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PANDEMIC ALERT LEVEL
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Now tracking the new emerging South Africa Omicron Variant

China november 2023

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Dutch Josh View Drop Down
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    Posted: November 24 2023 at 12:29am

DJ From Chinese sources; 

[url]https://www.globaltimes.cn/page/202311/1302400.shtml[/url] or https://www.globaltimes.cn/page/202311/1302400.shtml ;

China's health authorities advised medical institutes to implement hierarchical medical diagnosis mechanisms to relieve medical pressure in major hospitals amidst a spike in respiratory diseases and pneumonia across the country, especially among children. 

The National Health Commission (NHC) has been monitoring the diagnosis among vulnerable children during the high incidence of infectious diseases, for which, the NHC has guided local medical institutes to allocate resources properly and adopt a hierarchical medical diagnosis mechanism, an official from the NHC said during an interview with the Xinhua News Agency on Thursday.

The official advised that minors who have relatively mild symptoms should see doctors at local clinics or the pediatric department of general hospitals to avoid dense gatherings and long wait times at major hospitals. 

Mycoplasma infection, influenza and adenovirus infection are among the common respiratory diseases currently prevalent in China. Recently, the number of patients infected with mycoplasma has been declining, but other respiratory viral infections such as influenza are on the rise, media reported, citing respiratory experts.

In the week of November 13-19, the positive rate of influenza virus detection continued to rise in the southern and northern provinces, with the A (H3N2) subtype predominating, followed by B (Victoria), according to the newest weekly report on Thursday from China's National Influenza Center.

"I brought my kid to Beijing Children's Hospital a few days ago. It was fully packed. There were 300 people in front of us waiting. We waited four hours until afternoon to see a doctor," Liu, a mother of a 4-year-old, told the Global Times. 

It may be China has to find out what is happening themselves...More still learning than hiding....

[url]https://afludiary.blogspot.com/2023/11/who-statement-on-reports-of-clusters-of.html[/url] or https://afludiary.blogspot.com/2023/11/who-statement-on-reports-of-clusters-of.html ;

A little over 24 hours ago ProMed published an RFI (Request for Information) after posting a report from a Taiwan media source on a surge in `Undiagnosed pneumonia' - primarily in children - hospitalized in Beijing and Liaoning Provinces in China. 

While obviously concerning, `undiagnosed pneumonia' covers a lot of territory, and its been well documented (see FluTrackers threads herehere, and here) that for the past couple of months China as been dealing with a surge in respiratory illness, particularly in children.

The `official' Chinese explanation has been `Mycoplasma pneumonia', but this time of year it is more  likely to be a mixture of respiratory viruses (flu, RSV, COVID, etc.) on top of any CAP (Community Acquired Pneumonia).  

China has a history of being less than forthcoming when it comes to disease outbreaks (see EID Journal: Estimate of COVID-19 Deaths, China, December 2022–February 2023), and so something more exotic can't be ruled out.

Overnight the World Health Organization posted the following statement on Twitter/X.  I'll return with a postscript after the break.


WHO statement on reported clusters of respiratory illness in children in northern China

WHO has made an official request to #China for detailed information on an increase in respiratory illnesses and reported clusters of pneumonia in children.

At a press conference on 13 November 2023, Chinese authorities from the National Health Commission reported an increase in incidence of respiratory diseases in China. 

Chinese authorities attributed this increase to the lifting of COVID-19 restrictions and the circulation of known pathogens such as influenza, mycoplasma pneumoniae (a common bacterial infection which typically affects younger children), respiratory syncytial virus (RSV), and SARS-CoV-2 (the virus that causes COVID-19). Authorities stressed the need for enhanced disease surveillance in healthcare facilities and community settings, as well as strengthening the capacity of the health system to manage patients.

On 21 November, media and ProMED reported clusters of undiagnosed pneumonia in children in northern China. It is unclear if these are associated with the overall increase in respiratory infections previously reported by Chinese authorities, or separate events.

On 22 November, WHO requested additional epidemiologic and clinical information, as well as laboratory results from these reported clusters among children, through the International Health Regulations mechanism.

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.

WHO is also in contact with clinicians and scientists through our existing technical partnerships and networks in China.

Since mid-October, northern China has reported an increase in influenza-like illness compared to the same period in the previous three years. 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.

WHO will continue to provide updates.

While this may be nothing more than a post-COVID surge in already-known seasonal respiratory illnesses, China often treats bad news as a national security issue - and with reports of their economy faltering, and growing dissent in the population - they may well be downplaying a more serious situation.  

It certainly wouldn't be the first time (see The China Syndrome). We've are also seen a slowdown in reports of HPAI H5N6, - and other avian flu viruses - from China over the past year.

