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Walking Pneumonia On The Rise: What You Need To Know
Walking pneumonia is on the rise, especially in kids. Learn the signs, spread, and why it's different from the common cold. Highlights:
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What is Walking Pneumonia? Walking pneumonia is a less severe kind of pneumonia, according to Michael Chang, M.D., an infectious disease specialist at UTHealth Houston. Every year, there are an estimated 2 million infections in the United States. However, Chang stated that without a national reporting mechanism to track these diseases, it is difficult to ascertain the exact number (1).Advertisement
Who Can Develop Walking Pneumonia and How Does It Spread? Walking pneumonia can affect anyone, but it is more prevalent among school-aged children, teenagers, and young adults (2). It is infrequently identified in preschool-aged children, who are far more likely to develop viral lower respiratory tract infections, viral pneumonia, or "classic" bacterial pneumonia.Walking pneumonia, like other respiratory illnesses, spreads via respiratory droplets when people come into close contact, when an infected individual coughs or sneezes, bacteria in the droplets can be ingested by others, resulting in illness (2).
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Why Are Walking Pneumonia Cases Rising? It's unknown why instances are increasing right now, but warm weather, children returning to school, and adults returning to in-person employment could all have a role, according to Sharon Nachman, M.D., Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children's Hospital."It is also possible that our ability to rapidly test for this pathogen via PCR testing may have contributed to the spike of recognized cases," Nachman informed Verywell through an email.
Chang suggested that cyclical tendencies could potentially explain the growth. Walking pneumonia surges every three to seven years, but they are difficult to foresee without a national surveillance system. These surges often occur in late summer or early fall. Because symptoms can take 2-3 weeks to show, people can unintentionally spread the virus, making transmission easier.
"Furthermore, some patients can shed Mycoplasma for months even after receiving appropriate antibiotics," according to Chang. Chang also suggested that immunity gaps may be contributing to the surge. During the COVID-19 pandemic, children were exposed to fewer pathogens, which could impair their immune systems. "This immunity gap may make children more susceptible to infections now, coinciding with a seasonal epidemic," according to him.
While some immunity develops following a walking pneumonia infection, Chang said it is unclear how long that protection lasts, and people can be infected numerous times in their lives.
What are the Symptoms of Walking Pneumonia? Walking pneumonia symptoms are similar to those of common upper respiratory illnesses, such as fever, runny nose, and cough, and are not caused by a specific virus or bacteria.However, Nachman observed that Mycoplasma infections are frequently accompanied by a persistent cough that can endure for weeks or even months. This occurs because the infection damages the lungs' cilia, which normally help clear mucus and bacteria.
Chang stated that the illness in younger children is usually moderate or asymptomatic, but it can cause major breathing problems in individuals with compromised immune systems. The CDC also reports weariness, cold, and shortness of breath as typical symptoms (3). In rare situations, M. Pneumoniae can cause acute central nervous system (CNS) infections, probably due to antibodies that wrongly attack brain cells.
How does Walking Pneumonia Differ from the Common Cold? Observing how walking pneumonia spreads throughout a family can help separate it from the ordinary cold. "Viral infections often spread quickly from person to person within a household, so if siblings or family members get sick within a few days of each other, it's more likely to be a virus that is causing the symptoms," Chang told CNN. If the infection spreads slowly, with a week or two between cases, Mycoplasma could be the culprit.Mycoplasma pneumoniae is characterized by coughing in bursts or "fits," during which patients struggle to breathe. This cough can last for a month or more, unlike other viral illnesses, which recover quickly.
Nachman encouraged parents to look for indicators of laborious breathing in their children, such as neck or rib muscle tightness or trouble with strenuous activity like climbing stairs.
How Does a Pneumonia Cough Sound and Feel? A pneumonia cough can differ based on the type of infection. Chang explained that in most cases of bacterial pneumonia, the cough is "wet," producing mucus, phlegm, or pus. Chest pain is also common, especially after deep breaths, and it can worsen depending on your position, such as sleeping down.Chang observed that M. Pneumoniae typically causes a dry cough, which is frequently accompanied by chest tightness and difficulties taking deep breaths. Wheezing occurs more frequently, and continuous coughing might cause muscular or rib pain.
Nachman underlined that pneumonia does not create the distinctive "whoop" of whooping cough or the "barking" sound of croup. Some youngsters cough so intensely that they vomit mucus, while others swallow it, reducing their appetite.
When Should You Visit a Doctor? There are no vaccinations available to prevent Mycoplasma infection. If you or someone you know develops shortness of breath, wheezing, or difficulty completing words, Chang advises seeking medical assistance straight once. Trouble eating in newborns may potentially indicate a more serious viral infection. If a fever persists for more than a week, parents should seek medical attention.Chang points out that many doctors do not check for Mycoplasma or have testing accessible, making it difficult to establish the diagnosis. However, if a clinician suspects Mycoplasma, medications such as azithromycin or doxycycline are commonly administered.
"Antibiotics are most helpful if started within three to four days of the start of symptoms," according to Chang. "After that, it's unclear how much antibiotics help if people have already started coughing. It is unclear whether antibiotics help to resolve this faster."
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How To Tell If You Have Pneumonia Or The Common Cold
PHOTO: ADOBE STOCK
It's cold and flu season, but cases of pneumonia seem to be popping up everywhere too. The CDC has stated that cases of bacterial infections caused by Mycoplasma pneumoniae have increased in the United States since late spring and have remained high.
