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China has seen an uptick in respiratory illness and clusters of undiagnosed pneumonia in children.

The World Health Organisation (WHO) has asked China for more detailed information about the increase in respiratory disease.

Look back to 5 January, 2020, and you’ll find a statement from the WHO titled “Pneumonia of unknown cause – China”.

It is therefore unsurprising that news of another mystery outbreak has set alarm bells ringing – but a WHO doctor has warned against jumping to conclusions and says getting more information is key.

Here is what we know so far about the illness, what China has said, and what the WHO wants to find out.

What do we know about the mystery illness?

Northern China has reported an increase in influenza-like illnesses since mid-October, compared with the same period in the previous three years, according to the WHO.

Clusters of undiagnosed pneumonia in children in northern China have also been reported by groups including the Programme for Monitoring Emerging Diseases.

The WHO said it was unclear if the clusters were associated with an overall increase in respiratory infections – or separate events.

On 21 November, public disease surveillance system ProMed issued a notification about reports of “undiagnosed pneumonia”.

The alert, based on a report by Taiwanese outlet FTV News, said children’s hospitals in Beijing and Liaoning, 500 miles apart, were “overwhelmed with sick children”.

“Many, many are hospitalised,” Mr Wei, a Beijing citizen, told FTV News. “They don’t cough and have no symptoms. They just have a high temperature (fever) and many develop pulmonary nodules.”

In an editor’s note, ProMed said: “This report suggests a widespread outbreak of an undiagnosed respiratory illness … It is not at all clear when this outbreak started as it would be unusual for so many children to be affected so quickly.

“The report does not say that any adults were affected, suggesting some exposure at the schools.”

What has China said about the outbreaks?

Chinese authorities said the rise in respiratory illness was partly due to COVID-19 restrictions being lifted.

In the winters after pandemic measures lifted in the UK, there was a surge in illnesses including flu, RSV and strep A, as people mingled more after winter seasons where illnesses had been suppressed by people staying home and wearing masks.

China dropped its COVID restrictions much later than many other countries, scrapping testing and isolation rules last December.

Authorities also said the spike was due to known illnesses circulating, including flu, RSV, COVID-19 and mycoplasma pneumonia, a common bacterial infection that typically affects younger children.

The cold weather has also played a part, according to Chinese authorities.

As temperatures plummeted in Beijing, in northern China, the capital “entered a high incidence season of respiratory infectious diseases”, Wang Quanyi, deputy director and chief epidemiological expert at the Beijing Center for Disease Control and Prevention, told state media on Wednesday.

Read more from Sky News:
What is RSV? Symptoms, complications and treatment
Should you get the flu jab? Why it’s not just a ‘bad cold’

What has the WHO said?

The WHO has made an official request to China for additional epidemiologic and clinical information as well as laboratory results from the reported outbreaks among children.

It has also requested further information about trends in the circulation of known pathogens referenced by Chinese authorities.

The WHO said it was in contact with clinicians and scientists through its existing technical partnerships and networks in China.

Writing on X, formerly Twitter, Dr Krutika Kuppalli, who is part of the WHO’s emergency programme, said the outbreaks “really could be anything”.

She warned against jumping to conclusions, saying: “The point is we need information.”

The WHO said that while it was seeking additional information, it recommended people in China follow measures
to reduce the risk of respiratory illness.

These measures included vaccination, keeping distance from sick people, staying at home when ill, getting tested and
medical care as needed, wearing masks as appropriate, ensuring good ventilation, and regular hand-washing.

Thirty-four people have been arrested following “huge destruction by a riotous mob” in Dublin, Garda Commissioner Drew Harris said.

Three young children were injured in a stabbing outside a primary school which sparked violent protests and clashes with police.

A five-year-old schoolgirl and a female teacher believed to be in her 30s, remain in a very serious condition, police say.

Officers with riot shields held back crowds in the city centre where a police car was set on fire amid anger over the stabbings in Parnell Square East.

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A Qatar-mediated four-day truce has taken effect in Israel’s war on Gaza. The first pause after seven weeks of bombardment has been met with relief by Palestinians.

During the humanitarian break in the fighting, which began at 7am (05:00 GMT) on Friday, 150 Palestinian prisoners held in Israeli jails and 50 captives held by the Hamas armed group in Gaza are due to be released.

The first releases, which will see 39 Palestinians and 13 Israelis freed, are expected on Friday afternoon.

In the hours preceding the start of the truce, Israeli bombing intensified across the Gaza Strip, with attacks in Rafah and the city of Khan Younis in the south, as well as constant artillery shelling in the north of the enclave.

Almog Boker, a correspondent for the Israeli station Channel 13, has posted a video online showing Israeli soldiers celebrating from afar as a number of buildings were destroyed in the northern Gaza Strip in the last hour before the start of the truce.

