WHO asks China for details after surge in respiratory illness among children

China is seeing the circulation of multiple infectious respiratory illnesses this winter, with surging cases of mycoplasma pneumonia, and rising cases of influenza flu.

The WHO on Thursday said it has made an official request to China for detailed information on a spike in respiratory illnesses after the Chinese health authorities reported multiple infectious respiratory diseases with surging cases of mycoplasma pneumonia and influenza flu among children.

Earlier this month, Chinese experts also sounded an alert about the relapse of COVID-19 infections during the current winter season and asked elderly and vulnerable populations to get vaccinated.

The World Health Organisation (WHO) in a statement issued in Geneva said it had requested China to provide additional epidemiologic and clinical information, as well as laboratory results from reports of clusters of pneumonia in children through the International Health Regulations mechanism.

The WHO statement calling on information from China was seen as an attempt to secure official information in time unlike in 2019 when the global health body came under strong criticism for the delay in getting timely reports from Beijing on the breakout of the coronavirus, which later spiralled into a massive pandemic causing millions of deaths all over the world.

“We have also requested further information about recent trends in the circulation of known pathogens including influenza, SARS-CoV-2, RSV and mycoplasma pneumoniae, and the current burden on health care systems,” the WHO statement said.

“WHO is also in contact with clinicians and scientists through our existing technical partnerships and networks in China,” it said.

The statement by the global health body was in response to remarks by Mi Feng, spokesman of the National Health Commission, at a news conference here on November 13 that as winter approaches, China has entered the peak season for respiratory illnesses, and different viruses or pathogens are circulating simultaneously.

“Efforts should be made to monitor the spread of mycoplasma pneumonia, COVID-19, influenza flu, as well as dengue fever and norovirus infections, to step up surveillance and early warnings so as to understand the spread of these viruses and their mutations,” he said.

Chinese health experts said mycoplasma pneumoniae—a pathogen that commonly causes sore throat, fatigue, fever and a lingering cough that can last for months in children aged five and above—has drawn heightened attention this winter as hospitals nationwide have seen young patients swarming there to seek treatment.

China is seeing the circulation of multiple infectious respiratory illnesses this winter, with surging cases of mycoplasma pneumonia, and rising cases of influenza flu, but a downward trend in COVID-19 cases in recent days, according to a report in the state-run China Daily.

Chinese officials and experts have so far attributed the spread of pneumonia and other respiratory diseases among children to the lifting of Covid-19 measures, which included the wearing of masks, and the simultaneous circulation of multiple common pathogens.

Though Covid-19 is among the circulating pathogens, it has not been named as a top cause for the surge, the Hong Kong-based South China Morning Post reported on Thursday.

In September and October, the mycoplasma pneumoniae bacteria was the major cause of respiratory diseases among children across China, with many hospitals reporting a spike in young patients seeking treatment, the report said.

Paediatrics expert Wei Tianli at the Beijing Friendship Hospital was quoted by the city’s health authorities as saying that while mycoplasma pneumoniae infections surged every three to five years, the symptoms had become more serious this time.

The severity could be a result of the bacteria developing drug resistance against azithromycin, an antibiotic, Wei said. Some children can also become seriously sick when they are infected with more than one pathogen at once.

Wang Dayan, director of the China National Influenza Centre administered by the Chinese Centre for Disease Control and Prevention, said that flu activities across the nation have been rising, with H3N2 the dominant strain.

In past years, the flu season for winter and spring usually runs from about mid-October to early March and peaks in January, she said.

Wang stressed that an effective way to prevent flu infections and reduce related serious cases and deaths is by expanding vaccinations.

Regarding COVID-19, Wang said the number of domestic cases has been on a downward trend since late August and the positivity rate of the disease at fever clinics and hospitals is declining consistently, according to the China Daily report.

China reported 209 severe COVID-19 cases and 24 related deaths in October, according to the China CDC.

