Clusters of undiagnosed pneumonia in Beijing and North China
What’s behind China’s mysterious wave of childhood pneumonia?
China, surge in respiratory illnesses, including pneumonia, in children.
International society for infectious diseases
https://www.dailymail.co.uk/health/article-12779783/child-pneumonia-outbreak-china-hospitals.html
Program for Monitoring Emerging Diseases
(International Society for Infectious Diseases)
Clusters of “undiagnosed pneumonia”
We expected a surge in respiratory disease this time of year, but what is happening in China is unusual.
? more than rebound
? community immune debt
Hospitals in Beijing and 500 miles northeast in Liaoning are ‘overwhelmed with sick children’ with unusual symptoms that include
Radio Free Asia reported
said that more than 3,500 cases of ‘respiratory infection’ had been admitted to the Beijing Children’s Hospital at the start of October,.
1000 new cases per day
https://emedicine.medscape.com/article/223609-overview
China has now included Mycoplasma pneumoniae as well as other known respiratory pathogens, like influenza, covid and RSV
Local reports
inflammation in the lungs
a high fever but no cough
Mycoplasma pneumoniae
It is among the most common causes of community-acquired pneumonia in school age children.
Generalized aches and pains
Fever usually ≤ 102°F, (38.9’C)
Cough – Usually nonproductive
Sore throat (nonexudative pharyngitis)
Headache/myalgias
Chills but not rigors
Nasal congestion with coryza
Earache
General malaise
Pneumonia develops in only 5-10% of persons who are infected.
The Beijing Center for Disease Control and Prevention (CDC)
https://edition.cnn.com/2023/11/28/health/china-respiratory-illness-surge-wellness/index.html
https://foreignpolicy.com/2023/11/28/chinese-hospitals-pandemic-outbreak-pneumonia/
The World Health Organization
Upsurge of respiratory illnesses among children-Northern China
23rd November
https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON494
The WHO requested information
Using International health regulations
Laboratory results and data
Recent trends in the spread of respiratory illnesses,
from China’s health authorities last week.
WHO said China’s health authorities have said rise in hospitalizations since October to known pathogens,
such as adenoviruses, influenza virus, and RSV,
(which tends to cause only mild, cold-like symptoms)
Common winter infections — as opposed to any new pathogens — are behind the spike in hospitalizations.
https://themessenger.com/health/china-respiratory-illness-outbreak-mysterious-beijing-covid-2023
Nature news explainer, 27th November
https://www.nature.com/articles/d41586-023-03732-w
China’s first without COVID-19 restrictions since the pandemic began in 2020.
Mycoplasma pneumonia and RSV are known to affect children more than adults.
No changes in the disease presentation were reported by the Chinese health authorities.
Chinese authorities advised that, since mid-October, enhanced outpatient and inpatient surveillance has been implemented for respiratory illnesses
What is unusual, say epidemiologists, is the high prevalence of pneumonia in China.
UK, respiratory syncytial virus (RSV) mostly drove spikes in illness.
November 2022, more hospitalized influenza in US
Main cause of pneumonia
Mycoplasma pneumoniae,
bacterium that infects the lungs.
Normally causes a milder ‘walking pneumonia’,
doesn’t require bed rest or hospitalization.
Medscape
Slow spread throughout households is common, with a mean incubation period of 20-23 days. Disease tends to not be seasonal, except for a slight increase in late summer and early fall.
However
Mycoplasma pneumoniae infections have very been common.
Teachers getting ill
Bacterial pneumonia is often secondary to viral infections,
Opportunistic infection
Studies show that resistance rates of Mycoplasma pneumoniae to macrolides in Beijing are between 70% and 90%
Erythromycin, clarithromycin, azithromycin,
https://journals.asm.org/doi/10.1128/aac.02060-12
(data up to 2012)
levofloxacin as a secondary choice
Working hypotheses
No evidence of a novel virus or bacterium
Probably dangerous mycoplasma antibiotic resistance
Possible bacterial infection after novel virus, but less likely
New pandemic not immanent due to slow household transmission
Slow spread of multiple antibiotic resistance spread of mycoplasmic pneumonia
Need to optimise immune function, nutrition, vitamin D, sleep, exercise, appropriate antigenic challenge and hygiene hypothesis
Upgrade innate immunity as per Professor Angus Dalgleish and Professor Robert Clancy
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