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What 5 Infectious Disease Experts Think About China's Surge In Respiratory Illnesses

Is the surge in China's childhood respiratory illnesses a cause for concern? (Photo illustration: Yahoo News; photos: Getty Images)

The infectious disease community is closely watching a surge of mystery illnesses in China that many have compared to the start of the COVID-19 outbreak.

The World Health Organization (WHO) said last week that officials had requested "detailed information" from China about an "increase in respiratory illnesses and reported clusters of pneumonia in children." In a follow-up statement, the WHO reported its officials held a teleconference with Chinese health authorities and were given data that indicated an increase in outpatient visits and hospital admissions of children due to Mycoplasmapneumoniae pneumonia since May, along with RSV, adenovirus and the flu since October.

"Some of these increases are earlier in the season than historically experienced but not unexpected given the lifting of COVID-19 restrictions, as similarly experienced in other countries," the WHO release states. "Chinese authorities advised that there has been no detection of any unusual or novel pathogens or unusual clinical presentations, including in Beijing and Liaoning, but only the aforementioned general increase in respiratory illnesses due to multiple known pathogens."

Still, reports about this situation have been concerning. A headline published by the journal Nature this week reads, "What's behind China's mysterious wave of childhood pneumonia?," which is eerily similar to a January 2020 headline for the New York Times at the start of the COVID-19 pandemic that says, "China Grapples With Mystery Pneumonia-Like Illness."

So, what do infectious disease doctors think about all this? We spoke with five physicians to get their takes.

Is this a cause for concern?

Most doctors acknowledge the fact that this is happening in China, where COVID-19 originated, naturally raises eyebrows. "Any health information from China should be verified given what happened with COVID-19 and the fact that we still do not have a clear understanding of the origin of SARS-CoV-2 [the virus that causes COVID-19]," Dr. Richard Watkins, an infectious disease physician and a professor of internal medicine at the Northeast Ohio Medical University, tells Yahoo Life.

"What's going on in China does raise concern," Dr. Ian Michelow, division head of pediatric infectious diseases and immunology at Connecticut Children's Specialty Group, tells Yahoo Life. "Influenza and the original SARS also did arise in China. It's always good to be aware of outbreaks there so we can be prepared."

Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, agrees. "When the news first broke last week, all of us in infectious diseases wondered whether we had seen this movie before," he tells Yahoo Life. "Fortunately, I think the political leadership of China has learned some lessons from the COVID-19 pandemic."

But China's explanation for what is happening in the country makes sense, according to Dr. Thomas Russo, a professor and chief of infectious diseases at the University at Buffalo in New York. "China says this is due to the usual respiratory viruses such as influenza, RSV, COVID-19 and mycoplasma," he tells Yahoo Life. "While all we know is what China says, I think this is likely to be the case." Schaffner agrees: "Chinese scientists were very convincing that no strange new virus has been found."

Are we seeing similar increases in the U.S.?

To some degree, we already have, Dr. Amesh A. Adalja, a senior scholar at the Johns Hopkins Center for Health Security, tells Yahoo Life. "This is exactly what happened one year ago in the U.S. And other countries when children, who were fully socially interacting, became infected with pathogens that they had avoided during COVID-19 social distancing," he says.

Russo agrees. "Remember that China had a lockdown that extended for three years," he says. "We had a big bump in RSV last year, and China probably has three times that susceptibility pool for RSV. With the lockdown, children haven't seen mycoplasma and influenza as well. It's now catching up with them."

Michelow says it's "not surprising" that China would experience this too, noting that the country is "lagging by a year" due to lockdowns that extended until after last winter. "Because of lockdowns, children weren't exposed to these illnesses when they ordinarily would have built up immunity to these infections," he says. "Nature has made us pay a price for that."

As for mycoplasma, Michelow says that the bacteria tends to cause surges in infections every three to seven years, including in the United States. "We see it every year, and it's usually seasonal — fall and winter," he says. "but some years it happens to be more prevalent than other years."

Although doctors say China's explanation of the situation makes sense, they're also planning to continue to keep an eye on it. "The communication from China has substantially reduced the level of concern," Schaffner says. "That said, the world's public health community and we infectious disease doctors are going to continue to monitor this with great care. We're still a bit uneasy about how freely — or not — China will permit its public health experts to communicate with the Western world."

