What we know so far about surging respiratory illnesses in China

WHAT DO CHINA AND THE WORLD HEALTH ORGANIZATION SAY?

The report triggered memories of the pandemic, with social media users fearing “a new virus coming from China”, or a “new Covid”.

On Wednesday, the World Health Organization – which repeatedly criticised Beijing for a lack of transparency throughout the COVID-19 pandemic – requested more information from China about children suffering from “undiagnosed pneumonia”.

Beijing responded on Thursday, saying “there has been no detection of any unusual or novel pathogens”, according to a WHO statement.

The WHO has requested more information, noting that China closely monitors trends in viruses such as the flu, RSV and SARS-CoV-2.

China also started monitoring mycoplasma pneumonia for the first time in mid-October, the WHO added.

The WHO said that “there is limited detailed information available to fully characterise the overall risk of these reported cases of respiratory illness in children”.

However an increase in such illnesses was to be expected with the arrival of winter, it added.

WHAT DO THE EXPERTS THINK?

Several experts pointed to winter’s arrival, the end of COVID-19 restrictions, and a lack of prior immunity in children as likely being behind the surging infections.

“Since China experienced a far longer and harsher lockdown than essentially any other country on Earth, it was anticipated that those ‘lockdown exit’ waves could be substantial in China,” said Francois Balloux of University College London.

Unless there is new evidence suggesting otherwise, “there is no reason to suspect the emergence of a novel pathogen,” he added.

Paul Hunter of the UK’s University of East Anglia emphasised that “at present there is too little information to make a definitive diagnosis”.

However “overall, this does not sound to me like an epidemic due to a novel virus”, he added.

“If it was, I would expect to see many more infections in adults. The few infections reported in adults suggest existing immunity from a prior exposure.”

Catherine Bennett of Australia’s Deakin University pointed out that “young children in school in China will have spent up to half their life without the usual exposure to common pathogens, and so do not have the same levels of immunity”.

ARE THERE ANY RECOMMENDATIONS?

The WHO recommended that people in the affected areas follow the normal rules to avoid respiratory illnesses.

These include getting vaccinated, isolating if symptoms emerge, and getting tested or wearing masks if necessary.

Based on the current information, the WHO advised against any travel restrictions involving China.

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WHO asks China for details on respiratory illness outbreaks

The World Health Organization (WHO) on Wednesday (Nov 22) officially requested that China provide detailed information on an increase in respiratory illnesses and reported clusters of pneumonia in children.

Chinese authorities from the National Health Commission held a press conference on Nov 13 to report an increase in the incidence of respiratory diseases in the country, the WHO said in a statement.

The global health agency said Chinese authorities attributed the increase to the lifting of COVID-19 restrictions and the circulation of known pathogens such as influenza, mycoplasma pneumoniae (a common bacterial infection which typically affects younger children), respiratory syncytial virus, as well as the virus that causes COVID-19.

Chinese authorities stressed the need for enhanced disease surveillance in healthcare facilities and community settings, as well as strengthening the capacity of the health system to manage patients.

Both China and the WHO have faced questions about the transparency of reporting on the earliest COVID-19 cases which emerged in the city of Wuhan in late 2019 and early 2020.

On Wednesday, WHO said groups including the Program for Monitoring Emerging Diseases reported clusters of undiagnosed pneumonia in children in northern China. WHO said it is unclear if these are associated with the overall increase in respiratory infections previously reported by Chinese authorities, or separate events.

The health agency said it has requested additional epidemiologic and clinical information, as well as laboratory results from these reported outbreaks among children, through the International Health Regulations mechanism.

It has also asked China for further information about trends in the circulation of known pathogens and the current burden on healthcare systems. WHO said it is in contact with clinicians and scientists through its existing technical partnerships and networks in China.

Since mid-October, WHO said northern China has reported an increase in influenza-like illness compared with the same period in the previous three years.

It said the country has systems in place to capture information on trends in illness incidence and to report that data to platforms such as the Global Influenza Surveillance and Response System.

WHO said that while it seeks additional information, it recommends that people in China follow measures to reduce the risk of respiratory illness, including vaccination; keeping their distance from people who are ill; staying home when ill; getting tested and medical care as needed; wearing masks as appropriate; ensuring good ventilation; and regular hand-washing.

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