The Union Health Ministry said it has decided to proactively review preparatory measures against respiratory illnesses as a matter of caution.
Published Nov 26, 2023 | 5:07 PM ⚊ Updated Mar 08, 2024 | 5:22 PM
China has seen a recent increase in respiratory illnesses. (Wikimedia Commons)
With reports emerging of an increasing respiratory illness in children in Northern China, the Union Health Ministry on Sunday, 26 November, advised states to immediately review public health preparedness.
In a statement, the ministry said it has decided to proactively review preparatory measures against respiratory illnesses as a matter of abundant caution.
“This is noted to be important in view of the ongoing influenza and winter season that results in an increase in respiratory illness cases. The Government of India is closely monitoring the situation and indicated that there is no need for any alarm,” it said.
While the advisory came from the ministry on Sunday, the Andhra Pradesh government led by Chief Minister YS Jagan Mohan Reddy formed a task force on the same day to closely watch the situation.
The task force consists of a Neonatologist, a Paediatrician, a Pulmonologist and a General medical doctor to closely watch the situation and suggest preparatory measures.
MT Krishna Babu, Special Chief Secretary, Health, Medical and Family Welfare, Andhra Pradesh told the media: “We have beefed up paediatric wards during Covid third wave expecting severe cases in children in all hospitals.”
He added: “A sufficient number of paediatric ventilators and other equipment which were procured are checked for availability.”
He also said: “All the oxygen infrastructure is being maintained. Drugs required based on the recommendation of the task force will be made available to all hospitals.”
In a letter to all states and Union Territories, the Union Health Secretary advised them to immediately review public health and preparedness of hospitals regarding the availability of beds, drugs and vaccines for influenza, medical oxygen, antibiotics, personal protective equipment, testing kits and reagents, functionality of oxygen plants and ventilators, and infection control practices.
The state authorities are also advised to implement the operational guidelines for revised surveillance strategy in the context of Covid-19, shared earlier this year, which provides for integrated surveillance of respiratory pathogens presenting as cases of Influenza Like Illness (ILI) and Severe Acute Respiratory Illness (SARI).
Meanwhile, the states have been asked to ensure that the trends of ILI and SARI, particularly among children and adolescents, are closely monitored by the surveillance units even in districts through the Integrated Disease Surveillance Project (IDSP).
“The data of ILI/SARI is required to be uploaded on the IDSP-IHIPportal,” the letter states.
The state authorities have been asked to send nasal and throat swab samples of patients with SARI, particularly children and adolescents, to the Virus Research and Diagnostic Laboratories for testing for respiratory pathogens.
Speaking to South First regarding the situation Dr Ravindra Mehta, a renowned pulmonologist and sleep expert from Vaayu Centre for Rehabilitation and Consultant, said: “The concern about the recent health situation in China is significant due to its similarities with the events of 2019, which also occurred around November-December. This period is typically when viruses tend to emerge,”
He said the uncertainty revolves around whether this was a regular virus or something more serious, like flu, RSV, adenoviruses, or a new form of COVID.
“There is particular concern about China’s vaccination strategies, which have been mediocre, especially regarding children’s vaccinations. It’s unclear if this situation represents a new trend or the same viruses, and more data is needed to understand fully,” he said.
“Given China’s history with the pandemic, it’s crucial that they manage this situation effectively. A key factor will be how well China communicates with the World Health Organisation (WHO) to address and potentially contain this issue as early as possible,” he added.
Expressing concern over the situation in China, domestic exporters on Sunday said that they were cautiously watching the situation as any spread of the disease may again hurt global supply chains and impact world trade.
They said that the present situation is not alarming but if the illness spreads to other parts of the globe, it will have an impact on world trade as China is a hub of global manufacturing and exports.
Leading leather exporter and Farida Group Chairman Rafeeq Ahmed said: “We are cautiously watching the situation. If the diseases spread, it will have an impact on trade”.