בשעה האחרונה שלפני הפסקת האש, כוחות צה”ל השמידו תוואי מנהרות תת קרקעיות ומספר פירי מנהרות במרחב בית החולים שיפאא’. כך זה נראה ונשמע: pic.twitter.com/FHabuf2C6r

— almog boker (@bokeralmog) November 24, 2023

The first pause in the fighting was met with huge relief by Palestinians, who were rejoicing to be safe from Israeli bombardment for the first time in weeks,  Al Jazeera’s Tareq Abu Azzoum reported from Khan Younis, southern Gaza.

“This is the first time that we have not heard Israeli drones since the beginning of this round of fighting,” he said. “People sense that there is a glimmer of hope that this short-term pause will pave the way for a longer ceasefire.”

Badly needed aid

Under the deal, brokered by Qatar, badly needed aid will be allowed into Gaza. The enclave has been under a total Israeli blockade since the war was triggered by Hamas’s attack on October 7.

Egypt said 130,000 litres of diesel and four trucks of gas will be delivered daily to Gaza over the four days. Overall, 200 trucks carrying aid are set to enter Gaza daily.

Al Jazeera’s Youmna ElSayed, reporting from the Rafah border crossing, said that two trucks carrying petrol and one transporting gas have already crossed into Gaza from Egypt.

“They are located in the parking for trucks inside Gaza and will soon be transferred to the stations,” she said.

Additional aid would start flowing into Gaza and the first captives, including elderly women, would be freed at 4pm (14:00 GMT), said Qatar’s foreign ministry spokesperson Majed al-Ansari in Doha. The total number of hostages to be freed by Hamas will rise to 50 over the four days.

Monitoring truce

Qatar will monitor the truce in real time for possible violations, reported Al Jazeera’s James Bays from Doha.

“Qatar has an operations room here in Doha where they are going to get real-time information from Gaza. They have direct links with the Israeli military, with Hamas,” he said.

“The idea is that if there is any sort of violation, that because of those direct links, they are going to try and nip it in the bud and make sure that this truce can continue, that this process can continue for the four days,” he added.

Fighting raged on in the hours leading up to the truce, with officials inside the Hamas-ruled enclave saying a hospital in Gaza City was among the targets bombed.

Both sides also signalled the pause would be temporary before fighting resumes.

The Indonesian Hospital was reeling under relentless bombing, operating without light and filled with bedridden old people and children too weak to be moved, Gaza health officials said.

Munir al-Bursh, the Gaza health ministry director, told Al Jazeera that a wounded woman was killed and three others injured.

Israel launched its devastating invasion of Gaza after gunmen from Hamas burst across the border fence on October 7, killing 1,200 people and seizing about 240 captives, according to Israeli tallies.

Since then, Israel has rained bombs on the besieged enclave, killing more than 14,000 people in Gaza, about 40 percent of them children, according to Palestinian health authorities.

‘I want to go home’

As soon as the fighting paused, thousands of displaced Palestinians have set out to check on their homes in central and southern areas of the enclave reports Al Jazeera’s Wael Dahdouh from Khan Younis.

“One man said, ‘I want to go home and even if it is destroyed, I want to stay there. I want to die there’,” the correspondent reported.

“One woman with a child said, ‘I pray that these days will get longer and longer, to just feel safe for a day or two’.”

However, the Israeli military said its forces will be stationed at the truce lines and will not allow Palestinians to head to northern Gaza.

NewsFeed

Video from southern Gaza shows displaced Palestinians making their way through the streets of Khan Younis to return to their homes, as a four-day truce came into effect.

When Cambodian police intercepted the bus transporting Carla Ramos Miembro and 26 other Filipinos, who had been sold from one cyber slavery operation to another, she thought her nightmare was finally over.

Instead, it was the beginning of another terrifying ordeal.

“The traffickers and police treated us just as bad. We were just as scared in both places,” said Ramos Miembro, who was stopped in September as a Chinese trafficking ring was taking her from a compound in northern Cambodia to Sihanoukville, a casino town on the southern coast.

“The police told us they were waiting for the mafia boss to pay the big money to send us back to the traffickers.”

Ramos Miembro, 27, is one of hundreds of thousands of people tricked into travelling overseas for respectable-sounding office jobs, only to find themselves sold to organised crime syndicates that operate investment scams and fake online betting sites.

The cyberscam compounds, often attached to licensed casinos, have proliferated in Cambodia, Laos, Myanmar, and the Philippines, but evidence from victims and NGOs suggests that countries as diverse as the United Arab Emirates and Ghana have also become cyber slavery hotspots.

Held in guarded compounds – many of which are connected to powerful politicians – and forced to commit fraud under the threat of beatings and torture, cyber slaves have little hope of escape.