But China is far from alone in strategically dispensing disease outbreak information (see Flying Blind In The Viral Storm). Much of the world has dismantled their COVID surveillance and reporting apparatus, and surveillance and reporting on other emerging infectious diseases (like like novel flu & MERS-CoV) have serious gaps as well. 

Regardless of what comes out of this week's reports of an `unidentified pneumonia' in China, you can be assured another global disease threat will emerge.

It's simply a matter of time. 

DJ...we all should know lots of diseases may become a growing risk...

We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 24 2023 at 2:27am

pcusick provided the [url]https://www.cidrap.umn.edu/covid-19/undiagnosed-pneumonia-outbreak-china-puts-pressure-pediatric-hospitals-prompts-questions[/url] or https://www.cidrap.umn.edu/covid-19/undiagnosed-pneumonia-outbreak-china-puts-pressure-pediatric-hospitals-prompts-questions link;

An undetermined pneumonia outbreak in China is hitting children hard, with media reports describing overwhelmed children's hospitals in multiple locations, according a post on ProMED Mail, the online reporting system of the International Society for Infectious Diseases. So far, there is no indication that the infections are deadly. But reports of a spike in pneumonia cases in China are eerily similar to early reports of a mystery pneumonia outbreak in late 2019 in Wuhan, which heralded the emergence of COVID-19.

DJ, What info needs to be made public when ? Most (western) countries have given up on (CoViD) testing, sequencing, reporting...so to claim "China is hiding info" in my view is a bit far fetched...Lots of countries will keep disease spread in the military "less open"...

Another question is how much time does a country need to get a "picture of unfolding events"....Is it better to be open when you are still in the dark on unfolding events ? Is avoiding panic wise ? 

Some observers speculate the outbreak could be caused by Mycoplasma pneumoniae, commonly known as "walking pneumonia." FluTrackers, an infectious disease news message board, has been tracking reports of overwhelmed pediatric hospitals and clinics and Mycoplasma pneumonia since the beginning of summer.

Speculations can do a lot of damage...good open info can avoid part of the damage...

[url]https://www.wormsandgermsblog.com/2023/11/articles/animals/dogs/mystery-dog-respiratory-disease-or-not-and-antibiotics-or-not/[/url] or https://www.wormsandgermsblog.com/2023/11/articles/animals/dogs/mystery-dog-respiratory-disease-or-not-and-antibiotics-or-not/ 

Despite lots of media attention and associated fear, we’re still not sure what’s going on with all these coughing dogs, or even if there’s really a story at all. 

DJ...US dogs also see a "mysterious respitory disease"...Lots of countries do see "more respitory problems in children"....So RSV may explain part of the story...there is also flu, CoViD...

⚠️UNDIAGNOSED PNEUMONIA OUTBREAK—An emerging large outbreak of pneumonia in China, with pediatric hospitals in Beijing, Liaoning overwhelmed with sick children, & many schools suspended. Beijing Children's Hospital overflowing. 🧵on what we know so far:

Dr. Eric Ding -among many others- trying to "get a view" on Chinese "events"....Maybe because of US thanksgiving he did not have new info...

[url]https://www.thailandmedical.news/news/new-rsv-strain-in-china-infecting-children-with-existing-sars-cov-2-impaired-innate-immunity,-paving-the-way-for-opportunistic-mycoplasma-pneumoniae[/url] or https://www.thailandmedical.news/news/new-rsv-strain-in-china-infecting-children-with-existing-sars-cov-2-impaired-innate-immunity,-paving-the-way-for-opportunistic-mycoplasma-pneumoniae A new RSV virus in children with decreased immunity after CoViD would explain the China healthstory...

May also be a factor in lots of other countries...But "China" would be the starter for CoViD/SARS-2...

DJ, Very likely [url]https://en.wikipedia.org/wiki/2019_Military_World_Games[/url] or https://en.wikipedia.org/wiki/2019_Military_World_GamesThe 2019 Military World Games (Chinese2019年世界军人运动会pinyinnián shìjiè jūnrén yùndònghuì), officially known as the 7th CISM Military World Games, (Chinese第七届世界军人运动会pinyindì qī jiè shìjiè jūnrén yùndònghuì) and commonly known as Wuhan 2019, was held from October 18–27, 2019 in WuhanHubeiChina.[2][3]

did play a role in the start of global spread of CoViD....[url]https://en.wikipedia.org/wiki/Origin_of_COVID-19[/url] or https://en.wikipedia.org/wiki/Origin_of_COVID-19Available evidence suggests that the SARS-CoV-2 virus was originally harbored by bats, and spread to humans from infected wild animals, functioning as an intermediate host, at the Huanan Seafood Market in Wuhan, Hubei, China, in December 2019.

