China claims all clear on child respiratory disease

The World Health Organization (WHO) said Chinese authorities had provided data on an upsurge in respiratory illnesses among children and given the all clear.

China's data suggested the new lung infections were caused by a number of known pathogens, including influenza viruses and mycoplasma bacteria which tend to affect children more than adults.

During the COVID-19 pandemic, China was accused of rarely handing over medical data on infections. That may be a reason why the WHO took the step of publicly requesting data, including laboratory results, now.

Chinese public asked to take measures to limit the spread of disease

China is bound under the WHO's International Health Regulations to declare outbreaks of infectious diseases caused by an unknown source.

The WHO called on the Chinese public to adopt measures to limit the risk of spreading the respiratory infection.

That includes taking recommended vaccines, keeping distance from infected people, staying at home when sick, seeking medical assistance, wearing face masks, ensuring good ventilation and washing hands regularly, according to a WHO statement.

Emergency rooms beyond capacity

China saw a spike in respiratory infections among children over a short space of time. At the start, most infections were located in the north of the country.

A Taiwanese news portal, FTV News, reported that hospitals in Beijing and in the province of Liaoning, located about 800 kilometers (497 miles) from the capital, were seeing cases.

In Liaoning's harbor city Dalian, the foyer of the children's hospital was reportedly full of kids who needed an infusion. Emergency rooms were also full in Xiamen, an island city on China's eastern coast, facing Taiwan.

Unusual symptoms

The respiratory disease has now spread throughout the entire country. In many places, schools were closed because both teachers and children were ill.

Instead of common lung infection symptoms, such as a dry cough, sick kids were experiencing high fevers and lung or pulmonary nodules, which are small lumps in the chest.  

On November 21, ProMED, an information service of the International Society for Infectious Diseases, drew attention to the developments in China, warning of "clusters of undiagnosed pneumonia in children in northern China."

ProMED noted it was too early to say if this would lead to a new pandemic, but that it was unusual the disease had affected so many children so quickly.

Beijing is hesitant

China was slow to release information. Its health authorities attributed the rising cases to the lifting of COVID-19 prevention measures and the spread of known illnesses, including flu and mycoplasma pneumoniae, Respiratory Syncytial Virus (RSV) and SARS-CoV-2, the virus that causes COVID.

To stop the spread, Chinese authorities said they wanted to strengthen monitoring in health facilities and the capacities of its health systems. 

Search for the cause of the outbreak

It is plausible that known pathogens are causing the outbreak of respiratory infections, rather than a new virus.

After three years of very strict COVID prevention measures, China suddenly lifted them in December 2022. As a result, COVID cases rose quickly again — about 90% of the 1.4 billion population is said to have gotten infected.

According to experts, the rigid COVID restrictions may have led to immune defenses throughout the population. Other countries saw similar waves of infections in the first winter after COVID restrictions were lifted.

"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 in China," said François Balloux, a professor of Computational Systems Biology at University College London in comments provided to the UK Science Media Centre (SMC).

Meanwhile, David Heymann, an infectious diseases expert at the London School of Hygiene and Tropical Medicine, said a number of known pathogens were currently in season in China.

"The challenge is to discern the outbreaks and determine the cause," Heymann told SMC. "There are many different known viruses that could be the cause and these must all be sought in testing."

Until there is evidence of a new pathogen, said both Heymann and Balloux, there was no reason to suggest that there was one.

This article was originally published in German.