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

CDC Advised To Weaken Infection Protections As Mysterious Pneumonia Brews Overseas


Judy Stone
Senior Contributor
I am an Infectious Disease specialist and author of Resilience: One Family's Story of Hope and Triumph over Evil and of Conducting Clinical Research, the essential guide to the topic
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Nov 24, 2023,12:56pm EST​

​​​​​​

The Healthcare Infection Control Advisory Committee met on November 3 and, to no one’s surprise, voted unanimously to accept their widely criticized draft guidelines, which weakens infection prevention precautions. The guidelines now go to Mandy Cohen, the CDC director, for approval.
​...an early warning network from the International Society for Infectious Diseases, issued a warning of a widespread outbreak of respiratory infections and clusters of pneumonia in children in China. The World Health Organization followed with a global alert on Nov 22. Some hypothesize that the infections are due to “immunity debt,” others that it is “immunity theft,” from immune systems weakened by prior Covid19. Even if this outbreak does not prove to be due to a novel pathogen, this serves as a warning for the future.​....

......Criticisms of HICPAC fall into three general areas. First, their guidelines themselves water down infection control protection for all. In particular, the new proposal suggests that surgical masks (aka “baggy blues”) are equivalent to N95s in protectiveness and will be the new standard.

Peg Seminario, a retired safety and health director for the AFL-CIO, said the proposed guidelines “don't protect healthcare workers and patients. They (HICPAC) certainly have not responded to any of the comments that have been made by the public or by experts both to HICPAC and the CDC.”
​.....:tiphat: https://www.forbes.com/sites/judyst...eumonia-brews-overseas/?sh=58f5943c48de​​​​​​
 
1) WHO did not issue a global alert. They contacted China officials and asked what is going on. The response is in post #12 above.
2) The referral service, ProMED, issued their report on November 22, 2023 which is about 7 months after the documented start of the increased pediatric respiratory illnesses phenomena. ...7 months...
3) See post #17 above for the real timeline.
 
Mysterious Pneumonia outbreak leaves China's hospitals 'overwhelmed with such children'
Alert issued to global scientists as infection tears through schools in Beijing and Liaoning province


6 HOURS AGO​
DANIEL KEANE

Scientists have raised concern over a mysterious “pneumonia like” illness that has left hospitals in China “overwhelmed with sick children”.

An alert was issued through ProMed – a large surveillance database which monitors disease outbreaks– warning of an epidemic of “undiagnosed pneumonia” in children.
Taiwanese news website FTV News said that children were presenting to hospitals in Beijing and Liaoning – 500 miles northeast – with symptoms including a high fever and inflammation of the lungs, but no cough.

A Beijing citizen told the outlet: “Many, many (children) are hospitalised. They don’t cough and have no symptoms. They just have a high temperature and many develop pulmonary nodules.”

He added: “Now you are not allowed to report to school. If you have any symptoms such as fever, cold, cough and then you are hospitalised, you can ask for leave.”

Local media reported that the lobby of Dalian Children’s Hospital in Liaoning province was also “full of sick children” receiving intravenous drips. ...

An editor’s note posted by ProMed on Wednesday said that the FTV News report suggested a “widespread outbreak of an undiagnosed respiratory illness”.

It added: “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.” ...

https://www.standard.co.uk/news/wor...k-china-hospitals-sick-children-b1122117.html

 
Source: https://www.taipeitimes.com/News/taiwan/archives/2023/11/24/2003809643

Fri, Nov 24, 2023 page3
Bacteria 60% resistant to Zithromax, other drugs
INFECTIOUS DISEASE: A strain of common bacteria creating a respiratory illness surge in China is already stronger than a common medication, health experts said
By Jake Chung / Staff writer, with CNA

Infectious disease experts yesterday raised caution about antibiotic resistance, saying that a bacteria partially responsible for a surge in respiratory illness in China is 60 percent resistant to antibiotics in Taiwan.

On Wednesday, the WHO officially asked China to provide detailed information on an increase in respiratory illnesses.

Chinese authorities attributed the increase to circulation of known pathogens such as influenza, Mycoplasma pneumoniae — a common bacterial infection that typically affects younger children — respiratory syncytial virus and the virus that causes COVID-19, the WHO said.