DJ...so if the Wuhan military games were a factor spread of CoViD started earlier than december 2019...

[url]https://en.wikipedia.org/wiki/Origin_of_COVID-19#Mojiang_mine_incident[/url] or https://en.wikipedia.org/wiki/Origin_of_COVID-19#Mojiang_mine_incident ;

Another proposed origin scenario relates to a 2012 incident involving six miners in an abandoned mining cave near the town of Tongguan in Mojiang county, YunnanChina. Six miners cleaning bat feces fell ill, three of whom died from fatal pneumonia.[89] Out of concerns that the miner's cases could represent a novel disease,[90] serum samples collected from the miners were sent to the Wuhan Institute of Virology and tested by Shi Zhengli and her group for various fatal viruses including Ebola virusNipah virus, and SARS-related coronaviruses

DJ,  SARS-1 in 2003 was Hong Kong China linked [url]https://en.wikipedia.org/wiki/SARS-CoV-1#Origin_and_evolutionary_history[/url] or https://en.wikipedia.org/wiki/SARS-CoV-1#Origin_and_evolutionary_historyIn March 2003, WHO established a global network of leading laboratories to collaborate in the identification of the causative agent of SARS. Early on, labs in the network narrowed the search to members of the paramyxovirus and coronavirus families. Early findings shared by the labs pointed to coronaviruses with increasing consistency. On 21 March, scientists from the University of Hong Kong announced the isolation of a new virus that was strongly suspected to be the causative agent of SARS.[16]

DJ, In time action and good border checks, but also less travel (from Hong Kong) limited SARS-1...Both SARS-1 and SARS-2 are linked to China (and travel-foe economy reasons that aspect is ignored). In my view-based on earlier samples being detected in 2019 outside China-SARS-2 could even have been imported into Wuhan...[url]https://www.coronaheadsup.com/science/origins/sars-cov-2-in-angola-from-23rd-september-2019/[/url] or https://www.coronaheadsup.com/science/origins/sars-cov-2-in-angola-from-23rd-september-2019/ ...blood/sewage samples go back even further in several countries...

So-yes-it is good to keep an eye on China...could there even be a SARS-3 ??? But we should not forget lots of other countries/regions-with much less healthcare/monitoring may be even higher risk...

My country-NL-is the fifth largest food exporter in the world. Second largest agri-culture exporter after the US (due to Dutch flowers...). From blue-tongue virus to H5N1...NL has a lot of animal diseases...Even very good science/monitoring is NOT 100% perfect...

So-an over focus on China may miss lots of other (much higher) risks...

We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 24 2023 at 1:22pm
Now it has spread to #Shanghai. It's rumored that as many as 400 K people were infected in Shanghai in just one day, and it's expected that there will be 1 million new infections daily by next week.   All 100 medical staff in the emergency department of Shanghai Zhongshan Hospital (中山医院) have been infected. P1: #Pediatric Hospital of #FudanUniversity  P2: Shanghai #Children's Hospital P3: Nighttime medicine dispensary window at Shanghai Children's Hospital P4: Shanghai Children's Hospital is overwhelmed with patients.

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#COVID Returns, Never Left, or a New #Virus Emerges? Recently, numerous cities across #China have seen children's hospitals overcrowded, with a widespread online circulation of news about mass infections among medical staff. There's been a surge in cases of children suffering from fever, common cold, #respiratory infections, and even cases of so-called ‘white lung' or reported deaths. What is happening? Watch to find out! #COVID19 #pandemic #CCPVirus #CCP

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DJ-Source is anti-China "news"...still alarming...

WHO: Upsurge of respiratory illnesses among children-Northern China "Chinese authorities advised that there has been no detection of any unusual or novel pathogens or unusual clinical presentations, including in Beijing and Liaoning." 23 November 2023

-[url]https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON494[/url] or https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON494 

Is there a real crisis in China or is it a propaganda war ?

