What we know about the unexplained outbreak of respiratory illness in China

China has seen an uptick in respiratory illness and clusters of undiagnosed pneumonia in children.

The World Health Organisation (WHO) has asked China for more detailed information about the increase in respiratory disease.

Look back to 5 January, 2020, and you’ll find a statement from the WHO titled “Pneumonia of unknown cause – China”.

It is therefore unsurprising that news of another mystery outbreak has set alarm bells ringing – but a WHO doctor has warned against jumping to conclusions and says getting more information is key.

Here is what we know so far about the illness, what China has said, and what the WHO wants to find out.

What do we know about the mystery illness?

Northern China has reported an increase in influenza-like illnesses since mid-October, compared with the same period in the previous three years, according to the WHO.

Clusters of undiagnosed pneumonia in children in northern China have also been reported by groups including the Programme for Monitoring Emerging Diseases.

The WHO said it was unclear if the clusters were associated with an overall increase in respiratory infections – or separate events.

On 21 November, public disease surveillance system ProMed issued a notification about reports of “undiagnosed pneumonia”.

The alert, based on a report by Taiwanese outlet FTV News, said children’s hospitals in Beijing and Liaoning, 500 miles apart, were “overwhelmed with sick children”.

“Many, many are hospitalised,” Mr Wei, a Beijing citizen, told FTV News. “They don’t cough and have no symptoms. They just have a high temperature (fever) and many develop pulmonary nodules.”

In an editor’s note, ProMed said: “This report suggests a widespread outbreak of an undiagnosed respiratory illness … 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.”

What has China said about the outbreaks?

Chinese authorities said the rise in respiratory illness was partly due to COVID-19 restrictions being lifted.

In the winters after pandemic measures lifted in the UK, there was a surge in illnesses including flu, RSV and strep A, as people mingled more after winter seasons where illnesses had been suppressed by people staying home and wearing masks.

China dropped its COVID restrictions much later than many other countries, scrapping testing and isolation rules last December.

Authorities also said the spike was due to known illnesses circulating, including flu, RSV, COVID-19 and mycoplasma pneumonia, a common bacterial infection that typically affects younger children.

The cold weather has also played a part, according to Chinese authorities.

As temperatures plummeted in Beijing, in northern China, the capital “entered a high incidence season of respiratory infectious diseases”, Wang Quanyi, deputy director and chief epidemiological expert at the Beijing Center for Disease Control and Prevention, told state media on Wednesday.

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What has the WHO said?

The WHO has made an official request to China for additional epidemiologic and clinical information as well as laboratory results from the reported outbreaks among children.

It has also requested further information about trends in the circulation of known pathogens referenced by Chinese authorities.

The WHO said it was in contact with clinicians and scientists through its existing technical partnerships and networks in China.

Writing on X, formerly Twitter, Dr Krutika Kuppalli, who is part of the WHO’s emergency programme, said the outbreaks “really could be anything”.

She warned against jumping to conclusions, saying: “The point is we need information.”

The WHO said that while it was seeking additional information, it recommended people in China follow measures
to reduce the risk of respiratory illness.

These measures included vaccination, keeping distance from sick people, staying at home when ill, getting tested and
medical care as needed, wearing masks as appropriate, ensuring good ventilation, and regular hand-washing.

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