CHINA´S PEDIATRIC PNEUMONIA OUTBREAK: WHAT WE KNOW SO FAR

Medically Reviewed by Dr. Sony Sherpa (MBBS) - September 23, 2024

Since October 2023, the World Health Organization (WHO) and Chinese health authorities have recorded an increase in the number of children hospitalized with severe pneumonia in Northern China, especially in Beijing, Tianjin, Hebei, and Inner Mongolia. The news reports have also confirmed the rising trend of respiratory infections in children, and some have even speculated about the possibility of a new virus or a variant of COVID-19.

Despite tensions surrounding the recent child pneumonia outbreak in Northern China, officials assure the public that they have emerged from known viral and bacterial infections and not some novel pathogen. ^[1]

According to China’s National Health Commission, the mysterious surge in respiratory infections in children is caused by the lifting of COVID-19 restrictions and the arrival of flu season. After reviewing the data, the World Health Organization (WHO) confirms that hospital admissions are due to the circulation of flu season regulars, such as Mycoplasma pneumoniae and respiratory syncytial virus (RSV). These are common causes of pneumonia and other respiratory diseases in children, and as with SARS-CoV-2, they can spread easily through respiratory droplets from coughing, sneezing, or talking. The symptoms can be mild to severe, depending on the age and health status of the infected person.

Why The China Respiratory Outbreak Is More Prevalent In Children Than In Adults

Child pneumonia may be more common than adult pneumonia for several reasons. Children are more susceptible to most respiratory infections than adults because they have not yet formed immunity to viruses and bacteria. They also have smaller airways and less developed defenses that help fight off infections. Interestingly, this is not true for SARS-CoV2 infections, in which children are oftentimes more asymptomatic (without symptoms).

In this particular case, lifting the COVID-19 prevention measures may have contributed to the surge of respiratory illness seen in the kids of Northern China. While effective against COVID-19, the measures are likely to have reduced the exposure of children to other respiratory viruses that circulate during the winter season, such as RSV and influenza. As a result, some children may have missed the opportunity to develop immunity to these viruses and maybe even more susceptible to infection now that the restrictions have been lifted.

Also, the pandemic has increased our awareness of any outbreak which may have been widespread and commonplace beforehand. To detect and monitor respiratory infections in children, many countries around the world have implemented surveillance systems that collect and analyze biometric data from several sources, such as hospitals, clinics, laboratories, and schools.

China has implemented two main surveillance systems: the severe acute respiratory infections (SARI) and influenza-like illness (ILI) sentinel surveillance systems. These keep track of respiratory illnesses in the population and are able to cover a broad spectrum of respiratory viruses and bacteria. In this case, these systems detected an unusually high level of hospitalizations for child pneumonia, even for flu season.

What Health Authorities Are Doing To Address Current And Future Pneumonia Outbreaks

The child pneumonia outbreak in northern China is one example that reflects the global situation of respiratory diseases and, by extension, infectious illnesses at large. With increased awareness of infections and better collaboration from nations all over the world, it is becoming ever more possible for the world to unite against infectious outbreaks, which act as a major contributor to many lifelong chronic diseases and ailments.

Chinese health authorities and the WHO have taken the child pneumonia outbreak seriously, working towards strengthening healthcare surveillance systems and medical treatment. Both are in constant communication and working together to address the current and future pneumonia outbreaks.^[2]

As a result, surveillance and testing in China are now being expanded to include a broader scope of respiratory infections. This includes mycoplasma pneumoniae (or “walking pneumonia”), which is known to be an ordinary cause of infantile pneumonia. Other viruses found to be responsible for these outbreaks included adenovirus, influenza of A(H3N2) and B/Victoria lineages, and respiratory syncytial virus (RSV).

With improved health surveillance systems like the one China has implemented, health authorities can identify the causes of outbreaks, symptoms, transmission modes, those at risk, and timely prevention measures.

In the future, we can expect to receive news on outbreaks the moment they occur. It is important for the public to be aware of how these changes will affect healthcare moving forward and to understand how they can contribute towards global disease control and prevention. By remaining informed and following simple hygiene and safety measures, everyone can feel calm and safe, and this helps improve the health and well-being of all around them.

Pneumonia Symptoms and Global Impact

The respiratory illness known as pneumonia is brought on by an accumulation of fluid in the lungs, which makes breathing difficult and frequently painful. It is usually caused by a viral or bacterial infection.

According to the WHO, respiratory diseases are among the leading causes of death and disability globally^[3], especially in low- and middle-income countries, where access to health care and vaccination are limited. Pneumonia is one of the most common respiratory diseases and is known to increase the risk for many others, including bronchitis, asthma, chronic obstructive pulmonary disease (COPD), and lung cancer. These can affect people of all ages, genders, and backgrounds. However, children, older adults, and people with chronic conditions tend to be more vulnerable.