Cases have increased significantly among young children, notable because they have not historically been widely affected by Mycoplasma pneumoniae.
Dr. Graham Snyder, medical director of infection prevention and hospital epidemiology at UPMC, says like many respiratory viruses, Mycoplasma pneumoniae became uncommon during the pandemic because of social distancing and masking.
"This is a pathogen that goes from person to person," he says. "When you cough or sneeze and you're in a close environment, it's spread by those droplets that you're coughing or sneezing, and so its reemergence has a lot to do with now we're back to our usual behaviors."
Snyder notes pneumonia, which is inflammation in the lungs, could be caused by bacteria, a virus or both. For walking pneumonia, so named because you can still function while ill, symptoms mimic cold symptoms — coughing, congestion and headache.
Snyder says there are various ways to identify whether you're experiencing the common cold or a type of pneumonia.
"If a child is having, let's say, a persistent cough with a fever, and you take your child to the pediatrician, the pediatrician may listen to the lungs and say, 'Aha. I can hear on the exam that sounds like there's a pneumonia."
A doctor could also order a chest X-ray, or they may use a nasal swab to test for the bacteria that causes pneumonia.
"Usually in most offices, those are either testing just for COVID, or they're testing for a combination of COVID, flu and RSV, but some of those tests that doctors can use test for a bigger range of respiratory germs," Snyder says.
Antibiotics are appropriate for bacterial pneumonia or your doctor may prescribe an anti-viral for viral pneomnia.
Snyder says to listen to your gut as to whether or not your illness is serious.
"I always encourage people to use judgment," he says. "If you're concerned about how sick your child looks, for example, make sure you seek medical care. It may be appropriate to go to an urgent care or [emergency department]."
Snyder says if you have a cough or fever that lasts more than a few days you should talk to your doctor about whether it could be pneumonia.
Anyone at risk of complications, such as those with asthma, should perhaps "lower your threshold to seek care and consider antibiotic treatment."
"This can make asthma worse, and that's one of the ways that this bacteria can cause more trouble than just a mild infection," Snyder says.
The CDC Now Recommends Getting The Pneumonia Vaccine Starting At 50
In October, the CDC lowered the age recommendation for the vaccine against pneumonia. Before, it was 65 and older. The health agency now says you should get the shot at age 50.
KERA's Sam Baker spoke with Dr. David Winter, an internist with Baylor, Scott, and White-Dallas about the reasons for the change.
Winter: We're seeing a lot more of it (pneumonia) lately. That's the concern.
It used to be mainly in older folks, but we're now seeing it in middle-aged Americans. And so, because of the increase in the incidence, the CDC now recommends the vaccine, which works pretty well to minimize or sometimes even prevent pneumonia.
Baker: But what's causing the spread?
Winter: Most cases pop up randomly. It's unlikely or unusual for someone to say, I got it from so-and-so.
You can get it from a viral infection. Once the virus gets in your lungs, it increases secretions. You can get a secondary bacterial infection. So, that's one way.
But we're not sure why there's more pneumonia out there. Maybe more people are congregating together. Maybe the pneumonia bug itself is more virulent. We just don't know the actual reason.
Baker: The CDC says the vaccine battles pneumococcal bacteria. I know that involves pneumonia, but also more than that, correct?
Winter: The bacteria can cause other infections. Very rare cases of pneumococcal meningitis. It's thought the vaccine may also help to prevent that.
But the most common thing it does is to get in the lungs where it spreads. And that's what they recommend the vaccine for because that's the most common thing we're seeing.
The pneumonia vaccine works very well. It has very minimal side effects. You might get a sore arm for a day or two, sometimes an aching, but usually not severe side effects at all.
It works very effectively. People who get pneumonia after a vaccine do very well, or may not get it at all. They have very mild symptoms. So, the vaccine is worthwhile to consider.
Baker: Will it require a follow-up or booster later?
Winter: Yeah, there's a lot of different pneumonia vaccines out there.
The newer ones are called pneumococcal 20 or pneumococcal 21. And those are a lifetime vaccine. If you get those, that's all that you need.
The older ones don't tend to last as long. So, it's recommended that you go ahead and get these newer vaccines, the pneumococcal 20 or pneumococcal 21.
Baker: Is this only for people 50 and older, or younger people with certain risk conditions?
Winter: The previous recommendations were that if you were 65 or older, you could get a pneumococcal vaccine. Now they're saying if you're 50 or older, you should get one. But indeed, if you are younger than that and have some immune deficiency condition or have some chronic illness like chronic heart disease, lung disease, or kidney disease, you also should consider getting what at that age.
Baker: Is this something that needed to be done before now?
Winter: Well, typically in the past, we see mainly serious cases of pneumonia in the older folks. And if you were younger, you tolerated it pretty well and got over it pretty quickly.
However, there has been an increase in severe cases of pneumonia in younger folks. That's the reason for the new recommendation.
Baker: Just how dangerous is pneumonia?
Winter: A lot of folks have mild cases. We call that walking pneumonia. That's not a medical term. It means you walk in the doctor's office and we say you have pneumonia and here are your antibiotics. You can now go home.
But we're seeing more severe cases now, and that's a concern. Severe cases require hospitalization, and sometimes they end up in death. That's the reason we're targeting everyone age 50 and older.
Also, young children. If they're under age five, they need pneumonia vaccinations. They can also get a severe case of pneumococcal pneumonia.
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