Walking Pneumonia on the Rise: What Parents Should Know

The Centers for Disease Control and Prevention recently issued a warning about a rise in cases of “walking pneumonia” in the U.S. This rise is most noted in children ages 2–4, a group not commonly affected by this respiratory infection.

University Hospitals Rainbow Babies & Children’s pediatric infectious disease specialist Amy Edwards, MD, explains more about the infection that is showing up in pediatrician offices throughout the country.

What Is Walking Pneumonia?

Walking pneumonia is the layman’s term for what infectious disease specialists refer to as interstitial pneumonia. The infection can be viral or bacterial but is most often associated with the bacteria Mycoplasma pneumoniae.

Mycoplasma pneumonia is different from classic pneumonia, which is caused by the pneumococcus bacteria. Classic pneumonia affects the air sacs in the lungs (alveoli), causing them to become filled with fluid or pus. With Mycoplasma pneumonia, the tissue around the air sacs becomes inflamed instead. It tends to be milder because the lungs aren’t filling up with fluid and the inflammation is more spread out instead of concentrated in one area.

It is often referred to as “walking pneumonia” because most cases are mild enough that you could be walking around and not even know that you’re infected. Like other respiratory infections, walking pneumonia is spread through droplets expelled when an infected person sneezes or coughs.

Symptoms of walking pneumonia can be difficult to distinguish from other respiratory infections like influenza, respiratory syncytial virus (RSV) or COVID-19. Common symptoms include:

• Cough
• High fever
• Runny nose
• Headache
• Fatigue

A symptom that is unique to mycoplasma pneumonia is irritation or inflammation of the mucous membranes, including the eyes, mouth, rectum or vagina. In rare cases it can also cause peeling of the mucous membranes. Walking pneumonia can also rarely cause infections outside of the lungs.

Why Are Cases Rising?

Walking pneumonia usually affects adults, teens and older children. It is much less common in children under the age of 5. However, Dr. Edwards says that cases of walking pneumonia are up across the board this year, most notably in younger children. These children aren’t necessarily ill enough to be admitted to the hospital, but pediatrician offices are seeing a marked uptick.

It’s not clear why cases are up, but Dr. Edwards says that there are some theories that warrant further investigation. One theory is that exposure to COVID-19 can cause damage to our T-cells and immune system, which may make us more susceptible to other infections. Dr. Edwards notes that in addition to this latest spike in walking pneumonia, other respiratory infections have been trending up since the arrival of COVID-19 as well.

“Every respiratory season since 2020, we’ve been dealing with more and with worse infections,” says Dr. Edwards.

Dr. Edwards also puts some of the blame on pandemic burnout for the increased spread of contagious infections. After the hypervigilance of the COVID-19 pandemic, people have become more lax with safety precautions when they or their children are ill, she says.

“The pandemic was exhausting, and many people are just done,” says Dr. Edwards. “People are now going to work sick, they’re sending their kids to school sick, and you see very few people wearing masks when they’re unwell.”

When Should You Seek Medical Care?

Many people who have walking pneumonia will never know they have it unless their symptoms are bad enough to seek medical care. Parents trying to determine whether their child needs to see their doctor should be guided by their child’s behavior. Some questions to ask yourself are:

• Is my child playing and/or active as usual?
• Is my child eating/drinking like normal?
• Is my child peeing/pooping like normal?
• Am I able to manage their fever with Tylenol?

You know your child best, says Dr. Edwards, and you will likely be able to tell by simple observation whether they need to see their doctor: “Regardless of what the infection is, if your child is not doing well, they should go to their pediatrician to see if there’s anything their pediatrician can do to help.”

Diagnosis, Treatment and Preventing the Spread

Since walking pneumonia symptoms are so similar to other respiratory viruses, it usually is diagnosed by ruling out other infections. It can also show up on an X-ray of the lungs and can be confirmed through a lab test if necessary.

Many cases of walking pneumonia are mild enough not to require antibiotics, but your child’s pediatrician can help you determine if antibiotics are necessary. Cases generally resolve within a week or two. A cough may not fully go away until several weeks after the infection has cleared.

There is no vaccine for mycoplasma pneumonia, so good hygiene is the most important thing you can do to prevent it, says Dr. Edwards. This includes covering your cough/sneezes, washing your hands frequently, staying home or keeping your child home when sick, or wearing a mask if you have to go out. Dr. Edwards says the simple act of wearing a mask can reduce the amount of droplets you release into the world by 70 to 80 percent.

“If you must go out and about when you’re not well you should wear a mask because you’re much less likely to make the people around you sick,” she says.

Related Links

University Hospitals Rainbow Babies & Children’s has the region’s largest coordinated network of pediatric primary care providers, committed to delivering the very best care to children of all ages, including for respiratory infections such as walking pneumonia, RSV and influenza. Find a UH Rainbow pediatric practice near you.