We cannot solve our problems with the same thinking we used when we created them.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 25 2023 at 1:29am







China and now France are having serious epidemics, and the suspected culprit is mycoplasma pneumoniae. One possible explanation is that COVID-mediated immune damage, leading to lymphocytopenia, is causing opportunistic disease of higher severity. Thread with citations below:

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We know that COVID can cause lymphocytopenia and that reinfection is common. It's in the Merck Manual for MDs. COVID is the only virus other than HIV specifically listed as a major cause of lymphocytopenia: https://merckmanuals.com/en-ca/professional/hematology-and-oncology/leukopenias/lymphocytopenia /2

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Immunology is incredibly complex, but certainly it is clear that T cell exhaustion & depletion are common features of COVID. There are many papers in various journals, but this one provides a closer to layperson explanation of some COVID harms: https://biosignaling.biomedcentral.com/articles/10.1186/s12964-022-00856-w /3

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Now consider: "The severity of pulmonary lesions [from mycoplasma pneumoniae] was associated with lower lymphocyte count and higher sero-negativity of diagnostic IgM antibodies at presentation." https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-10-48 /6

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Some research shows that mycoplasma severity is tied to CD4 and CD8 cell activity. "Depletion of CD8+ T cells exacerbates CD4+ Th cell-associated inflammatory lesions during murine mycoplasma respiratory disease" https://pubmed.ncbi.nlm.nih.gov/11907110/

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COVID infection is known to deplete CD8 in some individuals and it also has been shown to reduce CD8 immune response: https://news-medical.net/news/20230322/SARS-CoV-2-infection-damages-CD82b-T-cell-response.aspx#:~:text=In%20a%20recent%20study%20published,(COVID%2D19)%20vaccinations. /9

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If even a few percent more children get sick enough to be hospitalized because of COVID-induced immune dysfunction, that's enough to overrun pediatric hospitals and cause health care collapse. Many other diseases could also surge because of immune dysfunction. /10

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Disclaimer: I'm not a scientist, I just critically appraise some aspects of science for a living. That is why I present this as merely a possible explanation. I would be very interested to engage with experts on this in the replies and gather thoughts and criticisms. /11

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Note that children are highly under-vaccinated against COVID, especially relative to adults. Meaning that beyond existing physiological reasons why children sometimes get more severe disease than adults, there's also the obvious reason that we allowed COVID to ravage them. /12

DJ...France now also may be seeing a "China-like" health issue most in children ? Very likely linked to damage after CoViD infection....

[url]https://www.globaltimes.cn/page/202311/1302474.shtml[/url] or https://www.globaltimes.cn/page/202311/1302474.shtml ;

The respiratory cases that are currently being reported by the country's monitoring and hospital systems were caused by already known infectious agents, China's National Health Commission (NHC) said on Friday, after the World Health Organization (WHO) expressed concern over the country's increasing respiratory illnesses and reported clusters of pneumonia in children.

NHC said at a Friday press conference that it held an online video conference with the WHO over respiratory infectious diseases on Thursday. Experts from China's National Administration of Disease Prevention and Control, Chinese Center for Disease Control and Prevention, and National Children's Medical Center present at the meeting outlined the recent epidemic trend, pathogen monitoring, clinical diagnosis and treatment, as well as health education in China.

The country has seen a spike in respiratory infectious diseases including influenza, mycoplasma infection and pneumonia.

DJ...so "normal infections" resulting in abnormal reactions because of previous CoViD infection(s) damaging immunity...

------

[url]https://www.thailandmedical.news/news/breaking-medical-news-crisis-unfolding-new-feline-canine-coronavirus-hybrid-sparks-global-concern-among-scientist-despite-attempted-coverups[/url] or https://www.thailandmedical.news/news/breaking-medical-news-crisis-unfolding-new-feline-canine-coronavirus-hybrid-sparks-global-concern-among-scientist-despite-attempted-coverups making matters more complex; Lots of other variants of CoViD and -possibly ???- a new CoViD form -first detected in cats in Cyprus- could be spreading...

Another note; China at least is reporting this problem...lots of countries stopped testing/sequencing/monitoring so they may have the same kind of problem but are not even signaling it yet....

We cannot solve our problems with the same thinking we used when we created them.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 28 2023 at 1:41am

[url]https://www.irishtimes.com/ireland/social-affairs/2023/11/26/bacterial-infection-causing-concern-in-china-detected-in-ireland/[/url] or https://www.irishtimes.com/ireland/social-affairs/2023/11/26/bacterial-infection-causing-concern-in-china-detected-in-ireland/ ;

A bacterial infection implicated in a surge in respiratory illnesses in China is on the rise in the community in Ireland, authorities have confirmed.

An outbreak of mycoplasma pneumoniae notified to the Health Protection Surveillance Centre (HPSC) last month was the first in “a number of years”, it said.

A recent spike in respiratory illness and clusters of pneumonia in children in China led to an official request from the World Health Organisation last week for more information. It has also stoked unpleasant memories of the origins of the Covid-19 pandemic in the same country in late 2019.

China says it has not detected any unusual or new diseases on this occasion and has attributed the rise in illnesses to Covid-19, respiratory syncytial virus (RSV) and mycoplasma pneumoniae.