Infectious Diseases Society of Taiwan president Wang Fu-te (王復德) told an event in Taipei that Mycoplasma pneumoniae is an oft-seen infection in Taiwan that occurs year-round.

Zithromax, the antibiotic brand used to treat the infection, is already seeing 60 percent drug resistance in Taiwan, he said.​..
 
China: Rising cases of respiratory disease and pneumonia spark WHO concern - BMJ

Published 23 November 2023

Cite this as: BMJ 2023;383:p2770

BMJ 2023; 383 doi: https://doi.org/10.1136/bmj.p2770 ()​

The World Health Organization has made an official request to China for more detailed information after reports of an increase in respiratory illnesses and reported clusters of pneumonia in children.

On 21 November posts on ProMED, the free disease reporting service that first alerted the world to covid-19, reported clusters of undiagnosed pneumonia in children in northern China. WHO requested additional epidemiological and clinical information as well as laboratory results from the reported clusters through the International Health Regulations mechanism.

“There is currently no evidence that the increase in paediatric pneumonia cases in China may be due to a new virus,” said Zania Stamataki, associate professor in viral immunology at the University of Birmingham, UK.

Paul Hunter, professor in medicine at University of East Anglia, agreed that it did not sound like an epidemic caused by a novel …

https://www.bmj.com/content/383/bmj.p2770.full
 
Source: https://www.statnews.com/2023/11/24/china-respiratory-illness-immunity-gap-who-maria-van-kerkhove/

Pandemic-related immunity gap in kids explains surge of respiratory infections in children in China, says WHO
By Helen Branswell Nov. 24, 2023​


Reports this week that China is experiencing a surge in respiratory infections in young children triggered flashbacks of the start of the Covid-19 pandemic among infectious disease watchers. But a rapidly organized meeting Thursday between the World Health Organization and health officials in China assuaged much of that concern.

The evidence presented to the WHO team pointed to what’s sometimes called an immunity gap that was created by the pandemic. A dramatic reduction in circulation of other viruses and bacteria created a cohort of kids with few immunological defenses against bugs like influenza, RSV, and other cold-causing viruses, setting the stage for large outbreaks when those pathogens returned.

Maria Van Kerkhove, acting director of the WHO’s department of epidemic and pandemic preparedness and prevention, spoke to STAT on Friday about what the agency learned in the meeting, why this event set off such concern globally, and where things stand with Covid.

The conversation has been lightly edited for length and clarity.

WHO asked China for surveillance data but also for laboratory results. What kind of evidence did you get that what they’re seeing is what they told you they were seeing?

What they were giving us was an overview of current trends in acute respiratory illnesses across the country. And they were giving us some readouts from that surveillance system based on age. So, looking at the youngest age groups, looking at school-aged kids. They also gave us a readout on a new multiple pathogen surveillance system that started in mid-October looking at 13 pathogens — 10 viruses, three bacteria.

And we also utilize our Global Influenza Surveillance and Response System. Of course, we were checking the genetic sequences that were submitted to GISAID [a global sequence database] and looking at the variant circulation. There’s different ways that we cross-referenced some of that information.

And then 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.

And you think the immunity gap explanation is plausible?

Yes, that immunity gap opening up and new detection methods to be able to capture the incidence of these types of pathogens around the country. This is not an indication of a novel pathogen. This is expected. This is what most countries dealt with a year or two ago.​..
 
Perhaps information was 'misplaced' in media's translation, located in London: it happens.
..."On Tuesday, ProMED, a vigilant media and public disease surveillance system, flagged the presence of undiagnosed pneumonia clusters among children in northern China, prompting health authorities to investigate.

A ProMed alert issued in late December 2019 served as an early warning signal, alerting the medical community, scientific world, and high-ranking officials at the World Health Organization to the emergence of a novel virus, later identified as SARS-CoV-2 or coronavirus.

"With the outbreak of pneumonia 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," ProMed said in a statement. ..."

https://www.ndtv.com/world-news/chi...ery-pneumonia-surge-and-what-who-says-4598910
 
No new pathogens in respiratory disease surge, China tells WHO

Published: 9:12pm, 24 Nov, 2023​
  • WHO had asked for more information on ‘undiagnosed pneumonia’ among children in Beijing and the northeastern province of Liaoning
  • Recent spike worsened by overuse of antibiotics, health experts say
Beijing has told the World Health Organization that there was no new or unusual pathogen behind a spike in respiratory diseases among children in the past few months.

