“Mysterious” and “pneumonia” are two words we don’t need to see together. Recently, clusters of “mystery pneumonia” cases have made the impression among young people in northern China. The mystery is that the reasons for those cases of pneumonia are still unknown.
The World Health Organization has to take such an outbreak very seriously, as evidenced by, you know, the total Covid-19 pandemic. That’s why the WHO has officially requested more data from the Chinese government on what the WHO describes as a recent “surge” in reported cases of respiratory illness and pneumonia in children” in the country. That doesn’t mean you deserve to start using the P-word back and start hoarding toilet paper rolls. But the situation deserves close monitoring.
China has already been experiencing an upswing of respiratory illnesses in general. Northern China has had increases in influenza-like illnesses since mid-October that have topped the numbers from the prior three years. Back on November 13, 2023, Chinese authorities from the National Health Commission blamed this upswing on their lifting of Covid-19 restrictions and the spread of rather familiar pathogens like influenza, Mycoplasma pneumoniae, respiratory syncytial virus, and, of course, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). China does have some surveillance systems in place to track the rates of these different pathogens. But they don’t necessarily make numbers from these systems publicly available.
The word M – which means “mysterious” and not Mycoplasma – emerged after November 21, when PROMED and various media outlets began reporting on those clusters of pneumonia cases that had no obvious causes. The express pathogens could have led those young people to contract pneumonia.
The term pneumonia is a very general term for any disease characterized by inflammation of the small sacs of the lungs called alveoli. The alveoli are where the oxygen you inhale passes from the airways into the bloodstream and carbon dioxide goes in the opposite direction. so you can exhale that carbon dioxide. Such inflammation can be accompanied by filling the alveoli with fluid or pus, which, in turn, can make it very difficult to exchange oxygen and carbon dioxide. This can lead to other symptoms of pneumonia, ranging from coughing to shortness of breath to shortness of breath.
So, whenever you hear someone say, “I have pneumonia,” your next question should be “What’s causing it?” rather than just saying, “Oh, it sucks” and walking away. The cause of pneumonia can greatly influence its eventual treatability. and prognosis.
Of course, a number of known respiratory pathogens including influenza, Mycoplasma pneumoniae, RSV and SARS-CoV-2 can cause pneumonia. So, these pneumonia cases in Northern China could potentially, possibly, perhaps be linked to the general surge in respiratory illnesses. However, lots of things are still about as clear as gravy about what’s happening in China. It’s not completely apparent whether the surge in respiratory illnesses is indeed completely due to already well-known respiratory pathogens. And it’s also not clear what’s been causing these mysterious pneumonia cases among children and whether that’s really linked to the upswing in respiratory illnesses in general. Thus, the situation in China remains a bit of a mystery, wrapped in an enigma, and bedazzled with question marks.
The WHO made its request to China for more info on November 22. This included asking for more laboratory results and clinical info on the affected children and surveillance data on what’s happening with influenza, SARS-CoV-2, RSV, mycoplasma pneumoniae, and other known respiratory pathogens. The WHO has also maintained communications with various medical doctors and scientists working in China through existing scientific and public health networks presumably independent of China’s government. Maintaining scientific communications independent of politics is important. After all, the Covid-19 pandemic has clearly demonstrated that in China as well as other countries around the world scientists and health professionals may say what political leaders may not be willing or capable of saying.
All of this does not necessarily mean that some other new pathogen has emerged in China. And even if there were some other new pathogen, it would possibly still be imaginable to involve and control it, which in fact is not what happened in 2020 with SARS. CoV-2.
On the other hand, just because SARS-CoV-2 and Covid-19 continue to spread does not mean that a primary epidemic, or even a pandemic, can occur. Viruses and other pathogens don’t say, “You got this” or “We’ll stay away while you spread. “
Therefore, this situation in China does deserves very close monitoring. At the same time, China’s government needs to be open about sharing epidemiological and clinical information with the rest of the world, just as any country needs to do so. As the Covid-19 pandemic and other epidemics throughout history have demonstrated, what happens in one country won’t necessarily stay in that country.