As a mysterious pneumonia-like respiratory illness is affecting children and overwhelming hospitals in certain clusters across northern China, the World Health Organisation (WHO) has made an official request to that nation for detailed information on the illness. Although no known or new pathogen has been identified yet, the WHO is pressing the alert button in the wake of the COVID-19 pandemic. It doesn’t want to be caught unawares about a potential disease threat.
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WHEN WAS THE DISEASE NOTIFIED?
At a press conference on November 13, 2023, Chinese authorities from the National Health Commission reported an increase in incidence of respiratory diseases in China. However, information from the Chinese Center for Disease Control and Prevention has shown a spiral in influenza positivity since October even as COVID-19 rates continue to go down.
WHAT ARE SIGNS AND SYMPTOMS?
The primary symptoms reported are consistent with pneumonia, like fever, cough, cold and breathing difficulties. Some children are requiring hospitalisation given the severity of the disease.
WHAT’S THE CHINESE EXPLANATION?
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 November 21, 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.
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.
WHAT’S THE WHO’S PLAN?
On November 22, WHO requested additional epidemiologic and clinical information, as well as laboratory results from these reported clusters among children, through the International Health Regulations mechanism. It has 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 in contact with clinicians and scientists through its existing technical partnerships and networks in China.
WHAT ABOUT PREVENTION?
WHO has recommended 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.
The WHO is continuously monitoring the development and its alert mode underscores the importance of rapid investigation and studies to avoid a crisis in public health infrastructure across the world and avoid the swamp that COVID-19 had caused.
