Why the rise in “walking” pneumonia among Chinese children is causing alarm and concern

Anyone coming from China who sneezes, coughs or has respiratory symptoms will be quarantined. Not just because of the uncertainty created by its lack of transparency, but also because that’s how it all started four years ago. SARS is behind a spate of cases, this time in children. To this end, the World Health Organization asked China to clarify the situation.

What are the current events?

Since mid-October, the number of influenza-like illnesses in northern China has increased compared with the same period in the previous three years. On November 21, the situation worsened and the situation reached the media. In addition, the ProMED system also reported an epidemic of undiagnosed pneumonia in children in northern China.

Its origins are unknown, according to the World Health Organization. It also asked for an explanation as to whether the cases were related to a general increase in respiratory infections previously reported by Chinese authorities, or whether they were independent incidents. As stated in the statement, the international organization has formally requested China to provide detailed information on an increase in respiratory diseases and an outbreak of pneumonia in children.

Why are there questions about the origins of respiratory infections?

Experts remain cautious, but appeal to the fact that this time, as virologist Sonia Zúñiga of the National Center for Biotechnology (CNB-CSIC) explains, “the scientific community is conducting an exhaustive monitoring” and collected Spanish Science Media Center (SMC).

“Any news coming from China and related to an increase in pneumonia cases will be scrutinized,” Quique Bassat, a pediatrician and epidemiologist at the Barcelona Institute of Global Health (ISGlobal), told SMC. “The epidemiological situation that China is experiencing may Similar conditions to what we had last fall and winter. Regardless, we have to monitor closely to make sure that’s the case.”

Furthermore, and in the same sense, as stated by the SMC, says Salvador Peiró, epidemiologist and researcher in the field of health services and pharmacoepidemiological research at the Valencian Foundation for the Promotion of Community Health and Biomedical Research (FISABIO), “At the moment The information available is not sufficient to assess the global risk of the current pneumonia epidemic in China (if there is any, but it is unlikely), and the WHO’s action (requesting information and recommending general measures to control respiratory infections) seems appropriate in this context .

What are the possible reasons for the increase in pneumonia cases?

Most experts believe that China’s late lifting of restrictions, known as lockdowns protected by its zero-COVID policy, also left the population unable to receive seasonal immunity to other viruses, such as influenza or RSV (respiratory syncytial virus).

“China is the latest country to lift very strict Covid-19 control measures that have significantly reduced the spread of respiratory pathogens (not just SARS-CoV-2) over a long period of time. They are expected to be all rolled out this fall There will be a rebound in all types of respiratory infections, including covid-19, as has happened in most countries (albeit earlier than in China, predictably, as they expected to lift measures against mainland China),” explains Peiró .

Zuniga agreed, noting, “Not surprisingly, there is a general increase in all respiratory infections caused by viruses and bacteria when facing the first winter without the virus. Moreover, a large number of these cases occur in children, whose Previous immunity will be much lower than the rest of the population.

Why are SARS and its non-bacterial origin suspected?

“Similar situations have occurred in our setting and they have no impact on healthcare. Nonetheless, a clear assessment of the risks they may pose is now unavailable, pending confirmation by other means, such as serology. It’s too early,” warned SMC Adrian Hugo Aginagalde in a statement, specialist in preventive medicine and public health, coordinator of the Public Health Section of the Academy of Medical Sciences in Bilbao and head of the Service of Epidemic Surveillance and Health Information for the Province of Gipuzcoa people.

“SARS outbreaks among minors were not uncommon in our setting,” Ajnagard recalls. “In the context of increasing cases of respiratory syncytial virus, the situation described appears to be consistent with previously observed patterns. In addition, improvements in symptom surveillance (monitoring of pneumonia cases) have enabled early detection of increases in cases.”

As a Basque pediatrician explains, unlike viral respiratory infections, “cases are due to Mycoplasma (bacteria that cause respiratory infections) are more difficult to confirm. “They are milder, but empiric antibiotic treatment (without microbiological confirmation) makes it difficult to later identify the pathogen because its growth in the sputum sample is inhibited by its action.”

Because they presented with mild pneumonia, “they did not require hospitalization, they were treated in the same manner as patients acquired in the community, and their diagnosis was clinical and supported by X-rays and did not require microbiological confirmation. In summary, this is A reasonable hypothesis, but there are some difficulties in its confirmation,” Ajinagad stressed.

What does “walking” pneumonia, caused by the bacterium Mycoplasma, look like?

In this sense, Sescam pediatrician Miguel Jiménez Monteagudo explains to this outlet that “walking” pneumonia is caused by bacteria Mycoplasma “Its clinical manifestations are a large amount of irritating cough and a small fever, which is very similar to influenza pneumonia. Typical bacterial pneumonia is high fever and patients are more involved. X-ray examination shows that both have large amounts of involvement.” Pulmonary. This is very similar to COVID-19.

There are two types of pneumonia: “classic pneumonia or bacterial pneumonia, such as that caused by pneumococci,” Jimenez distinguished. “Bacterial infections are treated with the prescription of antibiotics from the penicillin family. And in atypical cases such as viruses, antibiotics do not work.” In addition, he noted that against ” Mycoplasma, Give a macrolide, such as clarithromycin.

Nonetheless, Seskam’s pediatrician insists that “at least based on the data we have received so far, the pneumonia in China does not match known pneumonia.”