China - Mycoplasma pneumonia, influenza or COVID-19?: Beijing expert says to confirm before treatment - November 13, 2023

[sharon sanders]

Mycoplasma pneumonia, influenza or COVID-19? Vice President of Beijing Chaoyang Hospital: Use medicine only after confirming the pathogen
red star news2023-11-13 16:18




On November 13, the National Health Commission held a press conference to introduce the prevention and control of respiratory diseases in winter. Recently, many people on the Internet said that their whole family was infected with mycoplasma pneumonia, but some people also believed that many of the adults were infected with the new coronavirus. In this regard, Tong Zhaohui, deputy director of Beijing Chaoyang Hospital affiliated to Capital Medical University and director of the Beijing Institute of Respiratory Diseases, suggested that medication should be used after confirming the cause of the disease, rather than relying on guesswork to abuse drugs.


▲Tong Zhaohui
It is reported that mycoplasma pneumonia is the most common cause of community-acquired pneumonia in children aged 5 and above in my country. It is prevalent in autumn and winter in northern areas, and in summer and autumn in southern areas. Regional cyclical epidemics occur in children every three to seven years. Its main clinical manifestations are fever and cough. At the onset, it manifests as severe, paroxysmal, and irritating dry cough, which may be accompanied by headache, runny nose, sore throat, earache, etc. Tong Zhaohui said that compared with previous years, during this year's epidemic, children under 3 years old were also infected, showing a trend of younger age, but the condition did not worsen significantly.
It is reported that Mycoplasma pneumoniae is one of the common respiratory pathogens. According to my country's 2016 Community-Acquired Pneumonia Guidelines and relevant data monitoring, Mycoplasma pneumoniae is one of the important causes of community-acquired pneumonia in my country, with a high incidence in autumn and winter every year, and children and adolescents are susceptible. Mycoplasma pneumoniae is mainly spread through respiratory droplets. Therefore, without protection, outbreaks will occur in densely populated places such as kindergartens and schools. It is also common for family members to be infected with mycoplasma.
According to Tong Zhaohui, influenza is more common in winter and spring. It often has an epidemiological history and a history of contact with patients with influenza and suspected influenza. It starts with fever and upper respiratory tract infection, followed by worsening cough, dyspnea and pulmonary symptoms. , and even the systemic symptoms are more severe, such as high fever, rapid disease progression, fatigue, headache, muscle aches and other obvious symptoms, and the imaging manifestations are similar to mycoplasma pneumonia. Some patients with Mycoplasma pneumoniae infection also have high fever, but the course of the disease tends to progress slower than that of influenza. At the same time, Mycoplasma pneumoniae infection will also cause severe irritating dry cough as the disease progresses. Therefore, Tong Zhaohui emphasized that it is more important to detect respiratory specimens, such as influenza A or B viruses, which can be distinguished by antigen and nucleic acid testing.
According to Tong Zhaohui, Beijing Chaoyang Hospital’s recent mycoplasma nucleic acid test detection rates are 5.59% for adults and 40.34% for children; 29.67% of adults and 4.94% for children have positive influenza antigen tests. In acute respiratory infections, the symptoms caused by Mycoplasma pneumoniae, new coronavirus, influenza virus, etc. are similar, and the etiological diagnosis can be confirmed through antigen and nucleic acid testing. It is recommended that you use medicine after confirming the cause of the disease, rather than abusing medicine based on guesswork.

source....zhttps://baijiahao.baidu.com/s?id=1782436096932768326&wfr=spider&for=pc

[sharon sanders]

We have been following pneumonia outbreaks in China during and since the summer of 2023. Please see this forum for some of the outbreaks:

https://flutrackers.com/forum/forum/china-other-health-threats/china-pneumonia-respiratory-and-influenza-like-illnesses-ili

The article below is nothing new. It appears there has been a surge of "pneumonia" countrywide since late April 2023.

It is unknown what all this pneumonia and fevers are..COVID-19, Mycoplasma pneumonia, seasonal flu, rsv, adenovirus, combination of the above? China is not candid about their disease situations and there is no free press there.




hat tip @sandyasm from a global alert issued by ProMED based on the single source, machine translated, Taiwan article below:


Pneumonia epidemic breaks out in China! Children's hospitals in Beijing and Liaoning are overcrowded with sick children seeking treatment

• 2023/11/21 17:37:10

The pneumonia epidemic broke out in China. 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 questioned whether the authorities were covering up the epidemic.

In the early hours of the morning, Beijing Children's Hospital was still overcrowded with parents and children whose children had pneumonia and came to seek treatment.
Mr. Wei, 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 grim. The lobby of Dalian Children's Hospital is full of sick children receiving intravenous drips. There are also long queues of patients at the Traditional Chinese Medicine Hospital and the Central Hospital.
A staff member of Dalian Central Hospital said: "We have to wait in line for two hours. We are all emergency patients and there are no general outpatient clinics."
Some school classes have even been wiped out. Not only are all students sick, teachers are also infected with pneumonia. Parents complain that the Chinese government is covering up the epidemic and harming the health of their children. Mr. Wei, a Beijing citizen: "Now you are not allowed to report to school. If you have any symptoms such as fever, cold, cough and then you are hospitalized, you can ask for leave alone with the teacher but you cannot discuss these things in the class group. Everything is a state secret."
Since China stopped adhering to the "clearance" policy at the beginning of the year, epidemics such as influenza, mycoplasma, and bronchopneumonia have broken out from time to time. Since the symptoms of these diseases are similar to those of the new coronavirus, people have questioned whether the government has been Covering up the epidemic.

zhttps://www.ftvnews.com.tw/news/detail/2023B21I19M1

[sharon sanders]

In addition to the reference to the forum in the above post, please also see:

China - Shenyang Huanggu District Education Bureau reported 17 children with diarrhea and vomiting symptoms, Liaoning province, June 7, 2023

[sharon sanders]

There is a picture circulating of children with IV lines.

