San Francisco Chronicle

Respirator­y illnesses surging in children across China

- By Aidin Vaziri Reach Aidin Vaziri: avaziri@sfchronicl­

A worrisome spike in mysterious respirator­y illnesses among children across northern China is drawing parallels to the early days of the COVID-19 pandemic.

But Chinese officials say there’s no need to panic. They attribute the surge of pneumonia-like cases to a convergenc­e of common pathogens during the nation’s first winter without stringent COVID-19 restrictio­ns, rather than to a previously unseen pathogen.

Reports from local and social media outlets last week revealed overwhelme­d pediatric wards in hospitals across various regions, including Beijing. This prompted the Program for Monitoring Emerging Diseases, an early warning network operated by the Internatio­nal Society for Infectious Diseases, to issue an alert about an “undiagnose­d respirator­y illness” rapidly spreading throughout China.

“It is not at all clear when this outbreak started as it would be unusual for so many children to be affected so quickly,” Dan Silver, a ProMED rapporteur, wrote in the post. While awaiting more comprehens­ive informatio­n, he cautioned against prematurel­y labeling this a potential pandemic.

ProMED issued the first alert about SARS-CoV-2, the virus leading to the COVID-19 pandemic, in December 2019.

No atypical surges of undiagnose­d respirator­y illnesses have been reported by any health agencies in California or other parts of the U.S.

Responding to a World Health Organizati­on call for increased transparen­cy, Chinese health officials held a press conference on Sunday, asserting they had not detected any “unusual or novel diseases” but acknowledg­ing a surge in respirator­y ailments among children.

Mi Feng, the spokespers­on for China’s National Health Commission, attributed the clusters to an overlap of influenza and other known pathogens, including Mycoplasma pneumoniae, a bacterium known to cause upper respirator­y infections commonly known as “walking pneumonia.”

“According to the analysis, acute respirator­y diseases in China have continued to rise recently, which is related to the superposit­ion of multiple respirator­y pathogens,” Mi said.

The ministry has called for the opening of additional fever clinics, urged children and the elderly to stay up-to-date on vaccinatio­ns, and advised the public to wear masks and avoid crowded places. It insisted that most cases are mild and there have been no deaths linked to the outbreaks. According to an article by state-owned China National Radio earlier this week, the daily patient count in the internal medicine department at Beijing Children’s Hospital topped 7,000, surpassing the hospital’s capacity.

Historical­ly, the emergence of new flu strains or potential pandemic-triggering viruses manifests through undiagnose­d respirator­y illness clusters. Notably, both SARS and COVID-19 were initially reported as unusual pneumonia cases.

Following a WHO meeting with local health authoritie­s, the global health agency seemed to agree with China’s assessment, acknowledg­ing the earlier-thanusual onset of illnesses since mid-October but deeming the surge “not unexpected” following the recent lifting of stringent lockdown restrictio­ns implemente­d in the country in early 2020.

“This is what most countries dealt with a year or two ago,” said Maria Van Kerkhove, the WHO’s COVID-19 technical lead, in an interview with Stat.

She added, “We specifical­ly asked about clustering: Are you seeing a clustering of undiagnose­d pneumonias? And they said no. They gave us the percentage­s of what is due to influenza, rhinovirus, adenovirus, Mycoplasma pneumoniae.”

Health officials in the Netherland­s also recently reported a sudden rise in pneumonia cases among children without a clear explanatio­n.

Earlier this month, the U.S. Centers for Disease Control and Prevention expanded its infectious disease surveillan­ce efforts in four major airports, including San Francisco Internatio­nal, to monitor incoming internatio­nal travelers for new viruses, bacteria and antimicrob­ial resistance targets that can cause outbreaks and pandemics.

Both Chinese authoritie­s and the WHO have been accused of a lack of transparen­cy in their initial reports on the 2019 COVID-19 pandemic originatin­g in Wuhan, located in central China. But public health experts say that in this case there is truly no cause for alarm.

“I think a lot of people were immediatel­y drawn back to the beginning of the COVID pandemic and thought: ‘oh God, not again,’ ” Van Kerkhove said, noting that words such as “undiagnose­d,” “clusters,” “children” and “pneumonia” can set off alarm bells for disease experts. But, she concluded, what the WHO ultimately saw “was just an indication of an overall transmissi­on increase across the country.”

 ?? Andy Wong/Associated Press ?? A man carries a child in a holding room of a children’s hospital in Beijing. A surge in respirator­y illnesses has drawn attention.
Andy Wong/Associated Press A man carries a child in a holding room of a children’s hospital in Beijing. A surge in respirator­y illnesses has drawn attention.

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