there signs of an emerging virus?

As UK public health expert Paul Hunter (University of East Anglia) explains, “Overall, this does not look like an epidemic caused by a new virus. If so, I expect to see more adults infected. The few infections reported in adults suggest immunity due to previous exposure. “

Professor Zania Stamataki (University of Birmingham) agrees, arguing that the harmless and not entirely new circulating virus may be related to other pathogens in the child population who have been exposed during the pandemic. less severe) occur simultaneously and then cause tissue damage. This is the case of strange acute hepatitis of unknown origin in 2022.

What are the symptoms of pneumonia cases in China?

Some news and social media reports describe The hospital is crowded with children Pneumonia has occurred in China, but the exact cause of the disease has not been specified. “This disease occurs in children Fever, no cough or other symptoms, but in some cases, lung nodules can be seen on a chest X-ray,” Hunter said.

But it’s worth distinguishing the recent pneumonia cases from other more or less general cases of respiratory illness reported in China since October. The increase in illnesses ranges from colds to bronchiolitis (Spain already has a vaccine against bronchiolitis this year) to classic flu with typical symptoms.

What is the causative agent of pneumonia in Chinese children?

“While we cannot make a definite diagnosis at this stage, the presence of nodules in the lungs often indicates a cause.” bacteria It’s not just viral,” Dr. Hunter suggested. Here are the main suspicions behind childhood pneumonia in China: Mycoplasma.

Mycoplasma bacteria, which are usually mild, appear to be involved, but may be related to other known pathogens.

ProMED system issues warning Mycoplasma bacteria Even before SARS-CoV-2 emerged, it was behind a common fall outbreak of respiratory infections in China. They tend to affect children and very young adults in a mild way. However, the current chest X-ray symptoms and findings are not entirely consistent with mycoplasma.

Mycoplasma may be involved, but along with other pathogens that are recirculating with the arrival of cold weather in northern China. For epidemiologist Salvador Pero (FISABIO), it’s likely a mix of different pathogens causing these events, not just an outbreak of pneumonia in Chinese children.

Because now?

Perot explained at the Spanish SMC that “China is Very strict control measures were later liftede COVID-19, these measures have significantly reduced the circulation of respiratory pathogens (not only SARS-CoV-2) over a long period of time. ” Just like we spend autumn and winter together Respiratory tract infection caused last year In much of the northern hemisphere, “a rebound in various respiratory infections is expected this autumn, as has happened in most countries, albeit earlier than in China, as they expected measures to be lifted” China. “mainland”.

In early December 2022, China suddenly canceled its zero-COVID policy. Given that complete and effective vaccination numbers are relatively low and “immune debt“In China’s more than two-and-a-half-year bubble, infants and young children had virtually no exposure to pathogens.”

Are there global risks now?

Experts consulted agreed that if the cause of pneumonia in China is a known pathogen, the global risk should not be high. Peiró noted: “The information currently available is Too low to estimate Overall risk.What if any This is unlikely. In this context, the WHO’s action (requesting information and recommending general measures to control respiratory infections) appears to be appropriate. “

Dr. Sonia Zúñiga of the CNB-CSIC Coronavirus Laboratory believes that “due to the experience accumulated during the pandemic, More detailed monitoring by the scientific community”. The WHO’s statement “is pertinent and accurate both in terms of its timing and the information it requests.”

Zuniga agreed that “there will be a general increase in all respiratory viral and bacterial infections” in the face of China’s first winter without restrictions.

What is China doing?

Chinese authorities asked today Strengthen primary care Coordination between hospitals to respond to an increase in respiratory infection cases. The official Xinhua News Agency quoted an official from the National Health Commission as saying the agency had introduced a series of measures to “improve the diagnosis and treatment capabilities of common respiratory infections in community health service centers and hospitals” and “Facilitate identification and referral of critical cases. “

The World Health Organization noted that it has requested additional epidemiological and clinical information, as well as laboratory results from reported outbreaks in children, through the mechanisms of the International Health Regulations.According to their rules, assuming China must respond to the World Health Organization within 24 hours. The Chinese delegation to the World Health Organization stated, “conventionalAccording to Reuters, the request was for information on an increase in respiratory illnesses in member states.

During the SARS outbreak in 2003 and the SARS-CoV-2 pandemic that began in Wuhan in 2020, China’s surveillance and reporting of infectious diseases raised concerns. Global scrutiny and criticism. In both cases, the cover-up of the first cases was notable, and although later cases began to be reported more fluidly, requests for patient information and records by foreign public health officials, notably the World Health Organization, were limited . For example, about the possible origin of the virus.

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