In the past when anyone went to an emergency room, the standard procedure was to hook a patient up to an IV. It was expected and demanded by citizens. The government has been trying to change the standard protocol of automatic IV installation. I believe the lines contain some type of beneficial cocktail like vitamins etc. - at least initially until a real diagnosis is reached.

So, therefore, a picture of children with IV lines may, or may not, be probative.

There is a lot of grey area in following disease developments in China.

[sharon sanders]

I wanted to point out that Tianjin, which is basically the port city for Beijing, has had a surge for 2 months. What are these diseases exactly? Who knows....


China - Number of respiratory diseases in pediatric cases has begun to rise, more than 1,600 children are hospitalized, Tianjin - October 25, 2023

China - Tianjin: Children's Hospital daily outpatient and emergency room surges - wave of respiratory infections - November 20, 2023

[sharon sanders]

World Health Organization (WHO)

@WHO
WHO statement on reported clusters of respiratory illness in children in northern China

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.

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.

We 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 our existing technical partnerships and networks in China.

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, we 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.


World Health Organization (WHO) Western Pacific
5:24 PM · Nov 22, 2023
·
573.8K
Views

[sharon sanders]

Apparently a doctor has written in to a referral service link who put out an alert titled "Subject: PRO/EDR> Undiagnosed pneumonia - China". This was widely carried because the "undiagnosed pneumonia" claim by the service can be almost anything from a human avian flu outbreak to mycoplasma pneumonia. It is a hot button to push that guarantees attention.

According to the referral service Dr. Stephan Gibson said:

"Regarding Undiagnosed pneumonia.....Mycoplasma_ pneumonia in both western and Chinese news sources, going on for at least 2 months now. My personal experience is also consistent with those reports: numerous friends with illness, primarily coughing and lethargy, but at least one with a high fever as the 1st symptom. Azithromycin and doxycycline are effective in at least the few cases I know of. In my mind, this presentation is consistent with _Mycoplasma_."

No information about this doctor's expertise, location, etc. is given.

[sharon sanders]

In response to Dr. Gibson someone at the referral service indicated that the "undiagnosed pneumonia" title is justified by the lack of cough and the presentation of pulmonary nodules mentioned in the Taiwan article. To me the implication in the article is that the government is covering up COVID-19 cases - not that there is an undiagnosed pneumonia situation: "Since the symptoms of these diseases are similar to those of the new coronavirus, people have questioned whether the government has been Covering up the epidemic." In addition, reporters who are not experienced in reporting disease often mischaracterize items in their reports. I have no data about the reporter.

[Treyfish]

Why is Mycoplasma pneumoniae infection difficult to treat? Expert: Standardize the use of antibiotics

Source: Yangcheng Evening News
2023-11-23 00:02Editor's note:
　　Too much is not enough. Drug abuse and misuse often stem from panic. Every year from November 18th to 24th is the World Antibiotic Awareness Week designated by the World Health Organization. In this early winter season with high incidence of respiratory diseases, it reminds us that the correct way to deal with the virus is to eliminate panic, respond rationally, and standardize medication.
　　Mycoplasma pneumoniae infections have been on the rise since August this year. As of November 15, statistics from the respiratory department, pediatrics and other inpatient and emergency outpatient clinics (including related specialties) of Guangzhou Women and Children’s Medical Center show that most of the children who visit are still It is Mycoplasma pneumoniae infection, and the number of outpatient visits per day is around 2,400, of which about 10% develop into pneumonia.

Experts said that the reason why Mycoplasma pneumoniae infection has been at its peak for a long time and some children have refractory pneumonia is that on the one hand, due to the COVID-19 epidemic in the past three years, self-protection was in place, and the body's antibodies were reduced, making it easier to be infected, leading to an infection peak. On the other hand, the abuse of antibiotics leads to drug resistance, which prolongs the course of the disease and makes the condition more severe.
　　Why is Mycoplasma pneumoniae infection difficult to treat?
　　In the past four months, cases of Mycoplasma pneumoniae infection have been at the top of the disease spectrum in pediatrics and emergency outpatient clinics. Jia Wei, director of the medical department of the Guangzhou Women and Children's Medical Center, said: "Since its launch in August, the total number of visits to the pediatric internal medicine and fever clinics of the Guangzhou Women and Children's Center has been between 2,400 and 2,850. Usually one doctor sees 50 children. Now the number has increased to 70 children. According to the results of the pathogen check, Mycoplasma pneumoniae pneumonia accounts for 10%-15%, and the hospital has allocated about 300 beds to cope with the peak number of patients."


