CNN
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Hospitals in northern China and Beijing are reporting a sharp rise in the number of children suffering from respiratory illnesses such as pneumonia. The World Health Organization last week asked China to provide more information on cases.
Based on what is known so far, how concerning are these incidents? Why could there be a spike in respiratory illnesses? Should travelers to China reconsider their plans? What further precautions should governments, health systems, and individuals take?
To understand the situation, we spoke to CNN wellness medical expert Dr. Leena Wen. Dr. Wen is an emergency physician and George She is a professor of health policy and management at the University of Washington Milken Institute School of Public Health. She previously served as the health commissioner for the city of Baltimore.
CNN: How concerning is the spike in respiratory illnesses reported in China?
Dr. Liana Wen: So far, based on the information we have from WHO, we do not believe that the surge in respiratory illnesses should cause global concern. Of greatest concern to the international medical community is whether new pathogens are emerging, as they were in the winter of 2019 in the form of the novel coronavirus. That doesn’t seem to be the case now.
After WHO requested additional information from Chinese health authorities. received data This indicates that the increase in outpatient visits and hospital visits may be due to an increase in known pre-existing pathogens. Specifically, since May, pneumonia caused by Mycoplasma pneumoniae has been increasing, and since October, influenza, adenovirus, and respiratory syncytial virus (RS virus) have been increasing. The WHO said the surge was “not unexpected given the lifting of COVID-19 restrictions, as has been experienced in other countries as well.”
Importantly, no new pathogens have been detected. There are also no unusual clinical symptoms in which children appear much sicker than usual.
CNN: Why is China so rapidly increasing now?
Wen: It is certainly important for the WHO and other members of the international medical community to independently verify these data points, especially given the slowness of Chinese authorities to warn the international community about the new coronavirus. . But the situation in China actually mirrors what happened last year in the United States and many other countries.
Last winter of 2022, U.S. children’s hospitals were flooded with children infected with Covid-19, influenza, RSV, and other common viruses. Much of this illness is thought to be due to the end of COVID-19 mitigation measures.
At the peak of the pandemic, there was a sharp decline in respiratory illnesses. In particular, children who would otherwise have been exposed to several infections a year did not get sick. Once mitigation measures were lifted, infectious diseases spread to schools and daycare centers, infections among children skyrocketed, and the number of children requiring hospitalization increased.
China lifted mitigation measures later than the United States and most other countries. It is no surprise that they will experience the same rise in respiratory illnesses that much of the world has experienced in the first full winter since the end of ‘zero coronavirus’.
CNN: Chinese health authorities attribute the increase in pediatric pneumonia cases to mycoplasma pneumonia, but what is it?
Wen: Pneumonia is a lung infection caused by bacteria, viruses, and fungi. Mycoplasma pneumonia is a common type of bacterial pneumonia.Some people speculate that Approximately 1% One person in the U.S. population is infected with mycoplasma each year. Only 5-10% of people infected with mycoplasma develop pneumonia.
Pneumonia caused by mycoplasma is called “atypical” pneumonia. The onset of the disease occurs gradually, and patients experience nonspecific symptoms such as low-grade fever, fatigue, and headache. Some people complain of a persistent cough or chest pain from coughing. A sore throat, runny nose, and ear pain may also occur, and in rare cases, rash, joint pain, and gastrointestinal symptoms may occur.
by Centers for Disease Control and Prevention, Mycoplasma pneumoniae infections are most common in adolescents 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 who are more likely to become seriously ill are the very young, the elderly, people with weakened immune systems, and people with serious underlying illnesses.
CNN: Can cases of pneumonia also be caused by other microorganisms?
Wen: yes.Bacteria called streptococcus This is also a common cause of pneumonia. RSV or Covid-19 is another type of virus that can cause pneumonia. Many medical facilities try to diagnose the cause of pneumonia and determine whether it is bacterial or viral. However, diagnostic capabilities may be more limited in some areas. Also, one person can suffer from several infections at once, and it is not always easy to attribute the development of pneumonia to one microorganism.
CNN: Should people avoid traveling to China at this time?
Wen: WHO says it clearly It advises against “applying travel or trade restrictions based on the latest information available regarding this event.” While it does not recommend any special precautions for travelers to China, it does advise people in China to take steps to reduce the spread of respiratory illnesses. That includes staying home when sick, ensuring adequate ventilation, practicing regular hand washing, and “wearing a mask when appropriate.”
I think these are all reasonable. It also adds that people who are vulnerable to severe symptoms from respiratory illnesses should take additional precautions, such as wearing an N95 or equivalent mask when indoors and in crowded places.
CNN: What further precautions should governments and health systems, especially other regions of China and neighboring countries, take?
Wen: I agree with the WHO that it is unreasonable to restrict travel and trade at this time, but of course the WHO should continue to press China to provide up-to-date and accurate data.
In the meantime, governments and hospitals can shore up their own infrastructure. We need to be alert to the rise in cases of influenza-like illnesses and pneumonia, and to get tested quickly.
We also need to ensure we have the capacity to treat patients who require inpatient treatment. Other regions, particularly those with previously strict virus mitigation measures, are very likely to see an increase in respiratory illnesses this winter. Health systems need to prepare for a potential influx of patients, just as they did during the peak of COVID-19.