Signs of pneumonia change depending on the geographic location, climate, and season. In some parts of the world, pneumonia is mainly caused by bacteria, such as Streptococcus pneumoniae and Haemophilus influenzae, and can be prevented by vaccination. In other parts of the world, pneumonia is mainly caused by viruses, such as RSV, influenza, and SARS-CoV-2, and can be prevented by hygiene measures and antiviral drugs. ^[4]

The symptoms and signs of pneumonia also differ depending on the type and severity of the infection, but they usually include:

• Cough
• Fever
• Chest pain
• Shortness of breath
• Wheezing
• Fatigue

Pneumonia and other respiratory diseases usually last for a few days or weeks, depending on the type and severity of the infection and the age and health status of the person. However, some cases may last longer or recur, especially if the infection is not treated properly or completely or if the person has a weak immune system or a chronic disease.

How to Diagnose and Treat Pneumonia

If you or your loved ones are displaying similar signs and symptoms, follow standard respiratory prevention measures and do not panic. The infected person will need to seek out medical attention as soon as possible to see whether they can receive treatment (whether it is bacterial or viral). As pneumonia is contagious and limits one’s ability to wear a mask, it may be best for the infected to arrange a house call with their GP.

A doctor will run tests on the infected person to assess what the cause of the pneumonia is and how they can best treat it. They might order blood tests, analyze sputum and urine samples, take nasal swabs, or perform a chest X-ray.

Treatment will depend on the infection and whether it is treatable.

• Antibiotics are available for treating Streptococcus pneumoniae, Haemophilus influenzae, or Mycoplasma pneumoniae.
• Antivirals may be able to treat RSV, influenza, and SARS-CoV2.

Corticosteroids may also be prescribed by the doctor to control moderately severe cases. Those with the worst infections will require hospitalization, respiratory assistance, and possibly IV fluid replacement as well.

If hospitalization is not required, the patient will need to remain in quarantine for at least 2 weeks until the symptoms are gone, and the test results are negative.

A few natural home remedies to help ease symptoms of pneumonia include:

• Drinking plenty of fluids
• Using a humidifier or steam inhalation
• Opting for herbal teas, spices, or essential oils to open the airways
• Enjoying immune-supportive foods and drinks, such as ginger, honey, and lemon
• Loading up on helpful supplements such as zinc and vitamin C

Pneumonia Prevention: How You Can Protect Yourself and Your Children From Respiratory Infections

The best way to protect yourself and your children from pneumonia and other respiratory diseases is to prevent them from happening in the first place. Prevention is cheaper, easier, and safer than receiving treatment. Prevention measures for pneumonia are similar to those used during the COVID-19 pandemic.

There are many things that you can do to prevent pneumonia and other respiratory diseases in yourself and your children, such as:

Get Vaccinated

Vaccination is one of the most effective and cost-effective ways to prevent pneumonia and other respiratory diseases, such as influenza and COVID-19. By stimulating the production of antibodies by the immune system against disease-causing microorganisms, a vaccine can prevent serious consequences and illness in both adults and children.

There are several vaccines that can prevent pneumonia and other respiratory diseases:

• Pneumococcal conjugate vaccine^[5]
• Haemophilus influenzae type b (Hib) vaccine^[6]
• Influenza vaccine
• Covid-19 vaccine

You and your children should get vaccinated according to the current guidelines and schedules, and you should consult your doctor if you have any questions or concerns about vaccination.

Practice Good Hygiene

Hygiene is another important way to prevent pneumonia and other respiratory diseases, as it can reduce the exposure and the transmission of the germs that cause the diseases. Hygiene involves keeping yourself and your children clean and healthy and avoiding contact with sick people and contaminated objects.

You and your children should practice good hygiene habits, such as

• Wash your hands frequently with soap and water.
• Use alcohol-based hand sanitizer.
• Cover your mouth and nose when you cough or sneeze, using a tissue or your elbow, and dispose of the tissue and other similar items properly.
• Do not share personal items, such as cups, utensils, or towels, with others.
• Clean and disinfect the surfaces and the objects that you touch often, such as doorknobs, keyboards, or toys.

Wear a Facemask

Facemasks can help to lower the spread of any respiratory infection. To avoid contracting infectious pneumonia, it is important to wear one when inside a public space (especially in a hospital or clinic) and on public transport. As pneumonia limits one’s breathing, it is best to go out as little as possible, as wearing a mask might worsen symptoms.

Practice Social Distancing

Keep a safe distance away from other people, especially if you think you are coming down with an infection, or have compromised immune function. It is also a good idea to practice social distancing around other people if they display signs of illness.

Ensure Good Ventilation

Ventilation is another key way to minimize the risk of pneumonia and other respiratory diseases, as it can improve the quality of the air you breathe and prevent the accumulation and spread of airborne diseases.

Ensure there is enough fresh and clean air in the places where you and your loved ones live, work, study, or play, and avoid the places that are crowded, closed, or poorly ventilated. Keep windows and doors open regularly, use fans or air conditioners, if available, and change the filters or the ducts, if necessary, to remove the dust or pollutants. It also helps to limit smoking and exposure to secondhand smoke.

Conclusion

Pneumonia and other respiratory diseases are common and serious health problems that affect millions of people around the world, especially children, and they can cause significant morbidity and mortality. The recent surge of respiratory illnesses and pneumonia cases in children in northern China is a reminder of the importance of being aware and informed about these diseases and of taking the necessary measures to prevent and treat them, especially during the flu season and the COVID-19 pandemic.

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