White Lung Pneumonia Outbreak in Ohio: White Lung Syndrome Symptoms & Treatment 2023

Children in an Ohio area are facing a surge in pediatric pneumonia cases people are also referring to it as white lung pneumonia, some of which involve mycoplasma pneumonia, a condition previously observed in outbreaks in Denmark and China.

The Warren County Health District in Ohio released a statement on Wednesday, indicating a rise in pneumonia cases—145 reported instances among children aged three to 14 since August. In an initial announcement on Tuesday, the health district identified the escalating illness as an “outbreak,” given the higher-than-usual case numbers.

The primary pathogens detected thus far include streptococcus pneumoniae, adenovirus, and mycoplasma pneumoniae—the latter currently spreading in China and Denmark. The average age of those affected is eight years old, with cases reported across multiple Ohio school districts. Yet, the health district cannot establish common patterns among the diagnosed children.

The district emphasized that these illnesses are not uncommon and highlighted that no fatalities have been associated with the outbreak. They clarified that the rise in reported pneumonia cases doesn’t appear to stem from a new or novel respiratory virus but reflects a significant increase in typical pediatric pneumonia cases.
While acknowledging a substantial increase in pneumonia cases among Ohio children this year, they noted that the spread of respiratory illnesses during colder months is not unusual within communities.

Similar respiratory cases have been observed on a larger scale in China, where influenza, rhinoviruses, and mycoplasma pneumonia—also known as white lung syndrome—have been circulating. Children’s hospitals in China, particularly in Beijing, reported overwhelming numbers of patients, with around 7,000 admissions daily.

The Chinese Health Ministry clarified that these respiratory illnesses are not new and are already known. Maria Van Kerkhove from the WHO’s Department of Epidemic and Pandemic Preparedness and Prevention suggested a plausible connection between the surge in cases among Chinese children and the complete lifting of COVID-19 restrictions for the first time, potentially increasing children’s exposure to pathogens—a trend previously seen in various countries after restrictions were eased.

Denmark has also experienced a rise in mycoplasma pneumonia cases, reaching epidemic levels with 541 new cases reported by the end of the previous week, according to a Danish Ministry of Health research group.
However, the Warren County Health District has stated that there is currently no evidence linking the Ohio outbreak to other surges, whether within the state, nationally, or internationally.

What is white lung syndrome?

White lung syndrome emerged to explain a perplexing respiratory ailment first observed in China, presenting symptoms akin to pneumonia. It was linked to a blend of respiratory conditions—such as influenza, SARS-CoV-2 (Covid-19), Respiratory syncytial virus (RSV), and mycoplasma pneumoniae. Though not a novel ailment, its resurgence amid the lingering memory of COVID-19 has sparked global concern due to a significant surge in reported cases,” explains Dr Ravi Dosi, a Pulmonary Medicine Consultant at Kokilaben Dhirubhai Ambani Hospital in Indore.

“White lung syndrome has now become a pressing global health issue. Initially associated with a respiratory outbreak in China, it now characterizes a similar pneumonia surge affecting children in the U.S. Particularly in Warren County, Ohio, about 150 pediatric pneumonia cases have been reported since August, mirroring the Chinese outbreak. This resurgence has reignited global health officials’ worries, prompting ongoing investigations into its precise cause,” adds Dr. Dosi.

Dr S Vidya Nair, Senior Consultant in Pulmonology at Marengo Asia Hospitals in Faridabad, describes it as a respiratory infection caused by multiple microorganisms (e.g., influenza, mycoplasma), resulting in pneumonia. On X-rays, it manifests as white patches in the lungs, leading to the swift coining of the term “white lung syndrome” to swiftly identify and address this sudden outbreak in China.

Symptoms of white lung syndrome

Symptoms associated with white lung syndrome involve the formation of widespread white patches within the lungs. Dr Vikas Maurya, Director and Head of Pulmonology at Fortis Shalimar Bagh, notes its occurrence primarily in China, where many children experience bilateral lung involvement due to pneumonia. Initial symptoms start with upper respiratory infections before progressing to lower respiratory tract issues. Patients exhibit signs like infection, fever, cough, sore throat, watery eyes, skin rash, or diarrhoea.

Dr. Maurya also emphasizes common symptoms among affected children, highlighting cough, fever, and fatigue, underscoring the importance of seeking early medical intervention for proper diagnosis and treatment. He correlates clinical symptoms to previous respiratory infections, starting with flu-like indications and advancing to cough, wheezing, breathlessness, and pneumonia.

Treatment

Treatment revolves around managing pneumonia symptoms and ensuring respiratory health. Medications target cough and fever alleviation, with constant monitoring and potential oxygen therapy if needed. Dr Dosi stresses the significance of preventive measures, advocating personal hygiene practices, flu vaccinations, and caution during gatherings to mitigate the risk of respiratory infections during the flu season.

Dr. Maurya reinforces these preventive measures, stressing the role of hygiene, masks, distancing, and vaccination; even though influenza vaccines might not cover all viruses, they significantly guard against influenza. Dr. Nair advises individuals with flu-like symptoms to stay home and consult a respiratory specialist. She urges chronic respiratory patients to adhere strictly to prescribed medications and seek review consultations for symptom changes.

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