‘Walking Pneumonia’ Cases Spike Among Children: What To Know In VA

VIRGINIA — It’s possible the persistent cough that has been nagging your child for weeks is a type of “walking pneumonia” that has been surging this year, especially in young children.

The percentage of children ages 2-4 who have been diagnosed with this common type of pneumonia grew from 1 percent to 7.2 percent from March 31 to Oct. 5, according to the Centers for Disease Control and Prevention. The agency said the increase is “notable” because the bacteria that causes it — Mycoplasma pneumoniae — historically hasn’t been recognized as a leading cause of pneumonia in this age group.

In Virginia, emergency department visits associated with Mycoplasma pneumoniae have increased by a factor of seven in children aged 2-4 since spring, according to the latest Virginia Department of Health’s situation update.

VDH is monitoring the increase in emergency room visits and outbreaks caused by pediatrict pneumonia, especially among children who are 5-17 years old, over the last few months.

"The increase in cases and outbreaks of pneumonia have been seen particularly in K-12 schools. In the past week (Oct. 20-26, 2024) there were 2,420 visits with diagnosed pneumonia among 0–17-year-olds," according to a VDH statement. "This is a 40 percent increase from the previous week and nearly triple the weekly peak observed in the past two years. This has prompted enhanced surveillance and increased testing, which are both ways for VDH to try to determine the cause of this increase. Laboratory testing so far has identified a variety of viruses and bacteria through this testing, including some viruses that typically cause the common cold such as enteroviruses, rhinoviruses and bacterial infections caused by Mycoplasma pneumoniae."

The bacteria is easily spread by coughing or sneezing, and while respiratory infections are generally mild, serious complications can also develop.

Virginia parents can take the following core prevention strategies to protect themselves and others from common respiratory illnesses, according to VDH:

• Stay up to date with immunizations, like COVID-19 and flu vaccines.
• Practice good hand and cough/sneeze hygiene - Wash your and your child’s hands frequently and often. Hand washing may be better than using hand sanitizer, especially against some of these cold viruses.
• Routinely clean and disinfect commonly touched surfaces or items.
• If you have a respiratory illness, stay home and away from others to prevent spread.
• Children can return to school and activities after they have had no fever for 24 hours without the use of fever-reducing medicines (such as acetaminophen or ibuprofen) and if their symptoms are improving, (unless otherwise directed by a healthcare provider).

Below are things Virginia parents need to know about Mycoplasma pneumonia:

What Is Walking Pneumonia?

Walking pneumonia is a colloquial term to describe atypical pneumonia — that is, mild lung infections whose symptoms are similar to a chest cold, including a sore throat, sneezing, coughing, headache, mild chills and low-grade fever.

People who have walking pneumonia generally feel well enough to go about their lives.

Unlike “regular” pneumonia, which is caused by various microorganisms, usually bacteria and viruses, walking pneumonia is caused by the difficult-to-detect bacterium Mycoplasma pneumoniae.

People of any age can develop walking pneumonia infections, but they’re most common among children ages 5-17 and young adults. Younger children may have different symptoms, including diarrhea, wheezing or vomiting.

How Common Is Walking Pneumonia?

An estimated 2 million infections are confirmed every year in the United States, but the CDC said the true number of people who are affected every year is unknown, as there is no national reporting or dedicated surveillance system for tracking.

The CDC data from March 31 through Oct. 5 that shows young children are getting sick at higher rates also shows an increase is diagnoses among all age groups. And although infection rates are highest among young children, the number of kids ages 5-17 diagnosed with walking pneumonia increased from 3.6 percent to 7.4 percent from March 31-Oct. 5.

The CDC also looks at lab data showing how frequently patients are testing positive for walking pneumonia infections. The positivity rate has also gone up since late spring for all age groups, from 0.7 percent to 3.3 percent.

Will Antibiotics Take Care Of It?

First-line antibiotics for children, including amoxicillin and penicillin, don’t work on this type of pneumonia. Instead, the CDC recommends macrolides, such as azithromycin, clarithromycin and erythromycin. Patients who don’t improve may need second-line treatments, such as fluoroquinolones or tetracyclines.

Why Are Cases Increasing Now?

Although Mycoplasma infection rates are now more in line with pre-pandemic levels, they have not exceeded them.

“It seems very dramatic now, but it’s more because during the peak of the Covid pandemic, just about everything else went down,” Dr. Geoffrey Weinberg, a pediatric infectious disease specialist at the University of Rochester Medical Center, told CNN “But the actual countrywide rates are fairly similar to what it was before 2019.”

Also, according to the CNN report, most infections cycle, meaning some years are worse than others. Mycoplasma pneumonia rates tend to spike every three to seven years as people lose their immunity to the virus.

Also, tests are more advanced. Multiplex tests can check for multiple types of viruses and bacteria at the same time, so doctors may be picking up on it more often, according to health experts.

What Else Can Be Done?

The bacteria can remain in the body for one to four weeks before a person gets sick. This type of pneumonia easily spreads through crowded settings, such as schools, college dorms and nursing homes, according to the CDC

One of the best ways to control its spread is to practice good hand-washing and other hygiene techniques, such as coughing into a sleeve.