What to Know About the Rise in Walking Pneumonia in Kids

A surge in cases of Mycoplasma pneumonia, commonly known as walking pneumonia, among young kids has raised concern about the respiratory infection. An advisory from the Centers for Disease Control and Prevention (CDC) last week reported a rise in all age groups since the late spring through the fall, with a notable increase in the percentage of children between ages 2 and 4 (from 1% to 7.2%). In previous years, most infections were observed among school-aged children and adolescents.

Mycoplasma pneumonia is caused by a type of bacteria called Mycoplasma pneumoniae, and it typically spreads in the spring and summer. An estimated 2 million infections occur each year in the U.S., according to the CDC. It is sometimes referred to as walking pneumonia because cases tend to be milder than classic pneumonia, so people may be able to still go about their daily activities despite the infection.

Dr. Karen Acker, a pediatric infectious diseases specialist and hospital epidemiologist at NewYork-Presbyterian Komansky Children’s Hospital, advises parents and caregivers to see a pediatrician if a child’s symptoms are not improving or they are having trouble breathing.

“We don’t have a vaccine for Mycoplasma pneumonia, so the best way to protect yourself is to go back to the basics,” says Dr. Acker. “Be diligent with hand hygiene because most of our exposure comes from touching something and touching our face. And if you are concerned about being at higher risk for respiratory illness or going into public places, wearing a mask is going to help.”

Health Matters spoke to Dr. Acker to learn more about walking pneumonia, including the symptoms to look for and how to treat it.

What is Mycoplasma pneumonia?
Mycoplasma pneumonia is an infection in the lungs caused by the Mycoplasma pneumoniae bacteria. However, it appears differently from classic pneumonia on a chest x-ray and is not treated by standard antibiotics like penicillin.

There has been a steady increase in Mycoplasma pneumoniae infections, and it peaked in August. While Mycoplasma pneumonia was typically more often found in older children and adolescents, we’re seeing younger children susceptible to it this year.

What are the symptoms?
In most cases, symptoms are relatively mild, with the most common being a prolonged cough and fever, along with malaise and headache. It may seem like a chest cold, and a dry cough can last weeks. About 10% of the time, you may see a rash. If the infection becomes more severe, children can experience low oxygen levels and feel like they’re having trouble breathing.

How is it diagnosed?
We can find Mycoplasma pneumoniae with a nasal swab that goes back through the nose to the throat. If you are tested in the emergency room, we get the results in about 1 to 2 hours. If it’s the pediatrician, it will take a day or two. The provider will also order a chest x-ray to be able to see if there’s an infection in the lungs.

What are the treatments?
Many children will get better without medicines and only need over-the-counter pain relievers. If treatment is indicated, then antibiotics such as macrolides (for example azithromycin, also known as a “z-pack”) are usually effective. And if a child is not getting better because of antibiotic resistance, we have alternative medications we can treat it with.

How contagious is it?
The infection is contagious and spread through respiratory droplets from sneezing and coughing, or touching a contaminated surface. Mycoplasma pneumoniae has a long incubation period (between one to four weeks) and can live in the respiratory tract for months. Since someone who is sick with this infection has a lingering cough, it’s important to cover your cough and frequently wash hands.

How do you know when to see a doctor?
When a child is clearly not feeling well, not running around, and acting lethargic, it’s a good idea to get them seen. If you’re seeing the outline of the ribs going in and out when they are breathing, that’s another sign to call your doctor. With Mycoplasma pneumonia, most parents know that something’s off. It’s always better to get kids checked out.