Explainer: What do we know about China’s respiratory illness surge?

Raffles Medical

01/12/2023 08:25

By Andrew Silver
       SHANGHAI, Dec 1 (Reuters) - A request by the World
Health Organization for more information on a surge in
respiratory illnesses and clusters of pneumonia in children in
China has attracted global attention.
    Health authorities have not detected any unusual or novel
pathogens, the WHO later said, and doctors and public health
researchers say there is no evidence for international alarm.
    Authorities in Taiwan, however, this week advised the
elderly, very young and those with poor immunity to avoid travel
to China.
    The following is what we know about the surge in illness in
the world's second most populous country so far, and why experts
think there is no need to panic. 
    
    WHAT IS HAPPENING ON THE GROUND?
    The rise in respiratory illnesses comes as China braces for
its first full winter season since it lifted strict COVID-19
restrictions in December last year. 
    The spike in illness came into the spotlight when the WHO
asked China for more information last week, citing a report by
the Program for Monitoring Emerging Diseases (ProMED) on
clusters of undiagnosed pneumonia in children.
    Some social media users have also posted photos of children
receiving intravenous drips in hospital, while media in cities
such as Xian in the northwest have posted videos of crowded
hospitals, fanning concerns potential strains on the healthcare
system.
    
    HOW BIG IS THE SURGE?
    The National Health Commission told a news conference on
Nov. 13 that there was an increase in incidence of respiratory
disease without providing further details.
    WHO China told Reuters in an email that "Chinese health
authorities advised that the current numbers they are observing
is not greater than the peak in the most recent cold season
prior to the COVID-19 pandemic".
    
    WHAT PATHOGENS ARE CIRCULATING?
    The data suggests the increase is linked to the lifting of
COVID-19 restrictions along with the circulation of known
pathogens such as mycoplasma pneumoniae, a common bacterial
infection that typically affects younger children and which has
circulated since May.
    Influenza, respiratory syncytial virus (RSV) and adenovirus
have been in circulation since October.
    
    IS MYCOPLASMA PNEUMONIAE A BIG WORRY?
    One concern about the surge in respiratory illness is
mycoplasma pneumoniae, which has also spiked in other countries.
    Maria Van Kerkhove, COVID-19 Technical Lead at the World
Health Organization told reporters on Wednesday that mycoplasma
pneumonia is not a reportable disease to the WHO, and it was on
the rise for the last couple of months but now appears to be
declining.
    "We're following up through our clinical networks and
working with clinicians in China to better understand resistance
to antibiotics, which is a problem across the world, but is a
particular problem in the Western Pacific and South East Asia
region," she said.
    Rajib Dasgupta, an epidemiologist and professor of community
health at Jawaharlal Nehru University in New Delhi, told Reuters
in some cases there may be serious complications from infection
caused by mycoplasma pneumoniae, but most people will recover
without antibiotics.
    
    WHY EXPERTS AREN'T CONCERNED?
    Doctors in China and experts abroad are not too worried
about the situation in China, noting many other countries saw
similar increases in respiratory diseases after easing pandemic
measures. 
    "The cases that we are seeing is nothing unusual at the
moment, because it's still the same cough, colds, fever
presentation, and the good thing about it is that it's actually
treatable," said Cecille Brion, head of the pediatrics
department at Raffles Medical Group Beijing.
    Van Kerkhove said that the rise in cases was expected. 
    "We are seeing, in general, an increase in respiratory
infections around the world. We do tend to see increases in
children because they're the school-aged children, and in the
northern hemisphere it's the autumn already. We're entering the
winter months," she said.

 (Reporting by Andrew Silver; Editing by Miyoung Kim and Miral
Fahmy)
 ((andrew.silver@thomsonreuters.com;))