Cases of Walking Pneumonia on the Rise in Children

Respiratory infections caused by the bacteria Mycoplasma pneumoniae have increased in the United States, especially in young children.  Across the state Ohio Valley, including the greater Wheeling area, hospital emergency departments and urgent care centers are seeing an increase in visits for diagnosed pneumonia, particularly among children.

The proportion of patients discharged from emergency departments/urgent care center with a diagnosis of M. pneumoniae-associated pneumonia or acute bronchitis has been increasing over the past six months, peaking in late August.  The CDC is closely tracking the recent rise in M. pneumoniae infections using various surveillance tools to better understand any differences in demographics, severity of illness, and outcomes as compared to M. pneumoniae infections prior to the COVID-19 pandemic. CDC is also reaching out to healthcare providers and state and local health departments to raise awareness of increasing M. pneumoniae infections and working to monitor for antibiotic resistance.

What is pneumonia?

Pneumonia is an infection of the lungs. It can be caused by different germs, including bacteria, viruses, fungi, and parasites. People can get pneumonia any time of the year, but it is more common in the fall and winter when germs that cause respiratory illnesses are spreading.  People with pneumonia caused by M. pneumoniae can seem better than expected for someone with a lung infection. With mild symptoms, people may not stay home or in bed. Thus, the phrase “walking pneumonia” was coined.

Common symptoms of pneumonia include:

  • Cough
  • Shortness of breath
  • Fever or chills
  • Chest pain when breathing or coughing
  • Fatigue (feeling tired)
  • Nausea, vomiting, or diarrhea
  • Confusion

Certain people are more likely to get pneumonia, including:

  • Adults 65 years and older (with risk increasing as age increases);
  • Children younger than 5 years old, with higher risk among infants and young children;
  • People with chronic medical conditions, including chronic heart disease, liver disease, lung disease, and diabetes; and,
  • People with a weakened immune system.

How can I protect myself and loved ones?

Vaccines can help prevent infections that can cause pneumonia, including influenza, COVID-19, respiratory syncytial virus (RSV), pneumococcal disease, pertussis (whooping cough), and measles. Staying up-to-date on routine and seasonal immunizations can protect those at risk for developing pneumonia.

Healthy habits can prevent respiratory infections that lead to pneumonia. Avoid infections by:

  • Coughing or sneezing into a tissue or into your elbow or sleeve
  • Washing your hands often
  • Cleaning and disinfecting surfaces that are touched a lot
  • Taking care of chronic medical conditions (like asthma)
  • Quitting smoking or avoiding cigarette smoke, as these can also increase the risk of lung infections

For clinicians and public health practitioners

  • Ensure that healthcare providers are aware of increasing M. pneumoniae infections.
  • Consider M. pneumoniae as a possible cause of infection among children hospitalized with community-acquired pneumonia.
  • Have increased suspicion of M. pneumoniae among patients with community-acquired pneumonia who aren’t clinically improving on antibiotics that are known to be ineffective against M. pneumoniae, such as beta-lactams.
  • Perform laboratory testing when M. pneumoniae infection is suspected, especially among hospitalized children, to ensure appropriate antibiotic therapy is administered.
  • Consider swabbing both the throat and the nasopharynx to improve the likelihood of detection in respiratory swab specimens.
  • Consider using a second-line antibiotic regimen, such as fluoroquinolones or tetracyclines, to treat patients with suspected or confirmed M. pneumoniae infection who aren’t improving on macrolides.
  • Consider potential adverse effects in children or pregnant people when using fluoroquinolones or tetracyclines.
  • Promote the judicious use of antibiotics and minimize the risk of antibiotic resistance by not prescribing antibiotics unless indicated by clinical and/or laboratory evidence.
  • Promote CDC recommendations for core prevention strategies to prevent respiratory illness, including practicing good hand hygiene and covering coughs and sneezes.

For the public

  • Learn about M. pneumoniae symptoms such as fever, headache, and a slowly worsening cough. Stay aware of who might be at higher risk of severe disease, including people with asthma or reactive airway disease.
  • Protect yourself and others by following core prevention strategies to prevent spread of M. pneumoniae and other respiratory germs.
  • Seek medical care if you or your child has persistent or worsening symptoms of possible M. pneumoniae infection, such as wheezing or difficulty breathing, especially if you or they might be at higher risk of developing severe disease.

For more information visit CDC at https://www.cdc.gov/ncird/whats-new/mycoplasma-pneumoniae-infections-have-been-increasing.html or contact the Wheeling-Ohio County Health Department at (304) 234-3682 to schedule a vaccination appointment.