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These Are The Signs Of 'Walking Pneumonia' In Kids

Mycoplasma can infect a person's lungs, causing pneumonia.
Mycoplasma can infect a person's lungs, causing pneumonia.

Mycoplasma can infect a person's lungs, causing pneumonia.

You may have seen headlines about recent outbreaks of respiratory illness affecting children in China, Europe and the United States.

The Warren County Health District in Lebanon, Ohio, issued an advisory on Nov. 29, noting an “extremely high number of pediatric pneumonia cases being reported this fall season.” The average age of patients is 8 years old, and case numbers were high enough to meet the Ohio Department of Health’s definition of an outbreak, according to the advisory.

Two days later, on Dec. 1, the Centers for Disease Control and Prevention issued an update saying they are monitoring reports of such illnesses among children around the world.

Both organizations named mycoplasma pneumoniae as one cause of the infections.

After navigating the COVID-19 pandemic, parents may be alarmed to hear of a new outbreak affecting kids. Mycoplasma pneumoniae infections, also known as “walking pneumonia,” sound worrisome. But the pathogen isn’t a new one, and we have effective treatments to combat it. Here’s what parents need to know about this illness.

What is mycoplasma pneumoniae?

As its name suggests, mycoplasma pneumoniae is a bacteria that can cause upper or lower respiratory tract infections, including pneumonia. Pneumonia, which can have various causes, is an infection of the lungs.

While we currently seem to be experiencing a spike in cases, the bacteria itself is not new. Unlike COVID-19, which was novel and affecting populations for the first time, mycoplasma is a bacteria that doctors have seen and treated before.

Why is it sometimes called ‘walking pneumonia’?

Lower respiratory or lung infections with mycoplasma pneumoniae are sometimes called “walking pneumonia.” This is because it “tends to have milder symptoms compared to pneumonia caused by other bacteria,” Dr. Ruth Kanthula, a pediatric infectious disease specialist at MedStar Health in Washington, D.C., told HuffPost.

“Most people with ‘walking pneumonia’ do not have to be hospitalized,” Kanthula said. The name comes from the fact that patients may not be in bed but instead up and walking around.

Mycoplasma is “unusual” among bacterial causes of pneumonia “for the fact that it generally comes on a person in a very gradual way,” Dr. Elizabeth Talbot, professor of medicine, infectious disease and international health at Dartmouth’s Geisel School of Medicine, told HuffPost. Other types of pneumonia may present with more sudden and severe symptoms.

Talbot said this infection has been referred to as “walking pneumonia” for decades. In addition, she said, neither mycoplasma pneumoniae nor clusters of infections at this time of year are new.

What is new is that some media outlets have begun calling this illness “white lung syndrome,” a reference to the way a patient’s lungs appear in an X-ray. While it may “sound scary,” Talbot explained that this is “not a medical term,” and does not denote a new phenomenon.

“There can be a rise in infections caused by mycoplasma every few years,” Kanthula said. “And this may be one of those years.”

What are the symptoms?

As Talbot explained, symptoms may appear gradually and can resemble those of many other respiratory infections.

These symptoms, she said, may include:

  • Headache

  • Fatigue

  • Sore throat (more likely at the onset of infection)

  • Fever

  • Cough

In children under age 5, the CDC notes that symptoms may be difficult to distinguish from a normal cold, and might include:

  • Sneezing

  • Stuffy or runny nose

  • Sore throat

  • Watery eyes

  • Wheezing

  • Vomiting

  • Diarrhea

It’s the duration of illness that usually tips parents off that something other than a common cold may be at play, and causes them to bring kids to see the doctor. Talbot noted that “we expect usual viral colds to go away after a few days,” but this illness typically persists for a longer period.

“If your child is with fever, with fatigue, coughing, producing sputum for longer than a week, it’s time to see the doctor,” Talbot said.

Likewise, the duration of this illness may prompt your child’s doctor to test for mycoplasma. “Pediatricians may consider testing and treating for mycoplasma when a patient with symptoms consistent with viral infection does not improve as expected,” Kanthula said.

There are two kinds of tests for mycoplasma that a doctor may order, Kanthula explained. One is a blood test for antibodies, and the other is a throat swab test for genetic material from the mycoplasma bacteria.

Why are children particularly at risk?

While the statement from the Ohio Health Department said the average age of pneumonia patients in that outbreak is 8 years, Kanthula said that “we typically think mycoplasma causes disease in older children, such as adolescents and young adults.”

She reiterated that “infections with mycoplasma in younger children may be asymptomatic or mild and difficult to distinguish from infections with winter viruses.”

While a rise in mycoplasma infections every few years may be normal, it can feel like a lot of kids are getting sick because the rate of respiratory illnesses in children is comparatively higher than during the pandemic ― when social distancing and masking brought the number of cases of the flu and other illnesses to record lows.

“I’ve seen this phenomenon of now kids getting sick as referred to as ‘immune debt,’” Talbot said. “The level of these infections is not out of the ordinary. It’s very consistent with pre-COVID. But in the last three years, we have not seen them as much.”

What treatment is available?

One important thing to know about mycoplasma pneumoniae is “it’s readily treatable,” Talbot said.

“There are antibiotics that can treat this,” she said, and these can be “especially effective at shortening the course of disease when received early.” This is a good reason to have your child seen by a doctor if they have a fever or other cold symptoms that last longer than expected.

How can we prevent infection? 

While there is a vaccine for pneumococcal disease caused by the bacteria  streptocuccus pneumoniae, there isn’t one for mycoplasma.

The preventive measures for mycoplasma infection are the same as for COVID-19 or any other respiratory illness. Talbot described these as “more of the usual”: handwashing, staying home when ill, and masking when appropriate.

With holiday gatherings on the horizon, Talbot said, “we all need to decide what what fits our lifestyle and what inconveniences we’re willing to suffer in order to avoid these routine respiratory diseases.”

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