San Francisco Chronicle
Respiratory illnesses surging in children across China
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.”