But a persistent drug resistance problem caused by the overuse of antibiotics had exacerbated outbreaks caused by the mycoplasma pneumonias in recent months, health experts said.

Pathogens like mycoplasma pneumonias can cause common bacterial infections that typically affect children.
​....Beijing told the WHO on Thursday that outpatient and hospital admissions of children with mycoplasma pneumonias started to rise as early as May. Respiratory diseases caused by other pathogens, including respiratory syncytial virus (RSV), adenovirus and influenza virus, began to jump in October.

Mycoplasma pneumonia bacteria infections usually cause mild respiratory symptoms. However, experts and officials said this year’s outbreak was particularly serious because of the bacteria’s macrolide resistance.....
David Hui Shu-cheong, a respiratory expert at the Chinese University of Hong Kong, said doctors in Beijing had to obtain parents’ consent to prescribe antibiotics not usually used for children – so-called off-label use – because of macrolide-resistant mycoplasma pneumonias.

“Doxycycline treatment may lead to yellow discolouration of teeth and slow down the growth of bones in children and thus is usually not recommended for children below the age of eight, while fluoroquinoline may damage cartilage and thus is usually not recommended for people below the age of 18,” Hui said, referring to two such antibiotics recently prescribed.

“However when there is a high frequency of mycoplasma resistance to macrolide, the off-label use of these drugs is needed.”.....While other pathogens have since overtaken mycoplasma pneumonias as major causes of respiratory diseases among children, a directive issued by China’s State Council on Friday warned that pathogens causing influenza and mycoplasma pneumonias would proliferate throughout this winter and into next spring.

:tiphat:

https://www.scmp.com/news/china/sci...-tells-who?module=top_story_8&pgtype=homepage
 
Desperate parents clutch children hooked to IVs on hospital floors as China’s mystery ‘pneumonia’ outbreak worsens

NOVEMBER 25, 2023

.....A MYSTERY pneumonia outbreak sweeping through China continues to get worse as desperate parents are clutching onto their children on hospital floors.

Kids are being hooked up to life-saving IVs as Beijing – where the unknown virus has badly hit – continues to downplay the dangers almost a week after issues started...

...The mystery illness has caused panic for parents who have been rushing to hospitals

The dangerous illness is taking down children and emptying out schools across China as worrying echos of the Covid outbreak are being reported.

Doctors have been left overwhelmed with thousands of calls from worried parents trying to book emergency appointments.

;) Beijing has told the World Health Organisation (WHO) that the increase in cases of people with flu like symptoms is down to a new winter bug that has taken over due to Covid lowering immunity to common viruses.....
​Officials have reported an increase in “influenza-like illness” since mid-October when compared to the same period in the last three years, the WHO said.

Children are now showing ground glass opacity, also known as “white lung syndrome”, in lung scans – an indicator of severe respiratory illness.

Many parents are deeply worried about “white lungs” and many sick children need “lung cleansing”, report Radio Free Asia.

But with hospitals warning of long waiting queues, parents are having to wait at least a day just for emergency care.
Li Meiling, 42, brought her eight-year-old daughter to the hospital, who she said was suffering from the same type of pneumonia.

“A lot of children her age are ill with this at the moment,” she added....

Dr Hua Shaodong, a paediatrician at the Beijing Children’s Hospital, told China Daily: “There is a steady number of patients developing severe cases, but there are very few critical cases, and there are no related deaths so far.

“The average days in hospital for hospitalised patients is around seven to 14 days.”......
UK Health Security Agency (UKHSA) chief executive Professor Dame Jenny Harries said despite China’s official response, they are keeping an ‘open mind’.:rolleyes:

She said: “The WHO has received an official response from China following its request for detailed information on an increase in respiratory illnesses and reported clusters of pneumonia in children.

“We need to keep an open mind about the cause of any increased reporting of clusters of disease including of this illness in Chinese children.’


