Is this Round 2 of a new Pandemic?

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I thought I would investigate cures for macrolide-resistant M. pneumoniae (MRMP). I will focus on children because this is the cause of the deaths in young children in China at the moment. But having said this, I am not an expert in this area but I will take a go of it.

Mycoplasma pneumoniae (MP) is a major cause of community-acquired pneumonia in children and young adults. Although more than 200 mycoplasma species have been discovered in animals and humans to date, MP is the most recognized human pathogen among them.

MP is an exceptionally small prokaryote, which, like viruses, can pass a filter paper. Because of the absence of a cell wall, this organism is insensitive to β-lactam antibiotics and is not stained by Gram staining.

Treatment

MP infection is usually mild and self-limited, without a need for a specific treatment. Because MP has no cell wall, antibiotics such as macrolides, tetracyclines, and quinolones have been used for treating MP pneumonia. For children, only macrolides (erythromycin, clarithromycin, roxithromycin, and azithromycin) are used because of the potential side effects of alternative drugs (tetracycline and fluoroquinolones). Although earlier studies reported that antibiotic therapy for young adult patients induced more rapid resolution of fever and cough, this therapy could not prevent the progression to severe pneumonia in some patients, as well as the associated extrapulmonary diseases. Patients infected with MRMP strains have prolonged fever duration; however, in general, disease progression was not observed with macrolide treatment. These findings suggest that in MP infection, the substances that induce the fever and the substances that induce the pneumonia may differ in vivo. Moreover, the effects of antibiotic treatment for MP pneumonia in children are still controversial.

Some investigators have reported that a change of antibiotics showed good outcome in MRMP-infected patients. However, others have reported that patients properly treated with antibiotics showed progressive pneumonia. In children and adults who were nonresponsive to antibiotics and showed progressive disease, including those with MRMP, many investigators have reported that additional corticosteroids are effective, especially in those with severe MP pneumonia. In addition, experimental studies have also reported the beneficial effect of corticosteroids on MP infections. We previously reported that the use of immune-modulators (prednisolone) for antibiotic-nonresponsive MP pneumonia patients was effective in improving clinical and radiographic findings. In this 2011 epidemic, we used prednisolone (1 mg/kg) early, with a macrolide (chlarithromycin) or/and a non-macrolide antibiotic (amoxicillin/clavulanate or cefuroxime) for MP pneumonia patients who had persist fever for >48 hours after admission. The majority of the patients defervesced without disease progression within 24 to 48 hours, even in those who received only a non-macrolide antibiotic. The small group of patients who did not response to this therapy received intravenous methylprednisone (10 mg/kg for 2 to 3 days, tapering within a week) or intravenous Ig (1 g/kg/day, 1 to 2 doses), and all patients improved clinically and radiographically within several days without side effects (unpublished observation). These findings may again verify the notion that the pathogenesis of pneumonia in MP infection is immune-mediate. Nevertheless, further controlled clinical studies for corticosteroids and candidate antibiotics (quinolones and tetracyclines) for children with MRMP infection are needed.

This article, Mycoplasma pneumoniae pneumonia in children was from Korea and was published in 2012. Other research may add more knowledge to the pandemic that is currently underway in China (and soon may spread through other parts of the globe.)

I was reading an article from a couple months ago. The article wrote:

Chinese authorities tried to cover up the start of the COVID-19 pandemic, which originated in Wuhan, China, and led to millions of deaths. In contrast, this time, the WHO says China promptly provided data to the organization showing that the sick children are affected by known pathogens common globally.

This statement is true but it misses an important point. Pneumonia unlike a virus is a bacterial disease. It normally treated with antibiotics. But what happens when the normal antibiotics that are used to treat the condition NO LONGER WORK. Then you have an antibiotic resistant form of pneumonia. That is the threat.

Antibiotics are medicines that fight infections caused by bacteria in humans and animals by either killing the bacteria or making it difficult for the bacteria to grow and multiply.

One recent article from India indicates China is under reporting the number of deaths the country is experiencing:

Overwhelmed crematoriums and pressure on doctors not to classify deaths as COVID-related had fueled suspicion over China's data transparency. In a rare move last July, China's Znejiang province, home to 5% of the country's population, reported a 70% surge in cremations in January-March last year. The data has since been taken down.

