עלייה חדה בהידבקויות בנגיפים נשימתיים בסין — פרשנות

Cases of human metapneumovirus, or HMPV, are reportedly on the rise in China. Now China's neighbors, including Japan, Hong Kong, Taiwan, and Malaysia, are closely monitoring HMPV infections. To break down these concerning reports, we have Shoren Lin, member of the Committee of Present Danger China, and a former U.S. Army microbiologist. Shoren, good evening. Good evening, Brendan. Thank you for inviting me. Before we talk about anything else, what exactly is HMPV? What are the symptoms? So HMPV, human metapneumovirus, is actually very similar to respiratory syncytial virus. It's another negative sense RNA virus. And so it's a common respiratory pathogen, and it can cause infection in upper and lower respiratory tract. And the symptoms are very similar to flu, and usually it doesn't cause severe symptoms. And the primary target is actually children under five years old or seniors. And so in the past, it's a target routinely surveillanced, but it's not a high priority. So usually for a respiratory infection, you're first for flu, right? So whether it's influenza A or B, that's flu. And then you have coronavirus, and then you do ISV, respiratory syncytial virus. So human metapneumovirus is not on the top three yet. What kind of numbers are we seeing reported in terms of deaths, hospitalizations in China? And what about in terms of China's neighbors? I think so far, the data from China is very fragmented. The government dimension, this winter season, they see a huge spike of the HMTV. But exactly what are the cities or regions have a significantly jump versus other region that may be like a routine or similar level at the last two years? We don't know the detail yet. And the neighboring country that you mentioned, I think they are playing very good strategy to be very cautious, to be very observant to see anything unusual happening in China, because every country learn the lessons from the pandemic, COVID pandemic. So everybody want to be paying close attention to the public health situation inside China. The data from China is still very limited. We haven't seen any major hospitals have a clear declaration, say they are facing an outbreak at the endemic level, not even pandemic level, right? So we do see in China, many of the big hospitals have a lot of children going to see doctors and more hospitalizations, more respiratory infections, need a secondary care. We see these kind of reports, but it's a lot of this sporadic on the Internet. So the problem is that the Chinese government didn't provide systematic data or outside work to understand what's the real situation. We just passed the five-year anniversary of the SARS-CoV-2 outbreak in Wuhan. Does this, what you're seeing in the pattern of this virus, does it bear any resemblance to what happened five years ago? I doubt. I don't think the human metamorphosis will be a question that the whole public health community will be really, really cautious about it. I think what is really very interesting is the potential of the bird flu transmitting more into human transmission, right? So this year, we do see some bird flu cases, human-infected H5N1 cases in the United States, but it has not become a human-to-human transmission, like a sustained transmission. In the past, in China, we see H7N8, H10N8, these kind of human infection, and also H5N1 human infection case. And some of these have potential to be highly pathogenic and have potential to be gradually adapted to be more human-prone infections. So I think this is what the whole world is really watching on right now, besides coronavirus. So I think flu situation will be very unique, or whether we have a new strain of H1N1 become more pathogenic. We just need to be close, pay close attention to that. And we do see some report mentioning in China this season for the influenza virus infection, 99% are actually H1N1. So very, very little H3N2 seasonal. So this is a little bit unusual. We still in the early winter period right now, so we just need to pay close attention to what's going on inside China.