The increase in the incidence of respiratory diseases, predominantly affecting children in China. 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), SARS-CoV-2. This “mysterious” pneumonia cases have attracted the world's attention.

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing.

In some cases, patients with a low immune system can experience complications in the form of the spread of bacteria in the bloodstream. This condition has the risk of causing failure in the function of the body's organs, which is usually characterized by lung abscesses and pus.

In addition, inflammation that is not treated immediately can cause the formation of inflammatory fluid, which can then collect in the protective lining of the lungs. If this condition occurs, a fluid removal procedure by a doctor becomes necessary.

Picture 1. Pneumonia

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. 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.

Chinese authorities also 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, respiratory syncytial virus (RSV), Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and Mycoplasma pneumoniae.

Mycoplasma pneumoniae is a common respiratory pathogen and a common cause of paediatric pneumonia, and is readily treated with antibiotics. Mycoplasma pneumonia and RSV are known to affect children more than adults, but can affect anyone. People living and working in crowded settings are at increased risk. Other people at increased risk for serious infections include those who recovering from a respiratory illness and weakened immune system.

Symptoms of pneumonia usually start with certain signs. The following are the symptoms that usually appear:

• Fever accompanied by headache and body chills.
• Cough without phlegm, or phlegm with yellowish pus-containing fluid.
• Chest pain that is felt when breathing, short of breath.
• Nausea, vomiting and diarrhea.
• Pain in muscles, joints, and fatigue easily.
• Weakened pulse up to 100 beats per minute.
• If a family member has trouble breathing or there is an increase in breathing frequency, immediately take them to the hospital to get appropriate treatment.

It is known that currently, the “mysterious” pneumonia phenomenon does not only occur in China. Other countries such as India and the Netherlands are also experiencing this phenomenon.

With the occurrence of this outbreak, other countries are expected to taken a proactive stance by initiating a comprehensive review of respiratory disease preparedness measures and immediate strengthening of public health and hospital preparedness measures.

To prevent the spread of this "mysterious" pneumonia, WHO recommends to follow measures to reduce the risk of respiratory illness. Which include:

1. Get vaccinated against influenza, COVID-19, and other respiratory pathogens as appropriate
2. Keeping distance from people who are ill
3. Staying home when ill
4. Getting tested and medical care as needed
5. Wearing masks as appropriate
6. Ensuring good ventilation
7. Practicing regular handwashing

WHO also 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.

References:

1. Centers for Disease Control and Prevention. (2022). Mycoplasma pneumoniae Infections: People at Risk
2. Kementerian Kesehatan Indonesia. Pneumonia
3. Mayo Clinic. (2020). Pneumonia
4. World Organization Health. (2023). Upsurge of respiratory illnesses among children-Northern China