She added that UKHSA is “closely monitoring the situation” and will keep a close eye on the situation to help keep the UK safe from any poten....
​:tiphat:

​​​​​​https://news.repithwin.com/desperat...as-chinas-mystery-pneumonia-outbreak-worsens/
 
Chinese hospitals swamped with severe child pneumonia cases

Mycoplasma pneumoniae is causing a wave of severe illness among children, as well as some adults, experts say.
By Hsia Hsiao-hwa for RFA Mandarin
2023.11.22​

​​​​​​Hospitals in northern China are currently overwhelmed by thousands of children suffering from a bacterial form of pneumonia that is causing a resurgence of severe illness following a lull during three years of zero-COVID restrictions, doctors and health experts told Radio Free Asia on Wednesday.

The Beijing Center for Disease Control and Prevention said that more than 3,500 cases of "respiratory infection" had been admitted to the Beijing Children's Hospital at the beginning of the month, while media reports blamed the outbreak on Mycoplasma pneumoniae, an atypical bacterium that causes lung infection.
Photos and video clips posted to social media from Beijing and Tianjin showed hospital waiting rooms crowded with people, many holding children, amid unconfirmed social media reports that many cases are showing ground glass opacity in lung scans – an indicator of severe respiratory illness.​....


....​​​​​​Chinese health officials on Monday warned that the country is now experiencing a peak of seasonal respiratory disease, with National Health Commission spokesperson Mi Feng calling on health officials to step up monitoring for M. pneumoniae, COVID-19 and seasonal influenza.

Monitoring data show that there is growing influenza in both the northern and southern regions, with H3N2 currently the dominant strain, state news agency Xinhua quoted National Influenza Center chief Wang Dayan as saying.

...Mi Ying, deputy chief physician of pediatrics at Peking Union Medical College Hospital, told the Workers' Daily on Nov. 15 that the bug can cause "mild, severe, or even critical illness."

"The severity isn't just related to the invasion by the pathogen, but to the person's immune response," he said.

​..Some medical journals have reported coinfection with COVID-19 and M. pneumoniae, while others have pointed to weakened immunity from infection and reinfection with COVID-19, which has also been linked to recent surges in other respiratory infections in children.....


....expert Wei Tianli said this year's outbreak is worse than usual "because the inflammatory response in the lungs is relatively severe ... across a relatively large area," making it harder to breathe.

Taiwan pediatrician Huang Li-min said children are more vulnerable to infection with mycoplasma pneumonia, yet the infection tends to transmit within households, affecting the adults, too.

"Recently, it has become more pathogenic due to mutations," Huang said. "Cases are higher, and more serious, causing an outbreak, with some people needing hospitalization."

"Members of the same family often catch it, one after another," she said, adding that Asia seems to be seeing a more mutated and pathogenic form of M. pneumoniae than Europe.


..Taiwan-based dissident Gong Yujian, who has contacts in China's medical system, said there is still a severe shortage of medical personnel, supplies and equipment in China, with many medical staff reluctant to work due to corruption, and a hierarchical medical system that offers patchy provision of care depending on how affluent someone is, and on where they live.​...

:tiphat:
https://www.rfa.org/english/news/china/child-pneumonia-11222023114634.html
 
New pneumonia-like illness in children in China, WHO urges citizens to vax, mask up
Jen Hodgson
Published on :
23 Nov 2023, 1:18 pm​​


​​​​​​The World Health Organization (WHO) confirmed “clusters” of cases of respiratory illnesses among children in northern China on Wednesday.

Symptoms include high fever and lung inflammation, but no cough or other flu-like symptoms.

The “undiagnosed pneumonia” has been found in children in Beijing and Liaoning province, which is about 500 km northeast of the capital. Health facilities are “overwhelmed with sick children” and schools may soon be suspended, according to local news reports.
​....Chinese officials made an official statement about the rise in pneumonia-like symptoms on November 13, after it had been spreading since mid-October. Chinese authorities “stressed the need for enhanced disease surveillance in healthcare facilities and community settings” a.....:tiphat:

​​​​​​https://www.westernstandard.news/ne...china-who-urges-citizens-to-vax-mask-up/50456
 
Map Shows Spread of Pneumonia Outbreak Across China

Nov 24, 2023 at 3:21 PM EST​
​​​​​​Parts of northern China are experiencing a dramatic increase in respiratory illnesses, particularly among children.

