Pathogens behind the outbreak of respiratory illness in China

December 14, 2023
Avatar for Jyoti KinghornJyoti Kinghorn
Pathogens cause new respiratory illness in China

As China enters its first winter after lifting the last of its restrictions to contain the COVID-19 pandemic, there is an upsurge in respiratory illness especially among children. In November of this year, ProMED reported “clusters of undiagnosed pneumonia” from children’s hospitals in Beijing and Liaoning. The reports are consistent with those obtained through other WHO-identified media sources.

Information about how many children are getting sick daily is not available. But their numbers seem to be overwhelming the hospitals, with over a day of waiting to get emergency care in the capital city of Beijing. In Liaoning Province, ProMED reports of sick children receiving intravenous drips in the lobby of Dalian Children’s Hospital. Some schools have been canceled as the students and teachers got sick with pneumonia-like symptoms.

Pathogens cause new respiratory illness in China


Symptoms of the sick children


From the limited information available, it appears that a majority of the sick children have pneumonia. ProMED cited a Beijing citizen, Mr. [W] explaining the symptoms as follows: “Many, many are hospitalized. They don’t cough and have no symptoms. They just have a high temperature (fever) and many develop pulmonary nodules.”

Pathogens responsible


As reported by the WHO, Chinese authorities have stated that they have not detected any new pathogens in any of these cases. They have attributed this wave of sickness to known pathogens such as mycoplasma pneumoniae, respiratory syncytial virus (RSV), and SARS-CoV-2.

Of these mycoplasma pneumoniae has received the most attention from the Chinese social media. This pathogen causes usually mild respiratory infections, sometimes more serious lung infections, and pneumonia. Pneumonia from mycoplasma pneumoniae is often not too debilitating, and most people affected may feel mild symptoms of a cold. Therefore, it is called “walking pneumonia”. The infection can be readily treated using antibiotics, and most people who get an infection from this pathogen can get better on their own without antibiotics.


WHO’s response to the outbreak


On the 22nd of November this year, WHO put out a statement on the reported clusters of respiratory illness in children in northern China. They informed the public that they have requested additional information including clinical information and laboratory test results from children in these clusters of respiratory infection. The WHO has also requested epidemiologic data, recent trends in the spread of known pathogens that can be causing this outbreak (such as SARS-CoV-2, RSV, mycoplasma pneumoniae), and the current burden on the affected healthcare systems in China.

Child washing hands to avoid pathogens


WHO recommendations


In their statement, the WHO

  1. Recommended that individuals in China practice the usual measures to avoid respiratory illness, such as washing hands regularly, staying home when feeling sick, social distancing from others showing symptoms of respiratory sickness, wearing masks as needed, and getting the flu shot.
  2. Did not recommend anything specific to those who are traveling to China. Observe general clean behaviors such as regularly washing hands, and avoiding someone who seems sick. If sickness develops during or soon after the travel, individuals are encouraged to get medical care and let their doctor know about their travel history.
  3. Advised against travel or trade restrictions.

These guidelines are based on the information WHO currently has and may change as more information becomes available.


U.S. response


The New York Times reports that officials in the CDC currently do not think that this outbreak is connected to a new pathogen. They cited Dr. Mandy Cohen, the director of the CDC, saying that based on their conversations with health workers, academic experts, and Chinese authorities, they believed that this recent uptick in sickness in the pediatric population is due to known bacteria and viruses.


Stay up to date on the evolving situation


Use the following resources to learn about the latest developments and findings.

ProMED (International Society for Infectious Diseases),353#promedmailmap

World Health Organization News


The information provided in our blog posts is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

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