WHO has made an official request to China for detailed information on an increase in respiratory illnesses and reported clusters of pneumonia in children.
At a press conference on 13 November 2023, Chinese authorities from the National Health Commission reported an increase in incidence of respiratory diseases in China. 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.
Clusters of illness
On 21 November, 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.
On 22 November, WHO requested additional epidemiologic and clinical information, as well as laboratory results from these reported clusters among children, through the International Health Regulations mechanism.
They have 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 also in contact with clinicians and scientists through existing technical partnerships and networks in China.
Influenza-like illness
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.
While WHO seeks this additional information, they recommend 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.
WHO will continue to provide updates.
Reports from China
A post on ProMED reported that children’s hospitals in Beijing, Liaoning and other places were overwhelmed with sick children, and schools and classes were on the verge of suspension. Parents had questioned whether the authorities were covering up the epidemic.
”In the early morning, Beijing Children’s Hospital was still overcrowded with parents and children whose children had pneumonia and came to seek treatment. Mr. [W], a Beijing citizen: ’Many, many are hospitalized. They don’t cough and have no symptoms. They just have a high temperature (fever) and many develop pulmonary nodules.’
”The situation in Liaoning Province is also serious. The lobby of Dalian Children’s Hospital is full of sick children receiving intravenous drips. There are also queues of patients at the traditional Chinese medicine hospitals and the central hospitals. A staff member of Dalian Central Hospital said: ’Patients have to wait in line for 2 hours, and we are all in the emergency department and there are no general outpatient clinics.’”
ProMED comment
ProMED said the report suggests a widespread outbreak of an undiagnosed respiratory illness in several areas in China as Beijing and Liaoning are almost 800 km apart.
”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. ProMED awaits more definitive information about the etiology and scope of this concerning illness in China.
”It is too early to project whether this could be another pandemic but as a wise influenza virologist once said to me ’The pandemic clock is ticking, we just do not know what time it is.’”
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