The Chinese national and local governments are not publishing infection numbers or other data on the outbreaks.
​....State-run CCTV news reported that in the capital of Beijing, hospitals have been operating at full capacity for over a month in response to this spike in infections. Beijing Children's Hospital revealed that its internal medicine department is seeing more than 7,000 cases daily. Beijing Jingdu Children's Hospital highlighted a significant rise in mycoplasma pneumonia inf.....The situation is similarly dire in Tianjin, a coastal city just east of Beijing. Tianjin Children's Hospital set a record on November 18, with 13,171 young patients visiting its outpatient and emergency departments in a single day, as reported by a local newspaper.....

China's largest city, Shanghai, along with the central city of Wuhan, where SARS-CoV-2 was initially identified, and the southern city of Guangzhou, have all experienced surges in mycoplasma infections in recent months, according to Chinese media group Caixin.

Taiwan-based NOWnews cited local reports saying the southern autonomous region of Guangxi is also seeing overcrowded hospitals....

.The World Health Organization said yesterday the Chinese health authorities had demonstrated the spike in hospital visits in northern regions was caused not by a new type of virus but by regular seasonal illnesses, including the typically mild mycoplasma pneumonia, or walking pneumonia, respiratory syncytial virus, adenovirus, and influenza.;)

Beijing's apparent reluctance to make information public has drawn comparisons between the current respiratory illness surge and the initial stages of the COVID outbreak.
​:tiphat:

​​​​​​https://www.newsweek.com/map-pneumonia-hot-spots-china-1846549
 
Taiwan CDC warns travelers to China of flu-like outbreak

TAIPEI (Taiwan News) — Taiwan’s Center for Disease Control (CDC) issued a warning for those traveling to China on Friday (Nov. 24) following reports of a respiratory disease outbreak with influenza-like symptoms.

Over the past month, there have been many reports of “pneumonia clusters” in China’s northeast, particularly around Beijing and Liaoning.

At a Friday press conference, the director of Taiwan’s CDC, Lo Yi-chun (羅一鈞), advised travelers going to China to wash their hands frequently, wear a face mask, and avoid visiting crowded public areas, reported CNA.

In response to reports of a spike in respiratory illnesses, the World Health Organization requested information on the illness from Beijing earlier this week. The Chinese authorities, who have a reputation for lacking transparency, promptly responded that “no unusual pathogens” have been detected among patients.
​,,,,,:tiphat:

https://news.trenddetail.com/news/442324.html
 
Taiwan CDC warns travelers to China of flu-like outbreak

TAIPEI (Taiwan News) — Taiwan’s Center for Disease Control (CDC) issued a warning for those traveling to China on Friday (Nov. 24) following reports of a respiratory disease outbreak with influenza-like symptoms.

Over the past month, there have been many reports of “pneumonia clusters” in China’s northeast, particularly around Beijing and Liaoning.

At a Friday press conference, the director of Taiwan’s CDC, Lo Yi-chun (羅一鈞), advised travelers going to China to wash their hands frequently, wear a face mask, and avoid visiting crowded public areas, reported CNA.

In response to reports of a spike in respiratory illnesses, the World Health Organization requested information on the illness from Beijing earlier this week. The Chinese authorities, who have a reputation for lacking transparency, promptly responded that “no unusual pathogens” have been detected among patients.
​,,,,,:tiphat:

https://news.trenddetail.com/news/442324.html


from the Taiwan CDC


CDC: People must pay attention to health protection when traveling to China as the influenza-like epidemic escalates

2023/11/24 18:22(Updated at 11/24 19:57


The Department of Disease Control and Prevention of the Ministry of Health and Welfare held a press conference on the 24th. Spokesperson Luo Yijun (left) pointed out during the conference that the classified influenza epidemic in northern China has increased for five consecutive weeks, and the increase last week was higher than before. The public is reminded that if they have traveled recently In mainland China, it is recommended to get a flu vaccine first, wash hands frequently, wear a mask, and avoid going to crowded places.

​snip

source: zhttps://www.cna.com.tw/news/ahel/202311240245.aspx
 
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