However, Zhong Nanshan, a prominent respiratory illness expert, said during a conference recently that modelling shows that small spikes of COVID-19 infections will likely appear this month through to January.

The WHO statement said China has systems in place to capture information on trends in influenza, influenza-like illnesses, RSV and SARS-CoV-2, and reports to platforms such as the Global Influenza Surveillance and Response System.

“While WHO seeks this additional information, we recommend that people in China follow measures to reduce the risk of respiratory illness, which include recommended vaccination; keeping distance from people who are ill; staying home when ill; getting tested and medical care as needed; wearing masks as appropriate; ensuring good ventilation; and regular hand-washing,” it said.

Vitamin B12 could boost tissue repair, help treat ulcerative colitis

Share on PinterestA new study looks at how vitamin B12 could accelerate tissue repair, and why that matters. Image credit: Berena Alvarez/Stocksy.

• Tissue regeneration is the process of reconstructing damaged tissues and organs in the body to heal or replace them.
• The area of regenerative medicine is still new and researchers are looking at how they can use tissue regeneration for certain diseases.
• Researchers from the Institute for Research in Biomedicine in Spain found that vitamin B12 plays an important role in tissue regeneration.
• Scientists also reported vitamin B12 supplementation accelerated tissue repair in a model of ulcerative colitis.

Tissue regenerationTrusted Source — also commonly referred to as regenerative medicine — is the process of reconstructing damaged tissues and organs in the body to heal or replace them.

These tissues and organs could have been injured through aging, trauma, disease, or congenital defects.

The area of regenerative medicine is still new and experimental. ResearchersTrusted Source are looking at ways to use tissue regeneration in the treatment of diseases like heartTrusted Source injuries and disease, bone fracturesTrusted Source, cartilage diseasesTrusted Source, pancreatitisTrusted Source, and inflammatory bowel diseaseTrusted Source.

Now researchers from the Institute for Research in Biomedicine in Spain report evidence suggesting that vitamin B12 plays an important role in cellular reprogramming and tissue regeneration.

The findings were recently published in the journal Nature MetabolismTrusted Source.

Scientists tested their theory in a model of ulcerative colitis — a type of inflammatory bowel disease (IBD) — showing that intestinal cells trying to repair themselves would benefit from vitamin B12 supplementation.

Why look at vitamin B12? 

According to Dr. Manuel Serrano, a researcher at the Institute for Research in Biomedicine in Spain during the time of the study — who has recently moved to Altos Labs in the United Kingdom — and co-lead author of this study, they decided to study the impact of vitamin B12 on cellular reprogramming and tissue regeneration after an unexpected finding when they analyzed how the microbial populations of the colon change during reprogramming.

“The microbiota of mammals is in equilibrium with the host,” Dr. Serrano explained to Medical News Today. “If the host metabolism changes, it affects the microbiota and vice versa. We found that during reprogramming in mice, the microbiota presented changes indicative of a shortage of [vitamin] B12. [Vitamin] B12 is essential for mammals and also for bacteria.”

Past research shows vitamin B12 assists the body with repair, such as stimulating neurological tissues needed for restoring musclesTrusted Source or after nerves are damaged, such as by traumatic brain injuryTrusted Source.

Vitamin B12 has also been shown to play a protective role in bone healthTrusted Source.

And a study published in August 2022 found that vitamin B12 can help repair and regenerate skin damaged by radiodermatitisTrusted Source, a side effect of radiotherapy in cancer treatment.

Vitamin B12 and tissue regeneration

Using both mouse and cultured cell models, the researchers found that vitamin B12 supplementation increased the efficiency of cell reprogramming, which is considered to be an early stage of tissue repair.

Dr. Marta Kovatcheva, a researcher at the Institute for Research in Biomedicine in Spain and co-lead author of this study, explained to MNT how vitamin B12 assists with cellular reprogramming and tissue regeneration.