As the number of cases of Mycoplasma pneumoniae infection increases, the media has reported that "azithromycin is the drug of choice for the treatment of Mycoplasma pneumoniae pneumonia," making azithromycin a hot-selling drug. There has also been a significant increase in the number of family members self-medicating children, which has led doctors to worry about the overuse of antibiotics leading to the development of drug resistance.
　　"A long-term illness makes a doctor", because she has a sick child at home, and Ms. Liu often gives her children medicine at home. Her 8-year-old child has experienced influenza, acute angina, tonsillitis, acute laryngitis, and Mycoplasma pneumoniae infection since childhood... On November 12, the child was infected again, suffering from high fever and cough. Even taking antipyretics can't fix it.
　　"It's strange. My child had been infected with Mycoplasma pneumoniae before. He had fever and dry cough that could be controlled with azithromycin in three days. But this time it didn't get better no matter what." Ms. Liu later purchased doxycycline online. After taking it for two days, I finally got my cough under control. The whole process from onset to cure took about 7 days. What puzzled Ms. Liu was that the conventional azithromycin was not effective for this Mycoplasma pneumonia infection.
Be wary of the serious consequences of overuse of antibiotics
　　Azithromycin is the drug of choice for the treatment of Mycoplasma pneumoniae pneumonia in children. However, this year, it is common for children infected with Mycoplasma pneumoniae to be resistant to azithromycin. Tan Yanfang, deputy chief physician of the Department of Pediatric Respiratory Medicine at Guangdong Maternal and Child Health Hospital, said: "According to the "Guide", domestic Mycoplasma resistance to azithromycin and other macrolide drugs The infection resistance rate may be as high as 90%, which is also one of the causes of severe mycoplasma infections."
　　Tan Yanfang explained: "We found that on the one hand, mycoplasma has a mutation in the resistance gene site, changing its own structure, causing drugs such as azithromycin to be unable to combine with it, and the treatment effect is poor; on the other hand, it is because azithromycin is taken as an antibiotic. It is convenient and the suspension can be flushed with water. Many parents will give it to their children whenever they have a fever or infection. Drug abuse leads to drug resistance."
　　Parents' voluntary use of antibiotics and hospitals' unregulated use of antibiotics have led to the occurrence of drug-resistant or even super-resistant bacteria. This has always been a concern for the medical community.....
zhttps://health--gmw--cn--03057tkbc6399.wsipv6.com/2023-11/23/content_36983551.htm

[sharon sanders]

This media is a government source.

Experts from Beijing Children's Hospital advise against the need for repeated medical treatment due to high incidence of respiratory diseases


Author: Zhang Yuemeng Source: Beijing Youth Daily Client November 22, 2023

Currently, Beijing has entered the season of high incidence of respiratory infectious diseases, with multiple pathogens co-circulating. As a susceptible group, children have seen a sharp increase in the number of infections. On November 22, a reporter from Beijing Youth Daily learned from Beijing Children’s Hospital Affiliated to Capital Medical University that in order to cope with this peak of infection, Beijing Children’s Hospital coordinated the medical resources of the entire hospital, adjusted the personnel investment in the professional/specialty clinics of the internal medicine system, and invested more resources in the internal medicine system. /

Fever and cough clinics are tilted, pneumonia sequential treatment clinics are opened, inpatient beds are adjusted, and beds in internal medicine system departments are opened to treat children with pneumonia to ensure the medical needs of all types of children. In addition, Zhao Chengsong, deputy director of Beijing Children's Hospital Affiliated to Capital Medical University, also said that in order to avoid cross-infection, parents can give priority to nearby hospitals for first consultation according to the condition of their children, and do not need to make repeated visits. A reporter from Beiqing Daily learned that there are currently 242 hospitals in Beijing that provide Internet diagnosis and treatment services. In order to reduce offline waiting lines, parents can also choose Internet diagnosis and treatment services.

Most viral infections do not require infusion treatment and do not require repeated medical visits.

Experts from Beijing Children's Hospital said that this respiratory infectious disease is showing a trend of multiple pathogens co-epidemic. The current peak infection rate is mainly caused by common respiratory diseases such as mycoplasma infection, influenza, and adenovirus infection. The number of patients with mycoplasma infections has been declining recently, but other respiratory viral infectious diseases such as influenza are on the rise.

Fever is one of the common features of these respiratory infectious diseases, so does a child who has a fever need to go to the hospital immediately? Experts from Beijing Children's Hospital said that when treating children with fever or fever accompanied by cough symptoms, the first thing to do is to distinguish the age. If a relatively young baby, especially one under three months old, has obvious fever, with or without respiratory symptoms, parents are advised to take the baby to the doctor in time.

If an older child, even a child over school age, develops high fever accompanied by mild respiratory symptoms but no other systemic manifestations, it is recommended that parents observe at home and use some symptomatic drugs. If the child continues to have high fever for 3 to 5 days, or is accompanied by obvious worsening of respiratory symptoms, or even other symptoms, it is recommended that parents take the child to see a doctor in time.

Zhao Chengsong introduced that there are many pathogens in the respiratory tract, and cross-infection is easy to occur in a closed environment. Beijing Children's Hospital has recently seen a large number of patients, and there is a risk of cross-infection. It is recommended that parents give priority to seeking medical treatment nearby in the early stages of their children's illness. "At present, general hospitals in our city can provide routine treatment for children's respiratory diseases, and drugs are also very accessible. Parents do not need to be too anxious." Zhao Chengsong said.

In addition, Zhao Chengsong said that viral infection has a course, and it is recommended that parents pay more attention to the changes in the condition of their children and do not rush to seek medical treatment repeatedly. "Some parents think that infusion will heal quickly. This is a misunderstanding." Zhao Chengsong said that in fact, most viral infections do not require infusion treatment, and parents can take medication as directed by the doctor.

To supplement insufficient offline resources, parents can choose Internet medical care

As an effective supplement to offline diagnosis and treatment, Internet diagnosis and treatment can also play a very good role. According to a previous introduction by the Beijing Municipal Health Commission, currently Beijing

A total of 62 Internet hospitals have been built, and a total of 242 hospitals provide Internet diagnosis and treatment services. For children who are susceptible to respiratory diseases such as influenza, online consultation can effectively reduce the risk of cross-infection. "For working parents, they can use the Internet for diagnosis and treatment in the evening after get off work to avoid the burden of traveling to and from the hospital and improve the efficiency of medical treatment." Zhao Chengsong said.

