How much concern is there about the rise in respiratory diseases in China? A doctor explains

Beijing has not yet sent data to the World Health Organization about the cause of the rush to hospitals, although it has confirmed that it is not a new pathogen, as happened with Covid-19.

Hospitals in northern China and Beijing have seen an increase in the number of children with respiratory diseases, including pneumonia. Last week, the World Health Organization asked Xi Jinping’s government to provide more information about the cases.

Based on what is known so far, how serious are these cases? Why is there an increase in respiratory diseases? Should travelers to China rethink their plans? What additional precautions should governments, health systems and individuals take?

To help us understand the situation, we spoke to Leana Wen, an emergency room physician and professor of health policy and management at George Washington University Medical School in the US. She was previously Baltimore’s health commissioner.

How concerning is the increase in reported respiratory illnesses in China?

So far, based on what we know from the World Health Organization, I don’t think the rise in respiratory illnesses should be a concern globally. Even more worrying for the international medical community is the emergence of a new pathogen, as happened with coronavirus disease 2019 (COVID-19) in the winter of 2019. This does not appear to be the case currently.

After the World Health Organization requested additional information from Chinese health authorities, Data received Which suggests that the increase in outpatient consultations and hospital visits can be attributed to an increase in known and present pathogens. Specifically, there has been an increase in cases of pneumonia caused by bacteria Mycoplasma pneumoniae Since May, and an increase in cases of influenza, adenovirus and respiratory syncytial virus (RSV) since October. According to the World Health Organization, these increases “are not unexpected, taking into account the lifting of restrictions imposed by Covid-19, as has happened in other countries.”

It is important to note that no new pathogens have been detected. There were also no unusual clinical symptoms, as the children appeared sicker than usual.

Why is China now seeing such a huge increase?

It is certainly crucial for the World Health Organization and other members of the international medical community to independently verify this data, especially in light of the Chinese authorities’ delay in alerting the global community about coronavirus disease 2019 (Covid-19). However, the situation in China actually mirrors what happened in the United States and many other countries in the past year.

In the winter of 2022, children’s hospitals in the United States were filled with children with COVID-19, influenza, respiratory syncytial virus, and other common viruses. Much of this illness is due to the end of coronavirus mitigation measures.

During the peak of the epidemic, respiratory illnesses decreased significantly. In particular, children who would have had several infections per year did not develop the disease. When mitigation measures were lifted, infectious diseases invaded schools and nurseries, leading to an increase in infections among children and thus also an increase in the number of children requiring hospitalization.

China lifted mitigation measures later than the United States and most other countries. It stands to reason that in the first full winter since the end of “Covid Zero,” there would be an increase in respiratory illnesses like those seen in most parts of the world.

Chinese health authorities attribute the increase in pneumonia cases in children to… Mycoplasma pneumoniae – What is this?

Pneumonia is a lung infection that can be caused by bacteria, viruses, and fungi. Hey Mycoplasma pneumoniae It is a common type of bacterial pneumonia. There are those who appreciate that about 1% Of the United States population is infected Mycoplasma every year. Only 5% to 10% of people get it Mycoplasma Pneumonia will develop.

Pneumonia caused by Mycoplasma It is called “atypical” pneumonia. The onset of the disease is often gradual, with patients experiencing nonspecific symptoms such as low-grade fever, fatigue, and headache. Some people report a persistent cough or chest pain when they cough. A sore throat, runny nose, and ear pain are also possible, and in rare cases, individuals may develop a rash, joint pain, and gastrointestinal symptoms.

According to the US Centers for Disease Control and Prevention, infections caused by Mycoplasma pneumoniae they Most common In youth and school-age children. People who live and work in crowded environments (such as schools) are at increased risk.

Most patients with this type of pneumonia do not require hospitalization and improve with outpatient antibiotic treatment. People most at risk of serious illness are the very young, the elderly, immunocompromised individuals, and people with serious underlying diseases.

Can cases of pneumonia also be caused by other organisms?

Yes, bacteria Streptococcus It is another common cause of pneumonia. RSV and SARS-CoV-2 are also among the types of viruses that can cause pneumonia. Many health care facilities will attempt to diagnose the source of pneumonia and determine whether it is bacterial or viral. However, diagnostic capabilities in some areas may be more limited. Moreover, the same person can have several infections at the same time, and it is not always easy to attribute the manifestation of pneumonia to a single organism.

Should people avoid traveling to China at this time?

The World Health Organization has said this explicitly Advise against “Implement any restrictions on travel or trade based on current information available about this event.” It also does not recommend any specific precautions for travelers to China, although it advises people in China to take steps to reduce the spread of respiratory illnesses. This includes staying home when sick, ensuring good ventilation, washing hands regularly and “wearing masks as appropriate.”

I believe all of these measures are reasonable and I would add that people at risk of serious respiratory illness should take extra precautions, including wearing an N95 mask or equivalent when in crowded, enclosed spaces.

What additional precautions should governments and health systems take, especially in neighboring countries?

I agree with the WHO that limiting travel or trade would not be reasonable at this time, although it is clear that the WHO must continue to pressure China to publish up-to-date and accurate data.

On the other hand, governments and hospitals can strengthen their infrastructure. They should be alert for increased incidence of influenza-like illnesses and pneumonia and get tested immediately.

They must also ensure that they have the capacity to treat patients who require hospital care. It is very likely that other regions, especially those that previously had strict virus mitigation measures, will see an increase in respiratory illnesses this winter. Health systems must prepare for a potential influx of patients, just as they did during the peak of the coronavirus.