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Nano-sized Cell Particles Are Promising Intervention Tool In Treating Infectious Diseases, Says Study

The COVID-19 pandemic demonstrated the importance of being prepared with drug interventions to contain viral outbreaks that can otherwise have devastating consequences. In preparing for the next pandemic—or Disease X, there is an urgent need for versatile platform technologies that could be repurposed upon short notice to combat infectious outbreaks.

A team of researchers, led by Assistant Professor Minh Le from the Institute for Digital Medicine (WisDM) and Department of Pharmacology at the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), discovered that nano-sized particles released by cells, termed "extracellular vesicles" (EVs), can curb the viral infectivity of SARS-CoV-2—its wild type and variant strains—and potentially other infectious diseases.

Asst Prof Le said, "Our study showed that these cell-derived nanoparticles are effective carriers of drugs that target viral genes precisely. These EVs are, therefore, an efficient tool for therapeutic intervention in patients who are infected with COVID-19 or other infectious diseases."

The study, conducted in collaboration with NUS Medicine's Biosafety Level 3 (BSL3) Core Facility, the Cancer Science Institute of Singapore at National University of Singapore, and the School of Physical and Mathematical Sciences at Nanyang Technological University (NTU), demonstrated potent inhibition of COVID-19 infection in laboratory models using a combination of EV-based inhibition and anti-sense RNA therapy mediated by antisense oligonucleotides (ASOs).

A versatile tool that can be applied to any gene of interest, ASOs can recognize and bind to complementary regions of target RNA molecules and induce their inhibition and degradation.

In the study, published in ACS Nano, the authors utilized human red blood cell-derived EVs to deliver ASOs to key sites infected with SARS-CoV-2, resulting in efficient suppression of SARS-CoV-2 infection and replication.

The researchers also discovered that EVs exhibited distinct antiviral properties, capable of inhibiting phosphatidylserine (PS) receptor-mediated pathways of viral infection—a key pathway utilized by many viruses to facilitate viral infection. These viral inhibitory mechanisms were applicable to multiple variants of SARS-CoV-2, including the delta and omicron strains, ensuring their broad effectiveness against SARS-CoV-2 infection.

The results from the study point to anti-sense RNA therapy with ASOs as a potentially effective approach that could serve to combat future viral outbreaks. The platform that was developed to deliver ASOs through EVs to target the SARS-CoV-2 viral genes can be readily applied to treat other viral infections by replacing the ASO sequences with those complementary to the target viral genes.

Asst Prof Le and her graduate students Migara Jay and Gao Chang, the first authors of the study, are currently developing more potent combinations of ASOs with the help of artificial intelligence prediction models to achieve enhanced viral inhibition. This collaborative effort includes a partnership with the research teams of Associate Professor Edward Chow from WisDM, NUS Medicine, and NUS Medicine's BSL3 Core Facility.

Associate Professor Justin Chu, Director of the BSL3 Core Facility at NUS Medicine and co-author of the study, added, "This remarkable extracellular vesicle-based delivery platform technology coupled with anti-viral therapy is highly promising to combat a broad range of viruses and even Disease X."

The latter is a general description of emerging and unknown infectious threats, such as novel coronaviruses. The term was used to alert and encourage the development of platform technologies, including vaccines, drug therapies, and diagnostic tests, which could be quickly customized and then deployed against future epidemic and pandemic outbreaks. Assoc Prof Chu is also from the Infectious Diseases Translational Research Programme at NUS Medicine.

Professor Dean Ho, Provost's Chair Professor and Director of WisDM at NUS Medicine, said, "This work brings the scalable and well-tolerated extracellular vesicle-based drug delivery platform an important step closer towards clinical validation studies."

More information: Migara K. Jayasinghe et al, Red Blood Cell-Derived Extracellular Vesicles Display Endogenous Antiviral Effects and Enhance the Efficacy of Antiviral Oligonucleotide Therapy, ACS Nano (2023). DOI: 10.1021/acsnano.3c06803

Citation: Nano-sized cell particles are promising intervention tool in treating infectious diseases, says study (2023, November 28) retrieved 28 November 2023 from https://phys.Org/news/2023-11-nano-sized-cell-particles-intervention-tool.Html

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