So under what circumstances can parents choose Internet diagnosis and treatment? Relevant experts from Beijing Children's Hospital said that firstly, children with long-term chronic diseases can use Internet diagnosis and treatment on the basis of regular treatment in the past to reduce the number of visits to the hospital during the season of high respiratory tract infections and avoid the risk of cross-infection. Second, for older children, if their general condition is relatively good and they only have symptoms of fever and cough, and they have completed necessary blood tests and other related tests at the nearest hospital, if parents are still worried, they can conduct online diagnosis and treatment. Online consultation. When a child's symptoms worsen significantly or are accompanied by other systemic symptoms, it is recommended to seek medical treatment offline in a timely manner.

So how to use Internet diagnosis and treatment? Take Beijing Children's Hospital as an example. After receiving the Beijing Children's Hospital QR code, parents can follow the "Beijing Children's Hospital Service Account" on WeChat and select "Medical Services" - "Internet Diagnosis and Treatment" in the bottom menu bar to make an appointment with the relevant department account. and seek medical attention. The doctor will send you video consultation services during the appointment period. Click the "Answer Video" button to have a video consultation with the doctor. According to the patient's condition, doctors can issue out-of-hospital prescriptions, in-house preparations and test orders online. After the diagnosis and treatment is completed, parents can go to "My Records" and click on the "Prescription and Guidance Form" for this visit. You can choose to pick up prescription drugs outside the hospital or have them delivered to your home, while self-prepared medicines in the hospital can be delivered to your home. Payment can be made within 3 months after the examination and issuance, and the follow-up process is the same as offline.

All departments of the internal medicine system have opened beds to treat children with pneumonia. Beijing Children's Hospital has taken multiple measures to cope with the peak of infection.

In response to this peak of respiratory infections, Zhao Chengsong told a reporter from Beiqing Daily that Beijing Children's Hospital coordinated the medical resources of the entire hospital to ensure the medical needs of all types of children. In order to improve the treatment capacity, Beijing Children's Hospital has adjusted the personnel investment in the professional/specialty clinics of the internal medicine system and tilted it towards the internal medicine/fever and cough clinics. The number of visiting doctors will be dynamically adjusted according to the number of patients. In order to ensure the treatment of critically ill children, the hospital has opened a pneumonia sequential treatment clinic to adjust the treatment plan for children with pneumonia in the outpatient clinic, effectively identify critically ill children, reduce the risk of severe illness, and maximize the limited beds for those who need them most. Hospitalized children. In addition, the hospital has also adjusted the number of inpatient beds. All departments of the internal medicine system have opened beds to treat children with pneumonia. An additional 30 beds have been added to the Shunyi Women's and Children's Hospital under the supervision of Beijing Children's Hospital. Respiratory experts will provide guidance to improve the overall treatment capacity. The testing, imaging, pharmacy and charging windows are linked to increase the number of staff and extend working hours to ensure clinical needs.

Zhao Chengsong introduced that Beijing Children’s Hospital insists on paying equal attention to traditional Chinese and Western medicine, and took the lead in formulating the Beijing “Diagnosis and Treatment Plan for Integrated Traditional Chinese and Western Medicine for Mycoplasma Pneumonia in Children (2023 Edition)”. Among children with respiratory infections in the hospital, the current utilization rate of traditional Chinese medicine reaches 93%. Including Chinese patent medicines, hospital preparations and Chinese medicine preparations. For children with residual symptoms and recurrent respiratory infections during the recovery period of respiratory infections, the Department of Traditional Chinese Medicine has opened a professional TCM conditioning clinic during the recovery period of respiratory infections to meet the diverse needs of children. The hospital provides high-quality services to improve children’s medical experience. The hospital continues to send more nursing staff to support fever and cough clinics, internal medicine clinics, infusion rooms, etc., and strengthens inspections to answer parents' questions; it has developed a QR code for "Inquiry on the Order of Treatment", and auxiliary doctors, security guards, and cleaning staff all wear QR code signs. brand, increase publicity; add electronic screens with warm reminders to clearly inform the medical treatment process, waiting, blood tests and other matters.

source: zhttps://news.cyol.com/gb/articles/20...zO8XdUvQB.html

[sharon sanders]

alert! Superinfection has occurred! Doctor: Regular hospitals can handle it, no need to go to big hospitals
CCTV2023-11-23 12:25




