Pilot Surveillance Program on Pneumonia with Public Health Risk - Shanghai Municipality, China, 2024-2025.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: China's surveillance for pneumonia of unknown etiology, established in 2004, is vital for identifying novel pathogens early. However, limited cases have been reported, indicating potential challenges regarding sensitivity and operational efficiency. WHAT IS ADDED BY THIS REPORT?: A pilot surveillance program to detect pneumonia with public health risk was implemented in Shanghai between October 2024 and July 2025. The system was established using an optimized workflow involving refined case definitions, tiered laboratory testing network, and joint expert risk assessment process. Forty-six cases were identified in medical institutions at different levels, demonstrating the system's operational feasibility. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: The pilot provides a framework for a proactive paradigm for monitoring emerging respiratory threats. Future surveillance should prioritize identifying case clusters and specific epidemiological links (e.g., suspicious animal contact and travel history). Applying advanced diagnostics, including metagenomic sequencing, and integrating multi-source data with information technology are crucial next steps for building a more responsive surveillance system.