MUSC Children's Health sees almost fivefold increase in walking pneumonia cases

Walking pneumonia, a slow-growing illness that usually causes cold-like symptoms but can become more serious, is on the rise in the Lowcountry. Ian Kane, M.D., takes care of kids in the Emergency Department at the MUSC Shawn Jenkins Children’s Hospital. 

“We see typically about 1% of our tests come back positive for mycoplasma pneumonia, which causes walking pneumonia. That's been typical over the last couple of years. But then over the last couple of months we've seen cases rise to about 5% of those tests. So it's almost a fivefold increase.”

 

Kane, an associate professor of Pediatric Emergency Medicine at the Medical University of South Carolina, explained what walking pneumonia is. “When we think of pneumonia, we think of bacterial pneumonia. Walking pneumonia is also caused by a bacteria, but it's a really interesting and small bacteria that grows very slowly,” he said. 

“It tends to cause symptoms that aren't quite so severe, and that's why people coined the term ‘walking pneumonia,’ because you feel lousy, but you can still go along with your day-to-day activities.”

That’s true for a lot of people – but not all. “Thankfully, for most cases of walking pneumonia, it gets better without treatment. So you're going to be feeling tired for a few days. You might have some low-grade fevers, you may have a cough that's persistent for a few weeks, but otherwise you get through it,” Kane said.

“Now for some kids and young adults it can be a little bit more serious. You may have prolonged fevers that are higher, difficulty breathing and a cough that's more severe. Those are the people who need to seek treatment.”

He said the people who are at highest risk of getting really sick with walking pneumonia are those whose immune systems are weakened, whether from HIV, cancer or another cause. Kane said the very old and the very young can be at higher risk as well. 

“What's interesting about this latest spike in cases is that it's affecting more younger children, but we haven't seen that they've been more seriously affected.”  

Kane said walking pneumonia is contagious, so holiday family gatherings can be occasions where it spreads. But if it does, it won’t be immediately apparent because the bacteria grow slowly, invading the cells that line the respiratory tract. 

“In contrast to things like the cold or the flu, you can be exposed to someone with mycoplasma and not develop symptoms for several weeks, so it can be very difficult to try to pinpoint where you may have gotten infected from.”

Most people with walking pneumonia can be treated at home. “Treat the fever with Motrin or Tylenol, make sure your child's staying hydrated and just keep an eye on how their breathing is. The cough is the one symptom that I will say it's difficult to deal with. That's probably the most persistent symptom,” Kane said. 

“So if that's all your child has, that's probably OK. But if they have trouble breathing, severe and persistent cough or fevers that last for more than a few days - those are the kids who should schedule an appointment with their pediatrician.”

Kane attributed some of the increase in cases to the ongoing aftermath of the pandemic. “With everything that we did with COVID in terms of handwashing and social distancing and masking, I think what that did was prevent a lot of younger kids, especially, from developing these infections and then gaining some immunity to mycoplasma. And so, I think what we're seeing now is that those kids are finally catching up and being exposed to the mycoplasma bacteria again."