Not COVID, not flu: Mystery pneumonia emerges in Argentina, what we know — and do not know

Mystery pneumonia in Argentina

Three people have died, five hospitalised after developing a “pneumonia of unknown origin”

"Atypical pneumonia" reports reminiscent of initial stages in 2020 about unknown virus, later called SARS-CoV2, the virus that causes COVID-19.

A “mystery pneumonia” has reportedly killed three and infected nine in Argentina, health authorities reported.

Tests are being run as experts have ruled out COVID-19, influenza and hantavirus as possible causes.

The European Centre for Disease Control’s (E-CDC) epidemic intelligence team as well as the Pan American Health Organisation have been tracking the cluster of cases since Tuesday.

The World Health Organisation (WHO) is also aware of the cases.

What we know so far:

On August 30, 2022 the ministry of health of Argentina informed PAHO and the WHO of the new notification by the ministry of public health of Tucumán province of a cluster of 6 cases of bilateral pneumonia and six patients without “etiological” logical identification so far.

When was it detected? What are the symptoms?

Onset of symptoms was reported to be between August 18-22, 2022, presenting with:

> fever

> myalgia

> abdominal pain

> dysapnea.

The six cases presented with bilateral pneumonia.

All cases are related to the same person.

??UNKNOWN PNEUMONIA—Very worrisome—3 people have died, 9 people infected, of which 8 medical workers, are in hospital after developing a “pneumonia of unknown origin”—Argentinian authorities announced. Not COVID or flu. #ArgentinaPneumonia

By @sneweyy https://t.co/UVBnbrbOZA pic.twitter.com/tYH10wTcs0

— Eric Feigl-Ding (@DrEricDing) September 1, 2022

The Ministry of Health in Tucumán — northwest of the country about 1,000 km from Buenos Aires — reported that nine people in the same private clinic unit have contracted what experts labelled as a “mystery pneumonia”.

What did health authorities say so far?

Because of the fact that the usual suspects — including COVID, influenza and hantavirus — all tested negative among the symptomatic patients, authorities are concerned about a possible outbreak as the lab tests and deaths suggests an aggressive infectious agent may be involved.

“What these patients have in common is the severe respiratory condition with bilateral pneumonia and compromise in [x-ray] images very similar to COVID, but that is ruled out,” Luis Medina Ruiz, Tucumán’s minister of health, was quoted by local media as saying.

Where were the samples tested?

The samples were tested in a local lab for infectious diseases, while confirmatory samples were also sent to the National Administration of Laboratories and Health Institutes (IANLIS, per its acronym in Spanish) for additional testing, including toxicological analyses. Test results are being awaited.

On Thursday (September 1, 2022), the Ministry of Public Health in Tucuman reported 3 additional patients — all health care workers — with onset of symptoms compared to the 6 cases reported previously.

To date, a total of 9 cases related to this cluster have been identified including 3 deaths.

What were the tests conducted on the patients?

The six patients have had a series of tests for “COVID, cold, influenza of both types A + and B +, Hantavirus and 25 other germs” — but the pathogen (disease-causing agent) has not yet been identified.

Contacts of the first patients are being tracked and the healthcare centre has been isolated.

Why is it called 'unexplained', or 'atypical pneumonia'?

The cases are a throwback to inital stages of the COVID-19 pandemic, when authorities raced against time to determine the cause of an unexplained or “atypical" pneumonia in Wuhan. Health experts, however, cautioned that more information is needed “before ringing the alarm bell”.

??Cases of pneumonia and death due to unknown cause - Argentina ???? @pahowho
9 cases in total with 3 deaths
The samples were tested negative for respiratory viruses, and other viral, bacterial and fungal agentshttps://t.co/xsqLmLGkZd#EpidemicWatch #ArgentinaPneumonia pic.twitter.com/tA7SlpfNlt

— Vinod Scaria (@vinodscaria) September 2, 2022

Experts are also analysing the water, and air conditioning units to determine whether the cause is toxic or environmental — for instance, whether legionella bacteria may have accumulated in the air conditioning duct.

Why is this unknown pathogen a cause of concern?

Prof. Devi Sridhar, chair of global health at Edinburgh University and author of ‘Preventable’, was quoted by British media as saying: “It’s obviously concerning but we still need key information on transmission and hopefully [on the] underlying cause.

“This shows our collective vulnerability to dangerous pathogens. An outbreak in any part of the world – if not quickly contained – can spread rapidly given air travel and trade.”

Rare event?

Another expert says this could be a rare event caused by a respiratory virus that virologists in the outbreak region do not routinely test for in pneumonia patient.

“Diagnostic labs, even in the UK, don't test for all respiratory viruses – just the most common ones or most significant ones. It was only recently that many labs bothered looking for coronaviruses,” he said.

Who can identify the deadly pathogen?

Prof Ball explained that genetic sequencing should determine whether this is a rare event from a known pathogen — or something new.

Prof Jonathan Ball, a professor of virology at the University of Nottingham, UK, suggested that due to fact that COVID measures also disrupted the spread of other pathogens, virus trackers should be on alert for more unusual symptoms.

“[This] might not be new illnesses – just a cluster of rare events from known illnesses,” he was quoted as saying. “Expect more until we settle back into the normal seasonal ebb and flow of respiratory viruses.”

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