“[Vitamin] B12 is involved in just two metabolic reactions in mammals — including mice and humans — and one of these reactions is critical to [producing)] a chemical tag, more technically ‘a methyl donorTrusted Source’,” she told us. “This chemical group is used to ‘tag’ many regulatory proteins of the DNA and the DNA itself, and in doing so, the activity of the DNA is modified — the DNA is ‘reprogrammed’.”

“This ‘tagging’ is very complex and dynamic and, although not yet fully understood, it is key for determining the behavior of cells, including their ability to repair or regenerate tissue,” Dr. Kovatcheva detailed.

Treatment for ulcerative colitis and beyond

Drs. Serrano and Kovatcheva also led their team through testing their vitamin B12 theory on a mouse model of ulcerative colitis.

Researchers found that intestinal cells initiating repair undergo a process similar to cellular reprogramming, which could benefit from vitamin B12 supplementation. And they reported vitamin B12 supplementation accelerated tissue repair in the mouse model of ulcerative colitis.

Both scientists believe these findings may open new doors for regenerative medicine.

“B12 supplementation is simple, inexpensive, and safe,” Dr. Serrano commented. “I would be very curious to know how this affects, for example, the recovery of surgery patients.”

“There are diseases that could also benefit, such as colon ulcers,” Dr. Kovatcheva added. “In theory, every disease that involves an active process of injury could benefit from this. But of course, this will require proper clinical tests.”

Dr. Serrano was also part of anotherTrusted Source recently published study on vitamin B12, this one looking at the vitamin’s potential health benefits in lowering inflammation.

“In this study, led by Prof. Rosa Lamuela and Ramon Estruch from the University of Barcelona, we found that elevated levels of B12 in the blood of volunteers were associated with lower levels of inflammatory markers,” Dr. Serrano explained.

“These inflammatory markers reflect the existence of ongoing injuries and damages that may occur on a very local scale. The association between high B12 and low inflammation is in agreement with the idea that high B12 helps the body to resolve and repair tissue damage,” he added.

Shedding light on complex processes

After reviewing this study, Dr. Rosario Ligresti, chief of the Division of Gastroenterology and director of The Pancreas Center at Hackensack University Medical Center, and associate professor of medicine at Hackensack Meridian School of Medicine told MNT he found the research fascinating.

 “As highlighted in this paper, in the gastrointestinal tract this depends on two functioning systems: the microbiome and adequate levels of vitamin B12,” he added. “If either of these two factors are deficient or altered, intestinal tract regeneration is not nearly as effective as it could be.”

Dr. Babak Firoozi, a board-certified gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, agreed and said this adds to our current knowledge of regenerative medicine.

“Specifically for my field, for gastroenterology, because intestinal cells need to regenerate on a very constant level, anytime there’s damage you want to repair that damage in the right way, so you need to have the right tools,” Dr. Firoozi explained to MNT. “And specifically for vitamins, you need to have the right nutrients in order to have that done effectively and in the best way.”

Dr. Firoozi said he would like to see a therapy developed using B12 for ulcerative colitis.

“The problem with ulcerative colitis is that you get a lot of inflammation, very high cell turnover,” he added. “And it would be nice to see if you can not only halt that but also reverse it so that you could end up having normal tissue again.”

What foods are highest in vitamin B12? 

According to Dr. Ligresti, vitamin B12 deficiency is found in populations that consume a largely vegan diet, in older people due to malabsorption, and in people with chronic Helicobacter pylori infection.

For those looking to up their vitamin B12 intake, Dr. Firoozi said they will mainly find itTrusted Source in meat — including fish and chicken.

However, dairy products and eggs also naturally contain vitamin B12. Vegan- and vegetarian-friendly B12 sources include fortified plant milks, nutritional yeasts, fortified cereals, or supplements.

“Older patients may find that visiting their doctors for a monthly B12 shot is the easiest way to supplement their intake — oral B12 replacement is largely ineffective in older patients,” Dr. Firoozi also noted.

https://www.tribuneindia.com/news/world/who-asks-china-for-details-after-surge-in-respiratory-illness-among-children-565238