Respiratory illnesses are spiking in China. A closer look.

By Lisa Marie Basile | Fact-checked by Davi Sherman
Published December 1, 2023

Key Takeaways

  • Several respiratory illnesses are currently surging in China, including Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Children are predominantly affected, and some hospitals are seeing a massive uptick in patients.

  • Chinese authorities say that no unusual or unknown pathogens have been identified.

  • Experts say that surveillance is necessary but that the surge in illness is likely caused by lifted COVID-19 restrictions.

China is experiencing a surge in respiratory illnesses, the World Health Organization (WHO) reports. The WHO has been tracking the illness since mid-October via data from Chinese surveillance systems.[]

On November 13, China’s National Health Commission said that the issue was predominantly affecting children and that the illness was a result of the cold season and the lifting of COVID-19 restrictions. The pathogens named included Mycoplasma pneumoniae, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Additional reports state that the country is also seeing rhinovirus and adenovirus infections. Both Mycoplasma pneumonia and RSV commonly affect children.[][][] 

On November 22, the WHO reported that there were “clusters of undiagnosed pneumonia in children's hospitals in Beijing, Liaoning and other places in China.”[]

When the WHO asked China to share specific data on the uptick in respiratory pathogens, China reported an “increase in outpatient consultations and hospital admissions of children due to Mycoplasma pneumoniae pneumonia since May, and RSV, adenovirus and influenza virus since October.” Chinese authorities say that no unusual or unknown pathogens or unusual clinical presentations have been discovered. This is the first time enhanced outpatient and inpatient surveillance has focused on Mycoplasma pneumoniae.

Bloomberg reports that health authorities in Hong Kong—worried that the illnesses could spread within and outside of China—are advising the public to take precautions, especially with children.[]

Even though the WHO reported that Chinese authorities said the hospitals were not overburdened, other reports suggest otherwise. For example, the Economist reported on a now-removed social media video sharing a glimpse into an unnamed hospital packed with hundreds of people. The video’s creator said that her daughter had tested positive for a bacterium that can cause pneumonia.[] []

More so, Newsweek reports that the Tianjin Children's Hospital in Beijing saw 13,171 young patients across its outpatient and emergency departments on November 18.[]

There is some silver lining in the situation, says Erica Susky, an infection control practitioner at Unity Health Toronto in Canada. “[Because no unusual pathogens have been identified], it is not something that sets it apart from what one would see [during] another year, especially prior to the COVID-19 pandemic,” she says.

These illnesses are likely surging due to the lifting of COVID-19 restrictions, Susky notes. “There is an increase [in] more severe infections from RSV and influenza in younger children, as they may not have developed regular immunological memory [since] these regular childhood pathogen encounters did not occur as often when people were interacting less with lockdowns/restrictions for the past three or so years,” she says.

Susky adds that Mycoplasma pneumoniae is unique in that it is a bacterium and not a virus like influenza, adenovirus, RSV, or rhinovirus. “It causes mild to serious respiratory infections and can spread from person-to-person,” she says. M. pneumoniae, she says, is referred to as an atypical pneumonia because of its difference to other typical bacteria like Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. “Infections from M. pneumoniae are rather common; the difference lies in the antibiotic treatment for an infection from M. pneumoniae due to the difference in its [aforementioned] structure,” Susky says.

Should people refrain from traveling to or out of China because of these illnesses?

“There are aspects of this that need some surveillance, such as ensuring the data that China collects on this virus gets appropriately transmitted to the WHO,” says Kenneth Perry, MD, FACEP, an emergency medicine attending physician and medical director of a free-standing emergency department in Charleston, SC. “But for the general population, there should be no specific changes to travel schedules. As with any travel, it is necessary to understand what is happening at the destination,” Dr. Perry says.

He adds that it’s important to remember that upper respiratory infections are very common worldwide and that spikes in infection occur.

“There is obvious bias in the world thinking about this infection based on the fact that we all have COVID so close in our memories,” Dr. Perry says. “[But] if there is any benefit to the recent issues with COVID-19, it is that the medical community can see the entire spectrum of a viral outbreak and prepare accordingly,” he says.

The WHO hasn’t shared any specific measures for travelers to China. Rather, the organization recommends not traveling while actively experiencing symptoms of respiratory illness. The WHO’s latest advice can be found here, a WHO representative tells MDLinx.[]

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