December 8, 2023
JAKARTA – he Health Ministry has urged the public to remain calm despite the announcement of six confirmed cases of mycoplasma pneumonia, a disease thought to be behind a recent pneumonia outbreak in northern China.
All the confirmed cases were children whose ages ranged from 3 to 12 years old in Jakarta, according to Maxi Rein Rondonuwu, the ministry’s disease control and prevention director general, in a press briefing on Wednesday.
Two patients were admitted to Medistra Hospital in South Jakarta in October and another one was treated in the Joy Women and Children Community (JWCC) hospital, also in South Jakarta. The rest of the cases were treated as outpatients.
All patients had fully recovered as of Wednesday, Maxi said.
The ministry is currently launching epidemiological surveillance to find the source of the infections and prevent further spread of the disease. It is also planning to instruct regional health authorities to educate teachers and schools about the disease, since the Mycoplasma pneumoniae bacterium commonly infects children.
“We’ve urged doctors and health workers to report any case of mycoplasma pneumonia to the ministry within 24 hours upon discovery,” Maxi said.
While urging healthcare workers and schools to be vigilant against the disease, he called on the public to remain calm, emphasizing the fact that this variant of pneumonia is not a new illness with typically mild symptoms.
The disease has been reported for years in Indonesia, according to Maxi, although the Health Ministry did not regularly track the cases due to its relatively low prevalence. Before the COVID-19 pandemic, mycoplasma pneumonia only accounted for around 8.5 percent of detected pneumonia cases, according to the ministry.
China’s ‘mysterious’ outbreak
Concerns about the mycoplasma pneumonia have been rising since mid-October, as Chinese health authorities reported a higher-level of an “influenza-like illness” particularly among children in the northern part of the country.
While the exact cause of the outbreak has yet to be determined, Chinese media reported that three out of four patients were diagnosed with mycoplasma infections. The disease was later also reported in other countries, such as the Netherlands.
Mycoplasma pneumonia typically affects younger children, causing symptoms such as coughing, sore throat and fever. Just like other respiratory diseases, M. pneumoniae spreads through airborne droplets.
The infection is usually mild, but it can cause lung inflammation, which occurs in some 10 percent of cases in the United States, according to medical news portal Medscape.
Responding to the outbreak report in China, Indonesia’s Health Ministry issued a circular late last month urging health workers to closely monitor respiratory infections and regularly report relevant data.
It also called for increased surveillance at border checkpoints, instructing border health authorities to pay closer attention to travelers, animals and goods arriving from China.
Echoing the Chinese authorities’ analysis, pediatrician Nastiti Kaswandani from Cipto Mangunkusumo General Hospital (RSCM) in Jakarta said the mycoplasma pneumonia outbreak in China was likely caused by the recent lifting of COVID-19 restrictions and a post-pandemic increase in epidemiological surveillance.
“The recent respiratory illness outbreak [in China] isn’t solely caused by the mycoplasma bacterium, but also the Respiratory Syncytial Virus [RSV], adenovirus and influenza virus,” she said in the Health Ministry’s press briefing on Wednesday.
‘No need to panic’
The severity of mycoplasma pneumonia is much lower compared with other respiratory ailments such as COVID-19 and influenza, according to Nastiti, with a mortality rate of between 0.5 and 2 percent. The disease is commonly fatal for people with underlying health conditions, she added.
“There’s no need to panic. The infection is mostly mild and the medications for the disease have been available for decades in Indonesia,” she continued.
As preventive measures, she advised members of the public to maintain personal hygiene, wear masks and limit outdoor activity when sick. Parents should also ensure babies under six months old are exclusively breastfed, as a 2019 study showed that exclusive breastfeeding could prevent pneumonia infection in toddlers.
Although there was no vaccine for mycoplasma pneumonia, children should get vaccinated for other respiratory diseases to prevent co-infections, or simultaneous infection by multiple pathogens, said pulmonologist Erlina Burhan of the Indonesian Pulmonologist Association (PDPI).
“China reported many co-infection cases in the recent outbreak, where children contracted not only mycoplasma pneumonia bacteria but other pathogens as well,” she said, referring to influenza and the SARS-CoV-2 virus that causes COVID-19.
Erlina stressed the importance of immunization for children as co-infection could lead to severe symptoms and hospitalization.
The announcement of mycoplasma pneumonia cases came amid a recent increase in COVID-19 infections in Indonesia and other countries, triggered by new subvariants of EG.5, informally dubbed “Eris.” The Health Ministry said the COVID-19 infections had risen from 20 cases weekly to 276 cases last week.