"There are more than 100 people queuing for blood tests, and there are circling queues in the lobby to get medicine. There are many children on the seats who are receiving infusions. Please wear a mask these days."
Zou Yingxue, chief physician and respiratory infection specialist at Tianjin Children's Hospital, said that in the past week, the combined daily outpatient and emergency volume of the two campuses of the Children's Hospital has exceeded 12,000.
Why are infection symptoms more severe in 2023? The Beijing Municipal Health Commission explained that 2023 is a "big year" for infections. The pathogen of mycoplasma may have genetic mutations and be resistant to azithromycin, which can easily cause lung infections very quickly.
Symptoms of infection are more severe this year
Superinfections have occurred recently
Wen Danning, director of the Pediatric Infection Department of Wuhan Jinyintan Hospital, found that from the overall trend, Mycoplasma pneumoniae infections are slowly beginning to transition at this stage, the number has decreased, and influenza has begun to become more prevalent. In October, almost all patients in the ward were infected with Mycoplasma pneumoniae. Recently, Mycoplasma pneumoniae infection and influenza accounted for half each.
There are also two cases of superinfection in clinical practice. When Mycoplasma pneumoniae is not completely cured, it is cross-infected with influenza, which mostly occurs in children. Lobar pneumonia will occur mainly due to Mycoplasma pneumoniae infection, and high fever will occur due to influenza due to pulmonary infection.
Wen Danning said that from a treatment perspective, influenza requires specialized anti-influenza virus treatment drugs, such as oseltamivir, peramivir and some injections. Mycoplasma pneumoniae requires anti-mycoplasma treatment, generally including azithromycin, erythromycin and other antibiotics. “It’s not just about using anti-inflammatories or cold medicines.”
Why are infection symptoms more severe in 2023? The Beijing Municipal Health Commission explained that mycoplasma pneumonia has a small peak every 3 to 5 years, and 2023 is a "big year" for infection. The pathogen of mycoplasma may have some genetic mutations and be resistant to azithromycin. Relatively speaking, the symptoms Just on the heavier side. The manifestation of mycoplasma infection in 2022 may only be a cough, but the 2023 strain is likely to cause lung infection very quickly.
The pulmonary inflammatory response caused by this year is more severe, the inflammation area is larger, and it is more difficult to cure. Clinically, the duration of fever in children is usually more than a week, and when children have poor immunity, they will be combined with other infections, such as bacterial infections or viral infections, and some extrapulmonary manifestations will appear. In more serious cases, symptoms of central nervous system encephalitis may occur, which may prolong the course of the disease and aggravate the symptoms.
Regular hospitals can handle it
No need to go to big hospitals together
Regarding the "lung washing" operation that parents are worried about, Wen Danning explained that in layman's terms, it is to extract phlegm from the lungs. "It's like a layer of mucus membrane attached to the bronchial tubes, making it difficult to breathe or even gasping for breath while walking. Generally, only severely ill patients need to do it. Children's lung repair function is better, and some children can expel phlegm more smoothly, so there is no need to do it. You can encourage them to Cough up the phlegm.”
This year, children generally have severe symptoms after being infected with Mycoplasma pneumoniae. Pneumonia may occur after two or three days of fever. She suggested that if a child develops symptoms, he or she should be taken to the hospital for treatment in a timely manner to avoid a "just push it through" mentality to avoid recurrence and aggravation of the condition.
"Taking Wuhan as an example, there are more than 80 second- and third-level medical institutions that provide pediatric diagnosis and treatment services. Regarding Mycoplasma pneumoniae, relevant departments have recently conducted several relevant trainings for hospitals with pediatrics, and the National Health Commission has also issued Diagnosis and treatment guide. As long as it is a regular hospital, it can generally handle it. You don’t have to go to a big hospital. If you encounter severe illness, you can transfer it to a higher-level hospital. "
Wen Danning said that Mycoplasma pneumoniae can be prevented according to the common anti-respiratory infection methods. Pay attention to rest, do not stay up late, strengthen your physical fitness, wash hands frequently, open windows for ventilation, and wear masks when going to public places with complex environments and gatherings of people. .
"Influenza and mycoplasma pneumonia are both very traditional and old diseases. They are not new. Basically, they have been studied clearly. There are special and effective drugs, the treatment methods are also standardized, and the treatment plans are constantly updated. For this Don’t ignore similar diseases and don’t be too nervous. For children, respiratory syncytial virus will reach a small peak this season and requires great attention.”
Beijing CDC:
Entering the season of high incidence of respiratory infectious diseases
Multiple pathogens co-circulate
According to reports, Beijing has entered the season of high incidence of respiratory infectious diseases, with multiple pathogens co-prevalent. At present, influenza is in an epidemic period, and the number of cases is rising rapidly.
Recently, the Beijing Center for Disease Control and Prevention reminded citizens to take personal protection, actively vaccinate, pay attention to common prevention of multiple diseases, and build a good immune barrier.
Wang Quanyi, deputy director of the Beijing Center for Disease Control and Prevention and chief expert in epidemiology, said that based on the outpatient visits at children's hospitals and pediatric research institutes, the current epidemic intensity of Mycoplasma pneumoniae has dropped to the fourth among children's respiratory infectious diseases, ranking among the top three For influenza, adenovirus and respiratory syncytial virus. (>>Previous report)
In addition, judging from the monitoring results of respiratory pathogens, the top three reported cases of respiratory infectious diseases among the entire population in Beijing are: influenza, rhinovirus and respiratory syncytial virus.

source: zhttps://baijiahao.baidu.com/s?id=1783327407113563324&wfr=spider&for=pc

[Pathfinder]

Translation Google


Pediatrics in hospitals in many places are overcrowded. Family members say hospitalization is delayed until 5 days later.
Doctors: There have been mixed infections recently, so there is no need to go to big hospitals.

Sina News
11.21 21;47

"There are more than 100 people queuing for blood tests, and there are circling queues in the lobby to get medicine. There are many children on the seats who are receiving infusions. Please wear a mask these days."

Recently, there has been a lot of discussion about "mycoplasma pneumonia", and many people have reported that hospitals are running out of pediatric beds. An infectious disease doctor said that in more than 30 years of practice, this is the first time he has encountered so many children with mycoplasma pneumonia.

According to Chao News, in September and October this year, the number of children infected with Mycoplasma pneumoniae in three key hospitals in Quzhou, Zhejiang was 17.8 times that of the same period last year.

Zou Yingxue, chief physician and respiratory infection specialist at Tianjin Children's Hospital, said that in the past week, the combined daily outpatient and emergency volume of the two campuses of the Children's Hospital has exceeded 12,000.

Why are infection symptoms more severe in 2023? The Beijing Municipal Health Commission explained that 2023 is a "big year" for infections. The pathogen of mycoplasma may have genetic mutations and be resistant to azithromycin, which can easily cause lung infections very quickly.