One study by Seattle-based Fred Hutchinson Cancer Center estimated 1.87 million excess deaths over what would normally be expected from all causes among Chinese older than 30 between December 2022 and January 2023.

Source: Weak economy, Covid rampage likely shrank China's population again in 2023

Well, I came across another interesting article. This time the article was about North Korea. They are also experiencing a series of deaths in elderly and also IN CHILDREN.

Recently, the number of people complaining of symptoms associated with COVID-19 has risen sharply in several North Korean regions along the border with China. Daily NK has learned of several cases of elderly people and children dying after experiencing COVID-like symptoms.

According to a Daily NK source in North Pyongan Province, the city of Sinuiju has recently seen a spike in the number of people suffering from high fever along with other symptoms such as cough, sore throat, headache, muscle aches, and fatigue.

The article then goes on to document the steps that average people are using to treat the problem.

However, despite the public health and medical achievements touted at the meeting (the 9th Plenary Session of the 8th Central Committee of the Workers’ Party of Korea), many people point out that it is a challenge to get proper medicines. In severe cases, it is not uncommon for people to turn to drugs such as opium or crystal meth.

“Imagine a parent forced to give crystal meth to a child with a high fever because they have nothing else to give. It’s frustrating not to know when things will get better,” one of the sources lamented.


This is a spillover of the plague that is sweeping China.

This article is a month old but provides some more insight into Mycoplasma Pneumoniae Pneumonia (MPP).

What to know about Mycoplasma bacteria behind recent spikes in pneumonia cases in Ohio and overseas

China, Denmark, France and the Netherlands have all recently reported an increase in cases of pneumonia in children linked to a bacteria called Mycoplasma pneumoniae. A spike in cases has also been reported in one county in Ohio.

According to the U.S. Centers for Disease Control and Prevention, resistance to the type of antibiotics used to treat this infection may be playing a role in the increase in cases in China.

“You can see periodic epidemics every few years, especially in the 5- to 12-year-olds, so school-aged kids,” said Dr. Peter Hotez, who co-directs the Texas Children’s Hospital Center for Vaccine Development.

Mycoplasma may not be familiar to parents, but it isn't a mystery to doctors, who know it to be a common cause of mild or "walking" pneumonia. It causes a cough that may linger for weeks, typically with a fever and headache, and often a splotchy rash on the trunk, back or arms.

Pneumonia is an inflammation that causes the lungs to fill with fluid or pus, and it has many causes, including viruses, bacteria and chemicals. Across the country, respiratory infections caused by COVID-19, flu and respiratory syncytial virus or RSV are on the rise now, sending cases of pneumonia up, too.

(There were several cases reported in Warren County, Ohio over the past few months.) Among the agents detected in testing were Mycoplasma and Strep bacteria, as well as adenovirus.

The front-line antibiotics that treat most kinds of pneumonia don't work for Mycoplasma infections. For those, doctors need to prescribe a different kind of antibiotic, typically azithromycin or a Z-Pak.

However, Z-Paks don't really work well for pneumonia caused by other things, so doctors and parents have to be thoughtful about how to treat these infections.

"The take-home point for parents is, when you start antibiotics for pneumonia, there's typically a reasonable response to therapy in the first couple of days. And if there’s not, then that’s a reason to check back in with your pediatrician".

The article links to an interesting discussion that says:

The World Health Organization is now requesting more information from China authorities about a recent major respiratory illnesses in the country.
The illnesses are affecting children the most with China saying that the uptick is due entirely to a mix of already known viruses. Adding that this particular recent uptick is due to their recent ending of the COVID restrictions.
Still ProMED reported last month that Chinese hospitals have been inundated and "overwhelmed with sick children" due to a pneumonia outbreak. And that same organization reported the very same thing ahead of the novel Corona-virus outbreak in 2019.
The current outbreak seems to be relatively localized to Beijing and China's northeastern Liaoning province.
No deaths have been reported due to outbreaks so far, but the afflicted report fever, lung inflammation and pulmonary nodules or lumps that appear on the lungs due to having been previously affected.
Experts say there is little cause for worry.
But Chinese authorities have long been criticized for their ambiguity with regards to their COVID reporting. With the World Health Organization writing in a statement, "There is limited detailed information available to fully characterize the overall risk of these reported cases of respiratory illness in children."
But the fact that adults are less affected points to previous immunity.

