Experts’ Consensus on the Management of Respiratory Disease Syndemic

   A recent comprehensive analysis by the Chinese Academy of Medical Sciences and Peking University sheds new light on the global challenge posed by respiratory disease syndemics, emphasizing the interconnectedness and co-occurrence of multiple respiratory conditions within populations. Chronic respiratory diseases, notably increasing since 1990, have been identified as the third leading cause of global mortality in 2017, highlighting the urgency for an integrated approach to management. This study proposes a syndemic framework to address the complex interplay of biological, social, and environmental factors contributing to respiratory diseases. The consensus, developed through rigorous analysis of over 7,000 articles, underscores the necessity of adopting a population-level, collaborative model focusing on proactive diagnosis, comprehensive disease severity assessment, and integrated condition management. Key recommendations include the critical assessment of syndemic impacts at both individual and population levels, prioritizing safety in diagnostic procedures, and the importance of personalized treatment to manage the intricacies of coexisting diseases. Furthermore, the consensus advocates for regular revisions based on practical feedback, aiming to refine strategies for managing the increasing burden of respiratory conditions effectively. This initiative, registered with the international Practice Guideline Registration for Transparency platform in collaboration with the WHO, seeks to pioneer a paradigm shift towards a syndemic perspective in respiratory disease management, promising a more holistic and effective approach to combating this growing global health crisis.

   For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.029

Respiratory Viruses and Mycoplasma Pneumoniae Surveillance Among Hospitalized Children with Acute Respiratory Infections — Wuhan City, Hubei Province, China, September–November 2023

   A comprehensive study conducted at Wuhan Children's Hospital, China, from September to November 2023, has provided crucial insights into the changing landscape of acute respiratory infections (ARIs) among children under five, a demographic significantly affected by ARIs globally. This retrospective analysis, focusing on the prevalence of respiratory viruses and Mycoplasma pneumoniae (MP) post-COVID-19 pandemic, involved examining nasopharyngeal aspirates/throat swabs and peripheral blood samples of 70,016 patients using advanced detection methods. The study highlighted a persistent prevalence of MP and a notable increase in influenza cases, diverging from pre-pandemic patterns. Specifically, MP was the most frequently detected pathogen, indicating a deviation from its traditional seasonal trend. The resurgence of influenza, particularly noted towards the end of November, raises concerns about potential increases in hospitalization rates due to accumulated immune debt, underscoring the importance of seasonal influenza vaccinations for children. These findings emphasize the need for enhanced surveillance and preventative strategies against ARIs, especially in the wake of shifting epidemiological patterns post-pandemic. The study, while limited by its retrospective nature and focus on a single center, calls for the establishment of a multicenter, prospective ARI surveillance system to better understand and mitigate the impacts of respiratory pathogens on vulnerable populations.

   For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.027

Trends in Respiratory Infectious Pathogens in Children Underthe Age of 14 — Xiamen City, Fujian Province, China, 2017–2023

   A comprehensive seven-year study conducted by the Women and Children's Hospital, School of Medicine, Xiamen University, offers vital insights into the shifting landscape of respiratory infections in children. Covering the period from 2017 to 2023, the research focused on pediatric patients with respiratory tract infections, examining the prevalence of major respiratory pathogens - five viruses, five bacteria, and Mycoplasma pneumoniae. The study is notable for its extensive sample collection: 25,506 virus detection samples, 21,640 bacterial detection samples, and 23,579 pneumonia detection samples. Notably, there was a significant decline in respiratory infections during 2020 and 2021, attributed to non-pharmaceutical interventions (NPIs) implemented during this period. However, the study found a subsequent resurgence in various pathogens, with Mycoplasma pneumoniae and several viruses like Respiratory syncytial virus (RSV), adenovirus, influenza A and B, and parainfluenza showing an alarming increase in recent months. This resurgence underscores the urgent need for enhanced surveillance and rapid diagnostics in the healthcare system. The study's findings are crucial for guiding targeted preventive measures and efficient management of medical resources in combating respiratory infections. However, limitations include the focus on only 11 pathogens and the use of different detection methods over the years, which might affect data comparability. This study provides essential epidemiological data, emphasizing the dynamic nature of respiratory pathogen prevalence and the need for ongoing vigilance in public health monitoring.

   For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.028

A Case of an 86-Year-Old Male Survivor with Human Respiratory Syncytial Virus and SARS-CoV-2 Virus Coinfection

   In a revealing study, researchers reported the successful recovery of an 86-year-old male patient from pneumonia caused by a rare coinfection of human respiratory syncytial virus (HRSV) subtype B and SARS-CoV-2, marking the oldest recorded case of such dual infection. Admitted with severe respiratory symptoms, the patient's early diagnosis and comprehensive treatment and excellent nursing service at the First Affiliated Hospital, Zhejiang University School of Medicine, led to a significant improvement and full recovery after a 13-day hospital stay. This case underscores the resilience against severe outcomes from coinfections in older adults, particularly those with prior vaccination, challenging previous assumptions about the heightened risks associated with multiple respiratory pathogens in this demographic. Furthermore, the study highlights the critical role of early and accurate multi-etiologic diagnosis and symptomatic care, and stringent infection control measures in managing respiratory infections among the elderly. It also emphasizes the importance of increasing vaccination coverage for respiratory infections to reduce morbidity and mortality in older populations. This case contributes valuable insights into the clinical management and public health policies aimed at protecting vulnerable groups, especially in the context of easing COVID-19 restrictions and the concurrent circulation of multiple respiratory viruses.

   For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.030