Wen Danning, director of the Pediatric Infectious Disease Department of Wuhan Jinyintan Hospital, found that mycoplasma pneumonia infections showed a downward trend during this period, but when viruses such as influenza struck, cases of mixed infections appeared. In order to prevent the condition from getting worse and recurring, she suggested that you should go to the hospital for medical treatment as soon as symptoms appear.

On November 21, Jiupai News came to a large tertiary hospital in Wuhan. Although it was already lunch break, there were still many patients waiting in the waiting area of the pediatric clinic, and the call system stayed at number 99.

On the promotional electronic screen next to the pre-examination desk, popular science materials about mycoplasma pneumonia were scrolling back and forth. Coughing sounds came one after another from the infusion area. Some children rested on the seats with fever-reducing patches on them. There were also children who put their homework books on the armrests of the chairs to write while receiving infusions.

Jiupai News randomly asked five or six children's family members in the infusion area. They all said that their children were treated here because of mycoplasma pneumonia.

According to the Beijing Municipal Health Commission, mycoplasma pneumonia is a reaction to lung inflammation caused by Mycoplasma pneumoniae infection and respiratory tract infection. It is a pathogen between viruses and bacteria and is more common in children and children aged 5 to 15 years old. In adolescents, it is mainly transmitted through respiratory droplets.
...
Wen Danning, director of the Pediatric Infection Department of Wuhan Jinyintan Hospital, found that from the overall trend, Mycoplasma pneumoniae infections are slowly beginning to transition at this stage, the number has decreased, and influenza has begun to become more prevalent. In October, almost all patients in the ward were infected with Mycoplasma pneumoniae. Recently, Mycoplasma pneumoniae infection and influenza accounted for half each.

There are also two situations of superinfection. When the Mycoplasma pneumoniae treatment is not completely cured, the patient is cross-infected with influenza, which mostly occurs in children. Lobar pneumonia will occur mainly due to Mycoplasma pneumoniae infection, and high fever will occur due to influenza due to pulmonary infection.

Wen Danning said that from a treatment perspective, influenza requires specialized anti-influenza virus treatment drugs, such as oseltamivir, peramivir and some injections. Mycoplasma pneumoniae requires anti-mycoplasma treatment, generally including azithromycin, erythromycin and other antibiotics. “It’s not just about using anti-inflammatory drugs or cold medicines.”

Why are infection symptoms more severe in 2023? The Beijing Municipal Health Commission explained that mycoplasma pneumonia has a small peak every 3 to 5 years, and 2023 is a "big year" for infection. The pathogen of mycoplasma may have some genetic mutations and be resistant to azithromycin. Relatively speaking, the symptoms are on the heavier side. The manifestation of mycoplasma infection in 2022 may only be a cough, but the strain of 2023 is likely to cause lung infection very quickly.

The pulmonary inflammatory response caused by this year is more severe, the inflammation area is larger, and it is more difficult to heal. Clinically, the duration of fever in children is usually more than a week, and when children have poor immunity, they will be combined with other infections, such as bacterial infections or viral infections, and some extrapulmonary manifestations will appear. In more serious cases, symptoms of central nervous system encephalitis may occur, which may prolong the course of the disease and aggravate the symptoms.
...
Regarding the "lung washing" operation that parents are worried about, Wen Danning explained that in layman's terms, it is to extract phlegm from the lungs. "It's like a layer of mucus membrane attached to the bronchial tubes, making it difficult to breathe or even gasping for breath while walking. Generally, only severely ill patients need to do it. Children's lung repair function is better, and some children can expel phlegm more smoothly, so there is no need to do it. You can encourage them to Cough up the phlegm.”

This year, children generally have severe symptoms after being infected with Mycoplasma pneumoniae. Pneumonia may occur after two or three days of fever. She suggested that if a child develops symptoms, he or she should be taken to the hospital for treatment in a timely manner to avoid a "just push it through" mentality to avoid recurrence and aggravation of the condition.

"Taking Wuhan as an example, there are more than 80 second- and third-level medical institutions that provide pediatric diagnosis and treatment services. Regarding Mycoplasma pneumoniae, relevant departments have recently conducted several relevant trainings for hospitals with pediatrics, and the National Health Commission has also issued Diagnosis and treatment guide. As long as it is a regular hospital, it can generally handle it. You don’t have to go to a big hospital. If you encounter severe illness, you can transfer it to a higher-level hospital. "

Wen Danning said that Mycoplasma pneumoniae can be prevented according to the common anti-respiratory infection methods. Pay attention to rest, do not stay up late, strengthen your physical fitness, wash hands frequently, open windows for ventilation, and wear masks when going to public places with complex environments and gatherings of people. .

"Influenza and mycoplasma pneumonia are actually very traditional and old diseases. They are not new. Basically, the research is relatively clear. There are special and effective drugs, the treatment methods are also standardized, and the treatment plans are constantly updated. For this Don’t ignore similar diseases and don’t be too nervous. For children, respiratory syncytial virus will reach a small peak this season and requires great attention.”

Jiupai News reporter Dai Mengying and Yang Bingyu

Editor in charge: Chen Yan SN225

https://news.sina.cn/gn/2023-11-22/d...d=wuc&loc=4&r= 0&rfunc=71&tj=cxvertical_wap_wuc&tr=182



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Pediatrics operates at "full capacity" and takes a multi-pronged approach to cope with peak diagnosis and treatment

2023-11-22

Recently, the peak of pediatric diagnosis and treatment has attracted social attention. We learned from many hospitals that the number of pediatric visits has increased significantly since the start of school. In the past week, the average daily number of outpatient and emergency visits at Yangpu Hospital Affiliated to Tongji University reached more than 220, a significant increase compared with the same period last year, and a month-on-month increase of 5%.