This is an interesting discussion. This is because many young children have died recently in Beijing and China's northeastern Liaoning province and their bodies were cremated so that no evidence of their deaths would survive and be reported. But the morticians leaked the information that described them working around the clock seven days a week, 24 hours a day cremating the dead including the bodies of many young children.

I found this report interesting.





At 2 minutes 22 seconds into their report, they describe the wave of deaths that have recently occurred in China. They affect not only elderly people but also very young children. The wave of viruses claimed many lives and the crematorium cannot keep up. It operates continuously day and night. It has 8 cremation furnaces and 24 hours a day there are people working there. He explains that hospitals in the area typically attribute these deaths to underlying health conditions. He noted that many older people in the area did have underlying health conditions like high blood pressure or diabetes but went on to say their conditions were stable with help from medications. That changed after getting infected by China's current outbreak. That when their condition declined quickly and many couldn't be saved. Now in the medical system, they don't really say that the deaths are related to COVID-19. The day before yesterday a friends father in his 70s passed away. The hospital said his death was due to underlying health conditions. That's the official narrative now. A resident of another city in Henan Province told us that his uncle passed away after getting infected. That is despite getting vaccinated with a dose produced in China. Every hospital is packed with people and there are numerous cases of what is called White Lung Syndrome. My uncle had White Lung. There were also many with it in his hospital. Some were discharged from the hospital even without being fully recovered. White Lung refers to a symptom of pneumonia that shows up on x-rays. It appears when a patients lungs get infected. It's a common symptom seen in China's most recent outbreak. This wave began spreading in China in September and has swept across the country. The Chinese Communist Party links the outbreak on influenza and Mycoplasma pneumoniae, while downplaying COVID-19.

Many people have died in China and their deaths have been kept secret from the outside world. Many Chinese children have died from Mycoplasma pneumoniae pneumonia (MPP). But what they are not telling anyone is that it is a Antibiotic Resistant form of the disease.

China ended zero-COVID lock-downs around the beginning of 2023. I came across an interesting article about China quick end to this approach.

As life in China under the shadow of the pandemic wore on, the strict quarantine measures started coming under increasing scrutiny by international observers and the Chinese public: making headlines were reports of health workers breaking into residents’ houses on the hunt for potential COVID infections, authorities killing pets while their owners were in quarantine, neighborhoods being shut in with padlocks and bicycle locks, residents struggling at home with food and medicine shortages. A mental health crisis and extreme loneliness also festered in locked down apartments, though an uptick in suicides was never officially attributed to the pandemic measures.

Public frustration came to a boil in November last year, when an apartment fire killed at least 10 people in Xinjiang and many blamed COVID restrictions for hampering rescue efforts. Unprecedented protests broke out in parts of the country, as thousands gathered to air their anger and grievances over the indefinite lockdowns they had been subjected to, mounting what some described at the time as the biggest challenge to President Xi Jinping’s legitimacy the country had seen. Just weeks after the historic demonstrations, China abandoned its zero-COVID policy.

Memories of zero-COVID, nevertheless, remain fresh in the minds of those who lived through it: some have learned to take humorous jabs at the widely criticized policy—hazmat suits were a notable costume of choice at a Halloween parade in Shanghai in October—but experts warn that many Chinese residents will take years to recover from trauma.

People in China Are Starting to Worry About COVID Testing and Controls Coming Back

The reason why these lock downs failed was because COVID was constantly on the move. It was becoming more and more contagious but at the same time less deadly. When China exited their Zero-COVID policy, it actually brought to light another problem. This was caused by their abuse of antibiotics. They were used so much by their people that they had created an antibiotic resistance to these drugs. As a result, when they lifted the lock-down, they set into motion an explosion of antibiotic resistant Mycoplasma Pneumoniae Pneumonia (MPP). This is a very small bacteria which is just a little larger than a virus.

