It is also not the first time rumours about his health have fired up intense flurries of speculation - only to be later dismissed. Kim Jong-un recently missed the celebration of his grandfather's birthday on 15 April. This is one of the biggest events of the year, marking the birth of the nation's founder. Kim Jong-un has never missed it - and it seemed very unlikely that he would simply choose not to turn up. Inevitably, his absence prompted speculation and rumour, none of which is easy to substantiate.
Kim Jong-un last appeared in state media on 12 April "inspecting a pursuit assault plane group" in a handout that is undated. As ever, the images portrayed him as relaxed and at ease. We know he chaired a key political meeting the day before, from state media despatches. But he has not been seen since.