But even those who are rescued find the relief is short-lived, with many trapped for months on end in dire conditions in detention centres – sometimes alongside their traffickers – as they wait for cases to be processed. Those found to have broken immigration rules, including for overstaying visas while held against their will, face penalties or prosecution.

In the worst cases, they fear corrupt authorities may even try to sell them back to the traffickers.

Seven months earlier, Ramos Miembro had flown to Bangkok believing she had a job in customer service for Binance, the world’s largest cryptocurrency exchange.

Instead, she was driven from the airport to O’Smach, an isolated outpost six hours away on the Cambodian side of the border. Too frightened, she says, to argue with the traffickers who paid for her flight and confiscated her phone, she was taken into a high-walled compound behind a casino and told she could not leave without paying a $5,000 ransom – far more than she could ever hope to afford.

The Filipina had been sold to a Chinese online scam gang that mostly targets people in the United Kingdom, persuading them to invest in a fake crypto platform before stealing their money. The bosses gave her a stack of UK SIM cards, 1,000 phone numbers and a script, and forced her to spend up to 20 hours a day sending wrong-number texts to strangers to start a conversation and build rapport. Anyone on her team who called for help was beaten or tortured with electric shocks. Twice, the beatings she witnessed were so severe that Ramos Miembro thought the victims, neither of whom she ever saw again, had died.

The Philippines Embassy in Cambodia confirmed that one of the two men who were beaten was hospitalised, but he survived and was later repatriated to the Philippines. Al Jazeera was unable to confirm whether the second man, a Vietnamese national, survived.

Multiple victims trafficked into the O’Smach compound at different times have independently alleged that they witnessed high-ranking police officers enter the compound to collect bribes. Huong*, a young Vietnamese woman who moved to Cambodia shortly after graduating from university to take up a job as a translator, was also sold to the same scam compound in O’Smach. She told Al Jazeera that her boss paid $30,000 a month to local police for protection.

(*Huong is not her real name; she asked to use a pseudonym to protect her identity in Vietnam, where she faces ongoing harassment from the authorities.)

Treated like prisoners

It was shortly before midnight on September 25 when Ramos Miembro and her team were given an hour to pack so they could be moved to Sihanoukville, a 10-hour drive away.

In the rush, Ramos Miembro was able to remove a work mobile from the office and reach out for help. The long journey created a window of opportunity for contacts on the outside to issue an urgent request for rescue from a police unit based along the bus’s route, which was unconnected to the compound and willing to intervene.

At about 10am the following day, the convoy of vehicles – the bus and an escorting truck and van, driven by members of the trafficking ring and scam company – was apprehended and several traffickers arrested. The victims claim that an armed, uniformed Cambodian police officer working with the trafficking ring also accompanied them on the bus from O’Smach, but changed into ordinary clothes when the vehicle stopped and managed to flee while police were focused on arresting the Chinese nationals.

But immediately after the rescue, the case was transferred to another police department – the Anti-Commercial Gambling Crimes Department, based in Cambodia’s capital Phnom Penh. All 27 victims and their traffickers were taken to the department’s headquarters to be detained.

“When we arrived at the police station, we were really scared. They were treating us like prisoners. They were not giving us accommodation but making us sleep on the floor. They don’t care if it is hot or raining – we have to stay outside. No shower, no toothbrush. Nothing. When we asked the police for these things they ignored us,” Ramos Miembro recalled. Worse, she says, “we were close enough to the traffickers inside the cells that they could threaten us. They told us if we told them about the location in O’Smach then they would kill us.”

The threats did not only come from the traffickers. For several days following their rescue, police at the Anti-Commercial Gambling Crimes Department told them they planned to sell the group back to the gang.

While the senior police figure involved in the rescue – who is in no way implicated in the events that followed – insisted this was simply a scare tactic to extort money from the victims, other cases suggest it may not have been an empty threat.

A source in the Cambodian police, who asked not to be named for fear of repercussions, told Al Jazeera that it is increasingly common for immigration police (who are typically responsible for processing and holding victims before they can be returned home), to orchestrate so-called rescues with a view to extracting bribes from scam groups and trafficking rings who want the victims back. The source claimed that, in October, he was directly involved in selling a group of trafficking victims held in the detention centre opposite Phnom Penh International Airport back to the Chinese criminal gang that had enslaved them.

Al Jazeera was only briefly able to enter the building where the group was held after their rescue – a dilapidated former mansion now used as an office by the police department – but was able to confirm that the Filipino victims were sleeping on bare ground in an open-air courtyard designed for a now-empty swimming pool, where they had no shelter from the sun or frequent heavy rain. Sources involved in the case confirmed that the group had been told they did not need a lawyer – which Ramos Miembro said “felt illegal” since they had been told they were also under criminal investigation at the time. Police officers also refused to provide food and water, she says, and a local charity stepped in to help.

