Pneumonia of unknown etiology, or PUE for short, is a worrying diagnosis.
It means the sufferer has all the worst symptoms of flu (lung lesions, a high fever and difficulty breathing) but that underlying virus cannot be identified – in many cases because it is new, or infecting humans for the first time.
This was case with the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 – SARs infected 8,096 worldwide and killed 744. To this day the World Health Organisation is unsure how that particular strain of coronavirus jumped from animals to humans.
This month fears of another SARS-like outbreak began to circulate when it emerged that dozens of people in the central Chinese city of Wuhan had fallen ill with an unidentifiable form of pneumonia.
Making matters worse, the news leaked out through social media in the form of a document intended for hospital use only.
This again brought back memories of SARS, which the government was initially accused of trying to cover up (SARS first emerged in southern China, but quickly spread to Beijing, Hong Kong, Singapore and Toronto).
That feeling was reinforced when social media platforms began to strike out discussion of the latest outbreak and eight Wuhan residents were arrested for posting messages saying that that the new illness was in fact a recurrence of SARS – something medical experts have now officially ruled out.
So what then is the mysteryinfection that has sickened 59 people thus far – seven of whom fell seriously ill in Hubei’s capital?
The short answer is that health experts still don’t know. On January 5 the Wuhan Municipal Health Commission announced it had ruled out SARS, bird flu and Middle East Respiratory syndrome, also known as camel flu.
But the working hypothesis is that like avian flu and SARS, the illness is zoonotic – i.e. that humans have contracted it from animals.
Health officials believe the epicentre of the outbreak was probably Wuhan’s Huanan Seafood Market, which also sells wild game and other rare meats. The market has now been closed and disinfected – and the number of new infections has slowed. As far as the medical exports know, the illness doesn’t have the capacity to pass from human to human either.
Speaking to the Changjiang Daily, the director of the Wuhan Centre of Disease Control said that his team were searching for new cases of the illness, which is why the number of recorded infections continued to grow even after the market was shut down.
All those thought to be infected had been put in medical isolation, he said, and those who had come into contact with them were being closely monitored as well.
“The public still needs to maintain good living and hygiene habits, wash their hands frequently, maintain indoor air circulation, properly open windows for ventilation, and get vaccinated against flu,” the director added.
Meanwhile the WHO has said that the outbreak doesn’t yet warrant the imposition of travel restrictions in China, though it did note that “there is limited information to determine the over-all risk of this reported cluster of pneumonia” – a line which could be read as criticism or a simple statement of scientific fact.
Other commentary has been more negative, claiming that the Chinese were slow to notify international organisations about the outbreak: the WHO was formally informed on December 31, it said, but the first cases began to appear at the start of the month. Public health experts in Hong Kong and Singapore, in particular, have expressed frustration that China was not more forthcoming early on. Both cities have had to hospitalise people who became ill after visiting Wuhan.
China’s media largely rebutted the criticism, saying that its authorities had moved on from an older, reflexive mode of cover-up.
“As government departments ensure that information is open and transparent, public confidence has doubled,” the China Daily said. “It turns out that in major or unexpected events, transparent information can prevent the spread of rumours and public panic,” it added, in a surprised tone. Others remarked that the 2003 debacle around SARS meant that China now has a much improved system of internal reporting and that most of the cases of suspected infection in Wuhan were sent up the communication chain within a day.
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