A few days ago, 3-year-old Qianqian (pseudonym) suffered from a high fever. His parents were worried and took him to Yangpu Hospital Affiliated to Tongji University for treatment. Autumn and winter are the peak seasons for respiratory infections, and the pediatric diagnosis and treatment area is "full". Even though it was lunch time that day, there was still a queue waiting outside the clinic. Seeing the sick Qian Qian curled up in his father's arms, director of pediatrics Zhang Jihong gently picked him up, gave him a physical examination, and asked about the child's condition in detail. After examination, the child was diagnosed with pneumonia. The doctor comforted the parents and said that although the child's condition was a bit serious, it was completely curable and there was no need to worry too much. After two weeks of standardized medication, Qianqian recovered. He happily opened his arms and embraced the angel in white who was guarding him tenderly.

Judging from the pediatric diagnosis of Yangpu Hospital Affiliated to Tongji University, the children recently admitted are mainly infected with respiratory mycoplasma infection combined with infection by bacteria, viruses and other pathogenic microorganisms. The condition is relatively complex and changeable, and some children have even developed to critical illness.

Since the pediatric clinic, fever clinic and wards are currently operating at full capacity, multiple departments in the hospital are working together to provide convenient, standardized and warm diagnostic and treatment services for children.

Individualized treatment, group care

Mycoplasma pneumoniae is a common respiratory pathogen that is mainly spread through respiratory droplets or close contact. Children and adolescents, as susceptible groups, are often the most susceptible to infection. "Mycoplasma pneumoniae is neither a bacterium nor a virus. Because it lacks a cell wall, it is naturally resistant to antibacterial drugs that act on the cell wall, such as cephalosporins and penicillins." Zhang Jihong introduced that in clinical practice, multiple pathogenic microorganisms such as bacteria and viruses are combined. Infected children are more common. Once the disease recurs, it is difficult to recover, and it is very easy to be life-threatening. Close attention is required.

Tongtong (pseudonym), who had a persistent cough and recurring fever, failed to achieve significant results after using azithromycin for five days, so he came to the pediatric outpatient clinic of the hospital. A chest CT examination revealed that Tongtong had a large area of infection in his lungs. He was diagnosed with severe pneumonia and needed to be hospitalized as soon as possible. While in the hospital, the thin Tongtong had a high fever and his chest was heaving. He was so weak that he could not speak a word. His parents were extremely anxious. The medical team quickly carried out standardized treatment, including sputum suction and expectoration, atomization, and anti-inflammation. They closely monitored changes in the condition throughout the process, adjusted the treatment plan many times, and finally stabilized the condition. After more than 20 days of careful treatment by the medical team, the child's lung lesions were largely absorbed and he was eventually discharged from the hospital.

According to doctors, macrolide antibiotics are the first choice for the treatment of Mycoplasma pneumoniae. Among them, azithromycin is commonly used in children. 2-3 courses of treatment are used according to the condition of the child. For children whose dry cough significantly affects their rest, antitussive drugs can be used as appropriate. At the same time, children with Mycoplasma pneumoniae pneumonia should ensure adequate rest and avoid strenuous exercise; eat a reasonable diet, eat a light diet during high fever, eat easily digestible food, and ensure the balance of water and electrolytes.

Multi-department collaboration and process optimization improve medical experience

Since late October, the number of pediatric outpatient clinics has remained high, and they are still overcrowded even during lunch breaks. The doctors who sit in the clinic carefully examine every child and patiently answer parents' questions. The meals delivered from the hospital cafeteria often get cold on their desks...

In the corridor, the only two benches could no longer accommodate the large number of people waiting for abortion, not to mention the children who needed infusions and their accompanying family members. To this end, the hospital's outpatient and emergency offices and logistics departments have added comfortable seats and mobile infusion poles in the corridors of pediatric clinics, creating a convenient and comfortable medical environment for children and their families who come for treatment. In this way, even though the waiting time is longer than before, parents who have seats can feel more at ease.

Considering that many children are prone to drug resistance due to repeated respiratory infections, abundant drug reserves and supplies are a strong guarantee for maintaining the level of treatment services. At present, once there is a shortage of effective drugs, the hospital's pharmacy department will quickly replenish them, paving the way for pediatricians' treatment work.

https://www.shyp.gov.cn/shypq/xwzx-tpyw/20231122/442214.html

[sharon sanders]

Disease Outbreak News

Upsurge of respiratory illnesses among children-Northern China

23 November 2023


Description of the Situation


Since mid-October 2023, the World Health Organization (WHO) has been monitoring data from Chinese surveillance systems that have been showing an increase in respiratory illness in children in northern China.

At a press conference on 13 November 2023, China’s National Health Commission reported on a nationwide increase in the incidence of respiratory diseases, predominantly affecting children. Chinese authorities attributed this increase to lifting of COVID-19 restrictions and the arrival of the cold season, and due to circulating known pathogens such as influenza, Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mycoplasma pneumonia and RSV are known to affect children more than adults.

On 22 November 2023, WHO identified media and ProMED reports about clusters of undiagnosed pneumonia in children's hospitals in Beijing, Liaoning and other places in China. Through the International Health Regulations mechanism, WHO made an official request to China to provide additional epidemiologic and clinical information, as well as laboratory results from these reported cases and data about recent trends in circulating respiratory pathogens. A key purpose was to identify whether there have been “clusters of undiagnosed pneumonia” in Beijing and Liaoning as referred to in media reports, and if so whether these were separate events, or part of the known general increase in respiratory illnesses in the community. WHO further reached out through clinical networks for additional information.

(My bolding in paragraph below. s.s.)