“The lack of information being released by the [Cambodian] government combined with the stories we have heard from people that have been in the compounds and through government detention centres are truly shocking. The detention centres appear completely ill-equipped by not having enough beds, food and water or provisions to ensure that traffickers and trafficking survivors are kept separate,” said a spokesperson from Amnesty International’s regional office, who asked not to be named for security reasons.

“Survivors of trafficking should not be placed in detention centres in the first place. They should be identified as trafficking victims and should be adequately housed and given access to lawyers.”

Demands for money

After spending up to a month at the Anti-Commercial Gambling Crimes Department, most people rescued from cyber slavery compounds are transferred to immigration detention for at least another month before they can return home. Conditions here are also dismal.

Huong, the recent graduate from Vietnam, was removed from the O’Smach compound in March after a senior government minister personally intervened to order her release, but this did not protect her from ill-treatment. She was held in immigration detention for almost three months, confined to a small cell with several other trafficking survivors, just metres away from Chinese gangsters who were being deported for their role in trafficking and enslaving young women in her position. Huong told Al Jazeera she was expected to order her own food and water for delivery from outside, but the guards withheld this unless she paid a bribe each time.

“If I don’t give them money, then they won’t let me go,” Huong said.  “I am so upset now and I don’t know why they want money from victims. I’ve been struggling for the past two months and I am even more desperate at this stage.”

Huong was eventually released and transported to the Vietnam border, where she was subjected to further extortion both by border guards and local police in her hometown, who claimed she had broken immigration laws by staying too long in Cambodia.

Like Huong, many survivors of cyber scams are criminalised by their rescuers or even their own governments when they finally reach home.

China’s anti-trafficking laws only cover sexual exploitation and only for women and children, meaning victims of cyber slavery, and men trafficked in any context, at best face a lack of legal support and at worst, prosecution for crimes they were forced to commit. In October, Radio Free Asia reported that 16 Laotians, the youngest of whom was just 15, had been stuck in police custody for more than two months after being rescued from a casino-based scam gang in Myanmar, while the authorities worked out what to do with them. In August, Thai media reported that a Vietnamese who sought refuge in the jungle on the Cambodia-Thailand border after escaping an alleged compound on the Cambodian side would face charges for crossing into Thai territory illegally.

Ramos Miembro’s group has been a little luckier.

After four days at the Anti-Commercial Gambling Crimes Department – during which they say police and traffickers threatened to intercept them on the way to immigration detention and return them to O’Smach – they were abruptly relocated to a well-equipped safe house in a secret location, with food and amenities provided by a charitable organisation. But two months after their rescue, despite sustained negotiations from their embassy and pressure from rights groups, the group is still waiting for their release papers to be signed so they can fly back to the Philippines, and are losing hope that they will make it home for Christmas.

In the meantime, Ramos Miembro and her cohort spend their days trying to track down victims they were forced to defraud to warn them against putting any more money into the scam site before it is too late.

The guilt weighs heavily. In an interview with Al Jazeera in the safe house in October, Ramos Miembro broke down in tears as she described how much she hated the work but had no choice but to comply. Reaching out to scam victims had also proved heart-breaking. Of those who responded to her, several had already lost significant sums.

“I blame myself because I was an absolute idiot,” explained Neil, a 47-year-old Londoner who lost 4,000 pounds ($4,860) to the scam after testing out smaller figures that turned a decent profit, which he was initially able to withdraw. Neil, who asked us to use only his first name,  confirmed that he received a wrong number text from a woman who said she was a Chinese investor working in the city of London, and that the conversation had turned into “a bit of a flirt” with no mention of money until she mentioned in passing that she’d been making money from the platform. He was shocked to discover that the text had come from Ramos Miembro – and that she had been trafficked into the role. While Neil was able to absorb the hit “and put it down to stupidity”, some victims have been left in desperate straits.

Meanwhile, the O’Smach compound, which is owned by the powerful Cambodian senator and casino magnate Ly Yong Phat, has been left untouched. The fake investment site the scam group used to steal thousands of dollars from UK users, called “Raiffeissen.vip” is still operational – although they are likely to have cloned sites under other names, too – and blockchain records show that cryptocurrency wallets linked to the group have moved tens of millions of dollars. While trafficking survivors rescued from the gang continue to be threatened and harassed by the authorities, there appears to be no appetite to shut down the criminal group or the scam itself.

“They didn’t ask us any details about the mafia group,” shrugged Ramos Miembro. “I guess they are not doing their job. They asked no details and no names.”

Neither the Cambodian Immigration Department nor Senator Ly Yong Phat could be reached for comment. A manager at the hotel-casino part of the O’Smach Resort complex, who gave his name as Khong, said he knew nothing about the workings of the scam compound and hung up the phone.