Respiratory diseases and pneumonia are increasing in China

After the unusual increase in respiratory diseases among children in China, the World Health Organization (WHO) has given the all-clear for the time being after consultation with Chinese authorities. In a telephone conference on Thursday, the Chinese health authority emphasized that it had not discovered any unusual or new pathogens or unusual clinical pictures, the WHO reported in Geneva in the evening.

The illnesses were caused by several known respiratory pathogens, including rhinoviruses, RSV (respiratory syncytial virus) and mycoplasma infections (Mycoplasma pneumoniae), Chinese authorities reported to the WHO. These are bacteria without cell walls that only occur in humans and are widespread worldwide. They can cause tracheobronchitis or pneumonia, especially in children and adolescents. Because the bacteria have no cell wall, they are resistant to certain antibiotics, but according to the WHO they can be easily treated with other antibiotics.

Children are particularly susceptible to pneumonia

Cases of respiratory illnesses have been increasing in China since mid-October. The authorities informed the public about this last week. They explained the increase in cases, among other things, with the easing of Covid-19 measures and the circulation of known respiratory viruses. At the beginning of this week it was also announced that children in northern China were suffering from pneumonia at a remarkably high rate.

The World Health Organization (WHO) then got involved. It is unclear whether the general increase in respiratory diseases and pneumonia in children are related, the WHO wrote in a statement. She demanded more details from the Chinese authorities about the cases, such as laboratory reports, data on the circulation of flu viruses and other pathogens, and the burden on the health system. The WHO is in contact with experts on site, it said.

The WHO recommends that the population follow protective measures. You should get vaccinated, keep your distance from sick people, ventilate, wash your hands and wear masks “where appropriate”. The WHO told Reuters that its intervention was only a “routine control”.

Does a bacterium cause the disease?

An initial professional assessment of the still unexplained cases of pneumonia in children can be found on the scientific information service Promed. This is a publicly available reporting system for emerging diseases and global outbreaks.

As an expert writes, the outbreak among children is consistent with the cases of illness with the bacterium Mycoplasma pneumoniae observed in China since mid-October. This is a well-known pathogen that causes so-called atypical pneumonia and is increasingly occurring again in Switzerland. These pneumonias are not caused by the classic pathogens such as pneumococci.

The commentator himself knows many sick people in China. Symptoms such as cough and fever are the main symptoms for them. The clinical picture in their case is consistent with a Mycoplasma infection. In the cases he knows of, the two antibiotics azithromycin and doxycycline were effective, he writes on Promed.

The situation is less clear for another expert who comments on Promed. In the most recent outbreak with previously unclear cases of pneumonia, the first report explicitly stated “no cough”. But this could also be related to the age of the patient. Younger children may experience slightly different symptoms than older children and adults.

But the findings in the X-ray images are also not very typical of mycoplasma pneumonia, the expert continues. One would expect diffuse rather than nodular infiltrates. However, this finding is not a clear argument against a specific pathogen. In order to better assess the situation in the unclear cases of pneumonia, more information is urgently needed.