DJ, After CoViD children may be more vulnerable for all kinds of other infections...Adults did see (more) CoViD vaccinations resulting in less CoVid caused decreased immunity...

So not only China now also France, Ireland report the same kind of healthissues...

"Last week, approximately 80 children between the ages of five and fourteen had pneumonia per 100,000 inhabitants. An increase was also visible in the winter of 2022, but the peak remained at 60 children per 100,000 inhabitants."

Here in NL we do see an increase of all kinds of diseases in (most) children. [url]https://en.wikipedia.org/wiki/Whooping_cough[/url] or https://en.wikipedia.org/wiki/Whooping_cough a problem in my region ( [url]https://www.gelderlander.nl/arnhem/kinkhoest-steekt-de-kop-op-gelderland-hotspot-gaat-vooral-om-jonge-kinderen~abb88e59/[/url] or https://www.gelderlander.nl/arnhem/kinkhoest-steekt-de-kop-op-gelderland-hotspot-gaat-vooral-om-jonge-kinderen~abb88e59/ )

In the first winter of the post-pandemic era, the cases of acute respiratory diseases, including influenza, rhinovirus and mycoplasma pneumonia, continue to rise across China with the superposition of multiple respiratory diseases, according to the national health authority on Sunday.

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Influenza is a major respiratory disease in people of all ages. Additionally, rhinovirus infection is also predominant in people age 0-4, mycoplasma pneumonia and adenovirus infections are also predominant in people age 5-14, rhinovirus infection and COVID-19 are predominant in people age 15-59, while human metapneumovirus and common coronavirus infections are predominant in people age 60 and above, according to Wang.

DJ...the story also comes up with "immunity gap" as part of the reasons why we see more diseases in children in China. However that idea maybe only explains immunity in very young-very protected children...Co-infection with several diseases (linked with less immunity after CoViD) could in part also explain more severe disease...

Statistics on excess deaths indicate still higher number of deaths in less vaccinated age groups 0-44 y/o

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[url]https://www.globaltimes.cn/page/202311/1302731.shtml[/url] or https://www.globaltimes.cn/page/202311/1302731.shtml ;

From providing more beds for pneumonia treatment and allocating more manpower to extending working hours, hospitals across China are grappling with a surge in cases of respiratory illnesses in children, especially a spike in mycoplasma pneumonia. 

But the Global Times learned from several hospitals and clinics in Beijing, Shanghi and Central China's Henan Province that though facing an obvious increase in outpatient and inpatient visits for respiratory illnesses this winter, the health system has not been overwhelmed as it did during the early stage of the fight against COVID-19.

The Capital Institute of Pediatrics, a Beijing-headquartered renowned hospital for children, which has been one of the top choices for Beijing parents when their children get sick, has made several improvements to enhance its medical treatment capability - raising the number of infusion seats by 48.7 percent on the daily basis compared to their usual capacity, and also expanding the number of beds available for patients with pneumonia by 40.58 percent, according to Beijing Youth Daily.

See also [url]https://flutrackers.com/forum/forum/china-other-health-threats/china-pneumonia-respiratory-and-influenza-like-illnesses-ili/982359-china-pediatric-hospitals-full-with-seasonal-flu-mycoplasma-pneumonia-patients-guangzhou-guangdong-province-november-27-2023[/url] or https://flutrackers.com/forum/forum/china-other-health-threats/china-pneumonia-respiratory-and-influenza-like-illnesses-ili/982359-china-pediatric-hospitals-full-with-seasonal-flu-mycoplasma-pneumonia-patients-guangzhou-guangdong-province-november-27-2023 ;

In the clinic of Wu Zhu, head of the pediatric outpatient and emergency department of Zhujiang Hospital of Southern Medical University, the number of patients is also running at a high level. According to his recent observations, the number of children infected with Mycoplasma pneumoniae has declined, while influenza is on the rise, with influenza B being the dominant category.

so no mention of any human H3N3-flu

[url]https://en.wikipedia.org/wiki/Mycoplasma_pneumoniae[/url] or https://en.wikipedia.org/wiki/Mycoplasma_pneumoniae ;

Mycoplasma pneumoniae is a very small bacterium in the class Mollicutes. It is a human pathogen that causes the disease mycoplasma pneumonia, a form of atypical bacterial pneumonia related to cold agglutinin diseaseM. pneumoniae is characterized by the absence of a peptidoglycan cell wall and resulting resistance to many antibacterial agents. The persistence of M. pneumoniae infections even after treatment is associated with its ability to mimic host cell surface composition

Soon will be a global problem...

We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein
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