Scientists today called for vigilance and transparency from China amid reports of a mystery cluster of pneumonia which has eerie similarities to the early Covid outbreak.
Hospitals in Beijing and 500 miles northeast in Liaoning are 'overwhelmed with sick children' with unusual symptoms that include inflammation in the lungs and a high fever but no cough, according to local news reports.
Dr Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University School of Public Health, told DailyMail.com the news was 'alarming'.
She said we should 'hold all countries to that same standard', referencing China's history of covering up new outbreaks, which happened in 2003 with the original SARS and in 2019 with Covid.
Dr Krutika Kuppalli, an infectious disease physician who is part of the WHO's Health Emergencies Program, said testing and making those results public was crucial, adding in a post on X that the illness 'could be anything'.
Dr Neil Stone, an infectious diseases specialist doctor at the University College Hospital in London, wrote on the platform formerly known as Twitter: 'The last time I saw reports of an outbreak of undiagnosed pneumonia in China thought, naa...no big deal. [It] won't amount to much.
'That was in December 2019. Not making that same mistake again.'
The alert around China was issued late on Tuesday via ProMed - a large, publicly available global surveillance system that monitors infectious diseases.
It was a ProMed notification back in December 2019 that brought Covid to the attention of the world.
Taiwanese outlet FTV News reported that hospitals were being 'overwhelmed' with sick children in the latest outbreak.
It added that 'parents questioned whether the authorities were covering up the epidemic.'
But there is a suspicion the new outbreak could be related to mycoplasma pneumoniae, also known as walking pneumonia, which is reportedly growing in China as the country goes into its first winter without strict Covid lockdowns in place.
The US and UK also saw spikes in infections like RSV and flu after pandemic rules lifted.
Dr Nuzzo told DailyMail.com: 'Seeing an increased number of people presenting at any hospital is, of course, alarming.
'It may not be out of the ordinary, we do tend to see [increases] seasonally, so it's really too early to say.
'But any time we see people going to the hospital, we have reason to be concerned about it.'
State-run media outlet Sixth Tone reported that one-tenth of patients are coming from out of town because they cannot access bronchoscopies in their hometown.
The Beijing Center for Disease Control and Prevention (CDC) said that more than 3,500 cases of 'respiratory infection' had been admitted to the Beijing Children's Hospital at the start of October, Radio Free Asia reported.
A staff member at the Beijing Friendship Hospital pediatrics department said there is a 24-hour wait for emergency cases to be seen.
'They're still dealing with calls we took yesterday,' the worker said. 'They haven't even started on today's calls yet – there are at least 1,000 people waiting in the queue ahead of you.
'The calls coming in today won't get seen until tomorrow... We're taking more than 1,000 calls a day.'
According to state-run Haibao News, the Children’s Hospital of Capital Institute of Pediatrics had so many patients on Tuesday that the outpatient desk stopped accepting new patients by the afternoon.
At that point, 628 people were waiting in line to see a doctor at the emergency department.
Elsewhere, FTV News said: 'The situation in Liaoning Province is also grim.'
The lobby of Dalian Children's Hospital is reportedly full of sick children receiving intravenous drips.
There are also long queues of patients at the Traditional Chinese Medicine Hospital and the Central Hospital.
A staff member of Dalian Central Hospital said: 'Patients have to wait in line for two hours, and we are all in the emergency department and there are no general outpatient clinics.'
Some school classes have been canceled altogether. Not only are all students sick, but teachers are also infected with pneumonia.
Mr Wei, a Beijing citizen, told FTV News: 'Many, many are hospitalized. They don't cough and have no symptoms. They just have a high temperature (fever) and many develop pulmonary nodules.'
An editor's note by 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.
'ProMed awaits more definitive information about the etiology and scope of this concerning illness in China.'
Pneumonia is an infection that affects one of both lungs, which can be deadly. The air sacs in the lungs may fill with fluid or pus.
Generally, pneumonia is not contagious, but the respiratory viruses and bacteria that lead to it are.
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