Bacteria are single cells that can survive on their own, inside or outside the body. Viruses cause infections by entering and multiplying inside the host's healthy cells.

Mycoplasma are the smallest prokaryotic microbes present in nature. These wall‑less, malleable organisms can pass through cell filters, and grow and propagate under cell‑free conditions in vitro. Of the pathogenic Mycoplasma Mycoplasma pneumoniae has been examined the most. M. pneumoniae can induce autoimmune hemolytic anemia and other diseases in the blood, cardiovascular system, gastrointestinal tract and skin, and can induce pericarditis, myocarditis, nephritis and meningitis.

Although this thread has focused on Antibiotic Resistance Mycoplasma Pneumoniae Pneumoni, there is a larger threat at play. It is the death of known antibiotics caused by their misuse.

Huck Finn recently wrote:

This silent pandemic of antibiotic resistance continues to grow around the world.

Experts repeatedly warn of a "doomsday scenario" in which routine medical procedures - such as antibiotic prophylaxis in the treatment of cancer or other diseases - would no longer be effective and untold numbers of people could die from those that first they were simple treatable infections.

An example of a drug resistance mechanism that worries experts is New Delhi metallo-beta-lactamase 1 (NDM-1).
Bacteria that contain the gene for producing this enzyme are able to break down (and therefore resist) a wide range of carbapenem antibiotics, considered the last line of defense in antibiotic treatments where other antimicrobials have failed. The most common bacteria that produce this enzyme are Escherichia coli and Klebsiella pneumoniae, but the NDM-1 gene can spread from one strain of bacteria to another. The prevalence of NDM-1-containing bacteria continues to grow worldwide. Dr. Gigante says, “There is a large gap in drugs against multidrug-resistant (MDR) pathogens such as Acinetobacter baumannii and Pseudomonas aeruginosa (only one agent licensed against all critical pathogens and few in development). Very few agents are directed against metallo-β-lactamases, the prevalence of which continues to grow. Few innovative antibiotics are expected in the coming years."

He adds: “The rapid increase in multidrug-resistant infections around the world is worrying. Time is running out to bring new antibiotics to market and combat this urgent public health threat. Without immediate action, we risk returning to the pre-antibiotic era where common infections become deadly."

I believe Huck Finn is correct but I also feel this problem needs a physics/engineering approach, an approach that works around the need for antibiotics. This approach focuses on controlling the means by which they are spread - this is by purifying air, by purifying drinking water, by limiting touch, by purifying foods (and strengthening body by use of supplements), etc.

There was a discussion about the pandemic surge in China on 29 December 2023. It reported:

China’s health system was strained earlier this year with a spike in hospitalisations for various respiratory diseases, especially among children.

It was first hit by a surge of mycoplasma pneumoniae in May, then respiratory syncytial virus, adenovirus and influenza virus, from October.

But the unusually high rate of serious mycoplasma pneumoniae cases was also blamed on drug resistance.

Respiratory diseases often increase in winter as most people stay indoors. In China, that trend is exacerbated by mass travel around the Lunar New Year

Source: China braces for Covid surge as JN.1 variant spreads around the world

This article points to Antibiotic Resistant MPP pandemic currently impacting young children in China.

One of the main factors in the COVID and Antibiotic Resistant MPP outbreak in children in China is due to the humidity levels during the winter. As the temperatures dropped below freezing, people heated their homes and in many cases the heating drove down the indoor humidity levels. When indoor humidity levels fall down to the 0% to 10% range, this can be very deadly. That is the case in China this year. Many of their children fell victim to Mycoplasma Pneumoniae Pneumoni (MPP). But the other contributing factor in China is that because they have abused the use of antibiotics allowing anyone to buy and use them even without testing their condition to see if it was related to viruses, they have developed a population that has destroyed the power of antibiotics to treat this condition and therefore they have produced an Antibiotic Resistant Mycoplasma Pneumoniae Pneumoni event that cause the death of many of their young children. This has been hidden to the world, not reported, and the world is unaware of the danger to the rest of the people on the planet.

