Any sneeze, cough or respiratory symptoms reported from China are quarantined. Not only because of the uncertainty generated by its lack of transparency, but also because four years ago everything started like this. Atypical pneumonia is behind a large number of cases, this time in children. Therefore, the World Health Organization (WHO) asks China to clarify the situation.
What are the current events?
Since mid-October, northern China has reported an increase in flu-like illnesses compared to 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 reports on outbreaks of undiagnosed pneumonia in children in northern China.
Chinese hospitals overwhelmed by pneumonia outbreak in children
According to the WHO, its origin is not clear. And explanations are requested as to whether these are cases related to the general increase in respiratory infections previously reported by the Chinese authorities or whether they are independent episodes.. As stated in a statement, the international organization has officially requested detailed information from China about this increase in respiratory diseases and the outbreaks of childhood pneumonia..
Why are there doubts about the origin of respiratory infections?
The experts remain cautious, but appeal to the fact that on this occasion “exhaustive monitoring is being carried out by the scientific community”, as explained by Sonia Zúñiga, virologist at the National Center for Biotechnology (CNB-CSIC) and reported by Science Media Center España. (SMC).
“Any news that comes from China and is related to an increase in pneumonia cases will be subject to detailed scrutiny,” Quique Bassat, pediatrician and epidemiologist at the Barcelona Institute for Global Health (ISGlobal), tells SMC.. “It may be that China is experiencing an epidemiological situation similar to the one we experienced last fall-winter in our environment.. In any case, we would have to monitor it closely to ensure that this is the case.”.
Children and their parents wait in the outpatient area of the children's hospital in Beijing. AFP
Furthermore, in the same sense, Salvador Peiró, epidemiologist and researcher in the Health Services and Pharmacoepidemiology Research Area of the Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), as stated by SMC, states that “The information available at this time is too insufficient to assess the global risk – if any, which is unlikely – of the current pneumonia outbreaks in China and the actions of the WHO (request information and recommend general measures for infection control respiratory) seems appropriate in this context”.
What are the possible causes of the increase in pneumonia cases?
Most experts argue that the late lifting of China's restrictions, the famous lock protected by zero Covid policies, also isolated the population from seasonal immunization of other viruses, such as flu or RSV (respiratory syncytial virus). ).
“China was the country that was the latest to withdraw its very strict Covid-19 control measures, measures that notably reduced the circulation of respiratory pathogens (not just SARS-CoV-2) for a long period. It was expected that this fall they would have a rebound in respiratory infections of all kinds (including covid-19), as has happened in most countries (although earlier than in China, predictably because they anticipated the withdrawal of measures regarding mainland China)”, explains Peiró.
Zúñiga agrees with him, pointing out that “it is not surprising that, when facing the first winter without them, all respiratory infections caused by both viruses and bacteria generally increase.. And it is not strange that a significant number of these cases occur in children, whose prior immunity will be much lower than in other segments of the population.”.
Why are there suspicions about atypical pneumonia and its non-bacterial origin?
“Similar circumstances have been seen in our environment and they have had no impact on healthcare.”. Despite this, until confirmation by other means (such as serological), it is too early to have a definitive evaluation of the risk that it may pose,” warns Adrian Hugo Aginagalde, specialist in Preventive Medicine and Public Health, coordinator of SMC. the Public Health Section of the Academy of Medical Sciences of Bilbao and head of service of the Epidemiological Surveillance and Health Information Unit of Gipuzkoa.
“Outbreaks of atypical pneumonia in minors are not uncommon in our environment,” recalls Aginagalde.. “And in a context of increasing cases of RSV, the situation described seems to respond to previously observed patterns. Furthermore, the improvement of syndromic surveillance (monitoring of pneumonia cases) allows these increases in cases to be detected early.”.
Unlike viral respiratory infections, as the Basque pediatrician explains, “cases due to mycoplasma [bacteria that cause respiratory infections] are more difficult to confirm.”. “They are milder, but empirical antibiotic treatment (without microbiological confirmation) makes it difficult to determine the pathogen later, given that its growth in sputum samples is inhibited by its action.”.
As they present as mild pneumonia “they do not require hospitalization, they are treated like those acquired in the community whose diagnosis is clinical and with the support of x-ray, without requiring microbiological confirmation. In short, it is a plausible hypothesis whose confirmation has some difficulties,” emphasizes Aguinagalde..
What is “walking” pneumonia caused by the bacteria 'mycoplasma' like?
In this sense, Miguel Jiménez Monteagudo, pediatrician at Sescam, explains to this medium that “walking” pneumonia caused by the mycoplasma bacteria “has a clinical picture of a lot of irritating cough, little fever and is very similar to flu pneumonia.. Typical bacterial pneumonias are with high fever and a lot of patient involvement.. The x-ray shows a lot of involvement of both lungs.. “It would be very similar to Covid pneumonia.”.
There are two types of pneumonia: “typical or bacterial, which for example is what causes pneumococcus,” Jiménez distinguishes.. “The treatment of bacteria is through the prescription of antibiotics from the penicillin family.. And in the atypical case, which is that of viruses, antibiotics are of no use.”. In addition, he points out that against “mycoplasma, macrolides such as clarithromycin are given.”.
With all this, the Sescam pediatrician maintains that “the pneumonia that has appeared in China does not coincide with any known, at least, according to the data that we have received at the moment”.