Respiratory infections are on the rise, experts say: priority to etiological examination and then targeted treatment.
Winter is a high-risk season for respiratory infectious diseases. On January 9, 2025, the Chinese Center for Disease Control and Prevention released the national surveillance report on acute respiratory infectious diseases for the first week of 2025 (December 30, 2024 – January 5, 2025). The positive pathogens detected in respiratory samples from outpatient and emergency clinic cases at sentinel hospitals with flu-like symptoms are mainly influenza virus, human metapneumovirus, and rhinovirus. The positive pathogens detected in respiratory samples from severe acute respiratory infection cases in hospital are mainly influenza virus, Mycoplasma pneumoniae, and human metapneumovirus.
The result analysis shows that the overall trend of acute respiratory infectious diseases continues to rise, and there are differences in the trends of infection caused by different pathogens. Influenza is still in the seasonal outbreak period, and the positive rate of influenza virus has increased slowly. Among them, the positive rate of influenza virus in outpatient and emergency clinic cases of flu-like symptoms across the country has increased by 3.8% compared with last week, but it is still lower than the level of last year’s same period. It is expected that the level of flu activity may gradually decrease in the middle and late part of the month, and there are differences in flu activity levels among different provinces.
The analysis shows that the positive rate of human metapneumovirus is fluctuating at a high level, with a slow rise in the positive rate in northern provinces and a decrease in the positive rate among cases aged 14 years and younger. The positive rate of respiratory syncytial virus is fluctuating among cases aged 0-4 years. The positive rates of rhinovirus, adenovirus, and Mycoplasma pneumoniae continue to decline. New coronavirus and other respiratory pathogens are at a low level of prevalence.
Recently, Li Dongang, a chief physician of the Comprehensive Department of Infectious Diseases at Beijing You’an Hospital, stated in an interview with The Paper (www.thepaper.cn) that winter and spring are high-risk seasons for acute respiratory infectious diseases in China. Currently, influenza virus is on the rise, while Mycoplasma is on the decline. Human metapneumovirus, adenovirus, and rhinovirus are generally in a fluctuating state and may increase with further temperature drop. However, they may decrease due to reduced gathering after students go on holiday.
Lu Hongzhou, Director of the Third People’s Hospital of Shenzhen and Director of the National Clinical Research Center for Infectious Diseases stated to The Paper that with the popularization of pathogenic detection technology in China, the detection rate of various pathogens has increased, and the trends of infection caused by different pathogens are also different. For example, influenza is prevalent in autumn and winter, while COVID-19 exists throughout the year, with peak incidence at certain times but no clear trend yet.
“For children, we need to be vigilant about influenza viruses,” Lu Hongzhou mentioned. Firstly, there are specific antiviral drugs for influenza viruses such as oseltamivir and baloxavir marboxil which can improve symptoms and reduce the incidence of severe illness within 48 hours of illness onset. Secondly, influenza viruses are prone to cause cluster outbreaks in schools and kindergartens, amplifying transmission and leading to events such as student closures.
Regarding treatment for influenza, Wang An, a chief physician at Beijing Children’s Hospital stated at a press conference held by the National Health Commission on January 5th that antiviral therapy and targeted treatment are the main approaches for influenza infection. There are specific antiviral drugs available for children which should be used as soon as possible under the guidance of a doctor, especially within 48 hours of illness onset. Antibiotics are not effective against influenza viruses. Symptomatic treatment mainly focuses on fever reduction and discomfort relief. Parents can choose and use antipyretic drugs according to their child’s age and weight, and also use drugs to relieve symptoms such as cough and nasal congestion.
During the high season for influenza, sales of anti-flu drugs will experience significant growth. It has been reported that baloxavir marboxil (Xuelongda) is currently out of stock in many chain pharmacies.
“It is better to perform respiratory pathogen detection to identify which pathogen is causing the infection,” Li Dongang suggested. It is necessary to identify the type of respiratory infection caused by the pathogen first, and then use anti-infection drugs as soon as possible if diagnosed with influenza or Mycoplasma pneumonia. There is no need to stockpile too many drugs at home.
The symptoms of infection with human metapneumovirus can be relieved within about a week. In addition to influenza virus, “human metapneumovirus” has also become a viral name that many people pay attention to recently. The周报 released by the Chinese Center for Disease Control shows that the positive rate of human metapneumovirus is fluctuating at a high level, with a slow rise in the positive rate in northern provinces and a