This article from last month describes the very cold temperature in the area where this outbreak of MPP occurred.

Beijing recorded the most hours of sub-freezing temperatures in December in more than seven decades as a cold wave has enveloped northern and central swathes of China

A weather observatory in the Chinese capital as of Sunday (24 December) had recorded more than 300 hours of sub-freezing temperatures since Dec. 11 – the most since records began, in 1951, according to the official newspaper Beijing Daily.

The city saw nine consecutive days with temperatures below minus 10 degrees Celsius (14 degrees Fahrenheit), the paper added.

Parts of northern and central China have shivered under frigid cold snaps this month, with authorities closing schools and highways several times due to snowstorms.

Temperatures at 78 weather stations across the country hit record lows for the month of December, while average temperatures this month in northern and some central parts of China hit record lows set in 1961, according to the National Meteorological Centre.

Source: Beijing sees most hours of sub-freezing temperatures in December in more than 70 years

I came across another recent article about Mycoplasma Pneumonia. This time a very small surge is being reported in Australia.

What is mycoplasma pneumonia, the infection on the rise in children in Australia and around the world?

Mycoplasma pneumonia is a form of the inflammatory chest condition that is caused by the bacterial pathogen, mycoplasma pneumonaie.

The bacteria strain commonly causes mild respiratory infections, with a cough and weakness that could last for more than a month. It can lead to atypical pneumonia, also known as "walking pneumonia".

Dr Rebekah Hoffman, chair of the NSW and ACT branch of the Royal Australian College of General Practitioners, said that it's called that because patients feel "quite well" but may experience an "annoying, irritating cough that persists and persists".

Symptoms may develop over one to three weeks, and also include:
-- Fever
-- Headache
-- Sore throat
-- Malaise
-- Difficulty breathing

"Recently, the number of people presenting to EDs with pneumonia increased and the proportion due to mycoplasma has increased, particularly in children aged five to 16 years old," a NSW Health spokesperson said in a statement.

This is a new outbreak that we haven't really seen previously.

Paediatric specialists in Queensland also recorded a trebling of cases since the end of November.

Mycoplasma pneumonia is passed by aerosols and droplets from one person to another. Atypical pneumonia spreads from coughing.

Young people under the age of 20 are more likely to contract the bacteria, but particularly three to seven year olds who haven't been exposed to it before. The bacteria passes quickly between children before they show symptoms, particularly in childcare and the classroom. "Young children are much more in close contact with one another and they're very good at sharing their germs," Dr Bonning said.

Cases of a bacterial infection that predominantly affects children have been increasing across Australia. NSW has reported more than the average number of patients presenting with mycoplasma pneumonia for this time of year.

The situation has been reflected globally, with children affected in China, Taiwan, the Philippines, South Korea, North America and Europe, NSW Health said.

"Now that this has gotten going in communities around the world, it's made its way to Australia and we are starting to see more presentations with this different form of pneumonia in the community, especially among kids," Australian Medical Association (AMA) NSW branch president Dr Michael Bonning said.

I came across another interesting article about pneumonia in children. The article was in Indonesian but translated by computer. It began with "The following article was translated using both Microsoft Azure Open AI and Google Translation AI."

Source: Parents Play an Important Role in Preventing and Early Detecting Children's Pneumonia

JAKARTA, KOMPAS - Pneumonia remains the leading cause of death among children and toddlers. Prevention and early detection efforts are crucial to ensure that children are protected from the risk of disease transmission.

Early symptoms of pneumonia are like normal fever and cough. However, if the fever is already high and accompanied by faster breathing such as gasping or if the walls in the lower chest appear more sunken, the child must be immediately taken to the hospital.

In addition to early detection, parents need to ensure that their children are protected from the risk factors of pneumonia. These risk factors include poor nutrition, vitamin A deficiency, living in crowded environments, cold weather, exposure to air pollution caused by cigarette smoke, biomass burning smoke, and environmental air pollution.

