An undetermined pneumonia outbreak in China is causing alarm as reports emerge of overwhelmed children's hospitals in multiple locations. While there is no indication yet that the infections are deadly, the spike in pneumonia cases is reminiscent of the early reports of a mystery pneumonia outbreak in late 2019 that led to the emergence of COVID-19 in Wuhan.

The main victims of this outbreak appear to be children, with high fever being a common symptom, and some kids developing pulmonary nodules. Media reports have cited swamped pediatric hospitals in Beijing and Liaoning, located nearly 500 miles away. As a result, school cancellations have also been reported, and even some teachers falling ill.

Speculations about the possible cause of the outbreak have been circulating, with some pointing to a potential link to Mycoplasma pneumoniae, commonly known as "walking pneumonia." FluTrackers, an infectious disease news message board, has been monitoring overwhelmed pediatric hospitals and clinics, as well as reports of Mycoplasma pneumonia since the beginning of summer.

The US Centers for Disease Control and Prevention (CDC) provides background information on Mycoplasma pneumoniae infection, stating that it typically causes mild respiratory infections, which can sometimes turn severe and require hospitalization. In children, the infection often resembles a chest cold and can easily spread in crowded settings such as schools and college residence halls.

On Twitter, Krutika Kuppalli, MD, an infectious disease physician with the WHO's Health Emergencies Program, suggested that China may be experiencing a surge in respiratory infections as other countries did during their first winter after lifting lockdowns. While China has already reported a surge in Mycoplasma pneumonia cases, Dr. Kuppalli added that the current outbreaks could be caused by various factors, including respiratory syncytial virus, COVID-19, and seasonal flu. Urging for more information, she emphasized the need to understand the nature of the outbreak.

In a separate study by researchers at the University of Plymouth in the United Kingdom, the effectiveness of a chlorine-based cleaner used in UK hospitals against Clostridioides difficile bacteria was called into question. The study found that the cleaner, sodium hypochlorite disinfectant (NaOCL), commonly used on surfaces, showed limited effectiveness in killing C difficile spores, which can persist on hospital surfaces for months. This poses a significant concern, as C difficile is a leading cause of healthcare-associated diarrhea and is responsible for thousands of deaths annually in the United States and Europe.

When exposed to NaOCL at various concentrations, the spores of C difficile showed little change in viability or reduction in their outer spore coat. Furthermore, when the spores were applied to patient gowns and surgical scrubs and treated with NaOCL, the spores were found to survive the disinfection process. This indicates that scrubs and gowns may serve as vectors for the transmission of C difficile in hospitals.

The findings of this study underscore the need for a reevaluation of current disinfection guidelines for C difficile, as the bacteria display a tolerance to the chlorine-based cleaner commonly used in hospitals. The lead author of the study, Tina Joshi, PhD, associate professor in molecular microbiology at the University of Plymouth, emphasized the urgent need for disinfectants and guidelines that are effective against evolving bacteria. The study's implications are expected to impact disinfection protocols globally.

As the undetermined pneumonia outbreak unfolds in China and concerns arise about the effectiveness of disinfection measures in hospitals, authorities and healthcare professionals are urged to gather more information to understand the nature of the outbreak and implement appropriate preventive measures.