Sharing similar views, Federation of Indian Export Organisations (FIEO) Director General Ajay Sahai said: “We are definitely concerned and most of the things depend on its spread. The next 5-6 days will be crucial”.
He added that China is the major economy of the world and at present the global economic slowdown is already impacting exporters and importers. “If it spreads to more areas, then there will be a problem,” Sahai said.
Mumbai-based exporter Khalid Khan also said that during the Covid pandemic, the global supply chain was disrupted and if the current diseases in China spread again, it can again hit the chain.
“We are watching the situation closely. At present there should not be any panic,” Khan said.
Ludhiana-based engineering exporter SC Ralhan added that so far there is no problem or threat to the global supply chain and their imports are smooth from the neighbouring country.
Since mid-October, the World Health Organization (WHO) has been closely monitoring the situation in China following reports from the country’s surveillance systems indicating a rise in respiratory diseases that predominantly affect children.
The WHO requested additional information following reports from the outbreak surveillance network ProMed about “undiagnosed pneumonia” cases in northern China. This network was instrumental in initially bringing Covid-19 to the world’s attention.
This request aimed to determine if the reported pneumonia clusters were separate events or part of the general increase in respiratory illnesses.
While China’s National Health Commission (NHC) acknowledged a nationwide increase in respiratory diseases, the surge was attributed to the lifting of Covid-19 restrictions and the onset of colder weather.
“The increase is primarily due to known pathogens like influenza, Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Notably, Mycoplasma pneumoniae and RSV are more likely to affect children than adults,” the NHC told reporters in the second week of November.
On 23 November, the WHO held a teleconference with Chinese health authorities. The data provided indicated a rise in outpatient consultations and hospital admissions of children due to pneumonia caused by Mycoplasma pneumoniae since May, and due to RSV, adenovirus, and influenza virus since October.
The Chinese health authorities were said to have reported no detection of any unusual or novel pathogen.
Meanwhile, Chinese authorities have reportedly enhanced outpatient and inpatient surveillance for respiratory illnesses since mid-October, covering a broad spectrum of viruses and bacteria, including Mycoplasma pneumoniae.
This enhanced monitoring may have contributed to the increased detection and reporting of respiratory illness in children.
Since mid-October, Chinese authorities have emphasised the need to strengthen healthcare system capacity alongside enhancing disease surveillance.
China’s existing systems capture information on trends in influenza, influenza-like illness (ILI), RSV, SARS-CoV-2, pneumonia, and other severe acute respiratory infections (SARI).
These systems report influenza detections to platforms like the Global Influenza Surveillance and Response System (GISRS), led by the WHO.
As per the risk assessment by the WHO, the current outbreak’s reported symptoms align with several respiratory diseases.
The WHO, in its risk assessment report, said clinical manifestations, as per Chinese surveillance and hospital systems, are caused by known pathogens in circulation.
“Mycoplasma pneumoniae, a common cause of paediatric pneumonia, is treatable with antibiotics. Enhanced surveillance systems have been implemented in China for respiratory illness, covering a broad spectrum of respiratory viruses and bacteria, including Mycoplasma pneumoniae,” the report said.
However, it also noted that limited information was available to fully characterise the overall risk of these reported respiratory illness cases in children.
Then again, the WHO also said that with the winter’s arrival and the co-circulation of respiratory viruses, an increasing trend in respiratory illnesses was expected, potentially straining healthcare facilities.
The WHO recommended that people in China adhere to measures reducing respiratory illness risk.
These include vaccination against influenza, Covid-19, and other respiratory pathogens; maintaining distance from the ill; staying home when sick; getting tested and seeking medical care as needed; wearing masks appropriately; ensuring good ventilation; and regular handwashing.
No specific measures were recommended for travellers to China. However, travellers with respiratory-illness symptoms were advised to avoid doing so if possible and seek medical attention while sharing their travel history with healthcare providers.
The WHO also advised against any travel or trade restrictions based on the current information on this outbreak.