Then the article went on to say:

"Mycoplasma pneumoniae"

Nastiti said that the transmission of pneumonia caused by the bacteria Mycoplasma pneumoniae, which had become a public concern, was one of the infections that had long been identified. Pneumonia caused by bacteria is not a new and mysterious disease.

Symptoms or clinical signs of transmission of pneumonia caused by the bacteria Mycoplasma pneumoniae are generally no different from transmission of other pneumonias. Symptoms that appear include fever and cough. However, this type of pneumonia has the peculiarity that clinical symptoms are often not accompanied by shortness of breath or hypoxia (lack of oxygen in the body).

Because of this, pneumonia caused by Mycoplasma pneumoniae is often referred to as "walking pneumonia" where patients can still carry out normal activities while X-rays of the lungs show severity.

He explained that identifying pneumonia is not easy to do. This is also the reason why the transmission of pneumonia due to Mycoplasma pneumoniae, which was reported to be increasing in China, was referred to as unidentified pneumonia.

I came across one article that discusses the issue of destroying antibiotic resistance. Many times when a child becomes infected with a disease, the medical establishment will prescribe the use of antibiotics even though:

1. It is not effective against viral infections.
2. Taking that approach weakens the power of antibiotics by creating and cultivating antibiotic resistant strains.

Dr. Julia E. Szymczak, an associate professor at the University of Utah School of Medicine, in Salt Lake City goes on to say, "When asked what makes it difficult to not prescribe antibiotics for outpatient children with community-acquired pneumonia (CAP), clinicians cited several factors, including diagnostic uncertainty, fear of consequences associated with delaying treatment, cultural norms regarding pneumonia, parent expectations and a tolerance for the risk associated with excess antibiotic use.

Multiple Barriers Challenge Abx Stewardship for CAP

A 25 January 2024 article shows that there is a deadly pneumonia outbreak in one region of India that took the lives of 66 children in southern Punjab near the border with Pakistan this month.

66 kids die of pneumonia across south Punjab in current month

Health Department South Punjab Spokesperson Assad Ullah Shahzad told media on Wednesday that 41 deaths were reported from Children Complex Multan, nine from Bahawal Victoria Hospital Bahawalpur, 14 from Allama Iqbal Teaching Hospital DG Khan, and one each from Sheikh Zayed Hospital Rahim Yar Khan and Sir Sadiq Abbasi Hospital Bahawal­pur while no death was reported from Nishtar Hospital Multan by January 23.

Pneumonia can range in serious­ness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.

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At the same time 26 January 2024, a deadly pneumonia outbreak has occurred in Pakistan killing 46 children.

Source: 46 Pneumonia-Related Deaths Reported in Northwest Pakistan

With the increase in the severity of the cold, the infection is becoming viral, as 46 children have died of pneumonia in three major city hospitals in Peshawar, Khyber Pakhtunkhwa.

Health authorities said on Friday that pneumonia is disproportionately affecting children with weakened immune systems. The tally includes 20 fatalities each at Lady Reading and Khyber Teaching Hospitals, with an additional six at Hayatabad Medical Complex.

Many young children are dying of a major outbreak. The count is rising.

Pneumonia continues to claim lives in Pakistan's Punjab, recording deaths of at least 244 children over the course of the current month. According to the Punjab Health Department, 942 new pneumonia cases have been recorded across the province in the previous 24 hours, with 212 new cases confirmed in Lahore.
Punjab has reported 244 pneumonia-related deaths this month, with 50 fatalities in Lahore alone.

An article from July 21, 2021 describes a pneumonia crisis in Bangladesh.

Drug-resistant pneumonia tied to deaths in Bangladeshi kids

Young children with pneumonia were 5 times more likely to die if they had bacteremia and 17 times more likely to die if they had antibiotic-resistant bacteremia than if they had no bacteremia, according to a Bangladesh-based study late last week in Open Forum Infectious Diseases.

"If COVID-19 was a tsunami, then emerging antibiotic resistance is like a rising flood water. And it's kids in Bangladesh who are already going under," said co-first author Jason Harris, MD, MPH, in a Massachusetts General Hospital. "These kids are already dying early because of antibiotic-resistant bacteria, from what would be a routine infection in other parts of the world."