On 23 November, WHO held a teleconference with Chinese health authorities from the Chinese Center for Disease Control and Prevention and the Beijing Children’s Hospital, facilitated by the National Health Commission and the National Administration of Disease Control and Prevention, in which the requested data were provided, indicating an increase in outpatient consultations and hospital admissions of children due to Mycoplasma pneumoniae pneumonia since May, and RSV, adenovirus and influenza virus since October. Some of these increases are earlier in the season than historically experienced, but not unexpected given the lifting of COVID-19 restrictions, as similarly experienced in other countries. No changes in the disease presentation were reported by the Chinese health authorities. Chinese authorities advised that there has been no detection of any unusual or novel pathogens or unusual clinical presentations, including in Beijing and Liaoning, but only the aforementioned general increase in respiratory illnesses due to multiple known pathogens. They further stated that the rise in respiratory illness has not resulted in patient loads exceeding hospital capacities.

The Chinese authorities advised that, since mid-October, enhanced outpatient and inpatient surveillance has been implemented for respiratory illnesses covering a broad spectrum of viruses and bacteria, including, for the first time, Mycoplasma pneumoniae. This complements existing respiratory surveillance mechanisms and may have contributed to the observed increase in detection and reporting of respiratory illness in children.


Public Health Response


Since mid-October, in addition to enhancing disease surveillance in health care facilities and community settings, Chinese authorities have stressed the need to strengthen the capacity of the health system to manage patients. China has systems in place to capture information on trends in influenza, influenza-like illness (ILI), RSV and SARS-CoV-2, pneumonia and other severe acute respiratory infections (SARI), and reports influenza detections to platforms such as the Global Influenza Surveillance and Response System (GISRS). GISRS is led by WHO and used for the international virological and epidemiological surveillance of human influenza.

WHO is closely monitoring the situation and is in close contact with national authorities in China. WHO will continue to provide updates as warranted.


WHO Risk Assessment


In the current outbreak of respiratory illness, the reported symptoms are common to several respiratory diseases and, as of now, at the present time, Chinese surveillance and hospital systems report that the clinical manifestations are caused by known pathogens in circulation. Mycoplasma pneumoniae is a common respiratory pathogen and a common cause of paediatric pneumonia, and is readily treated with antibiotics.

China has an influenza-like illness (ILI) and severe acute respiratory infections (SARI) sentinel surveillance system. Since mid-October, China has implemented enhanced surveillance systems for respiratory illness covering a broad spectrum of respiratory viruses and bacteria, including Mycoplasma pneumoniae.

There is limited detailed information available to fully characterize the overall risk of these reported cases of respiratory illness in children. However, due to the arrival of the winter season, the increasing trend in respiratory illnesses is expected; co-circulation of respiratory viruses may increase burden on health care facilities.

According to surveillance data reported to WHO’s FluNet and published by the National Influenza Centre in China, ILI was above usual levels for this time of year and increasing in the northern provinces. Influenza detections were predominantly A(H3N2) and B/Victoria lineage viruses.


WHO Advice


Based on the available information, WHO recommends that people in China follow measures to reduce the risk of respiratory illness, which include recommended vaccines against influenza, COVID-19 and other respiratory pathogens as appropriate; 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 practicing regular handwashing.

WHO does not recommend any specific measures for travellers to China. In general, persons should avoid travel while experiencing symptoms suggestive of respiratory illness, if possible; in case of symptoms during or after travel, travellers are encouraged to seek medical attention and share travel history with their health care provider.

WHO advises against the application of any travel or trade restrictions based on the current information available on this event.

https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON494

[Treyfish]

China Reports No Unusual Pathogens In Respiratory Illness Surge: WHO

---

By AFP - Agence France Presse
November 23, 2023

China says it has not detected any unusual or new pathogens in the increase in respiratory illnesses in the north, the WHO said Thursday after pressing Beijing for detailed information.

more....


https://www.barrons.com/news/china-r...e-who-8e276247

[Treyfish]

"NO IMMUNITY’

China to BLAME for mystery illness surge as ‘exit wave’ hits in first winter since world’s strictest lockdown, prof says


The unknown disease seems like a worrying echo of the deadly Covid outbreak

• Juliana Cruz Lima

• Published: 14:13 ET, Nov 23 2023

A PROFESSOR has "blamed" China's strict lockdown for the mystery pneumonia currently sweeping across the country.

Hospitals in Beijing and Liaoning are reportedly "overwhelmed with sick children" who have symptoms such as inflammation in the lungs and a high fever but no cough.
.....Professor Francois Balloux, from the UCL Genetics Institute, explained that China is likely going through "lockdown exit" waves of respiratory infections after the country lifted strict lockdown restrictions.

“China is likely experiencing a major wave of childhood respiratory infections now as this is the first winter after their lengthy lockdown, which must have drastically reduced the circulation of respiratory bugs, and hence decreased immunity to endemic bugs," he said.

....
However, "since China experienced a far longer and harsher lockdown than essentially any other country on earth, it was anticipated that those 'lockdown exit' waves could be substantial," he said.

The UCL expert reassured that there is no reason to suspect the emergence of a novel pathogen unless new evidence emerges.
.... https://www.the-sun.com/health/9701211/china-mystery-illness-surge-children-lockdown-covid/

[sharon sanders]

Helen Branswell
@HelenBranswell

17h
There's a maxim in medicine: When you hear hoofbeats, look for horses, not zebras. That's useful to remember as we wait for more info on childhood illnesses in #China. This sounds more like the legacy of its zero Covid policy than a new disease threat.

[sharon sanders]

For those who do not know, Helen Branswell is a veteran disease reporter. She was with Canadian Press for many years and is now with Stat. While she may, or may not be correct, her observations should always be seriously considered.