Walking pneumonia is booming − and targeting the young and the poor

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What you need to know about the rise of walking pneumonia cases

The Centers for Disease Control and Prevention have issued an alert over the surge in cases of walking pneumonia in children younger than 5 years old.

News 12

ARLINGTON, Va. − Infections of the bacteria that cause walking pneumonia, a lesser evil of the more serious illness of pneumonia, are seeing a dramatic jump after a lengthy decline that came with the start of the COVID-19 pandemic, health officials say.

Most alarming is the sharp increase in children infected with the disease. And, as with COVID-19, the impact of the disease can hit low-income Americans the hardest.

The Centers for Disease Control and Prevention said infections from the bacteria that can cause walking pneumonia are common: An estimated 2 million infections occur each year in the United States. However, the true number isn't known, in part, because so many people get it without seeking medical help and, in part, because there is no nationwide reporting system.

The infections dropped off during the COVID-19 pandemic but are now booming. Hospital emergency department discharge data from April to October showed an increase in infections of the bacteria among all age groups, according to the CDC. The increase, however, was highest among children, growing from 1.0% to 7.2% among those 2–4 years and from 3.6% to 7.4% among children 5–17 years. 

Though generally not too serious of an illness, a small percentage of patients can face serious and dangerous complications. In Arlington, the county Health Department issued an alert to health care workers this month citing an increase similar to national numbers based on pediatric emergency room visits. Physicians were asked to report clusters of three or more cases to the department.

"Encourage healthy habits to slow the spread" of the disease, the alert says.

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All that time spent social distancing during the worst of the pandemic likely is playing a role in the walking pneumonia outbreak.

"We emerged from the pandemic, people came out of their caves, and they were no longer isolated," Dr. Thomas Russo, who heads the infectious diseases department at the University at Buffalo School of Medicine, told USA TODAY. "We saw the bump in infections as people started to interact again."

Young children saw the highest jump in infections because they had little or no prior opportunity to develop immunities before lockdowns and social distancing swept the nation, Russo said.

Dr. Ogbonnaya Omenka, director of equitable population health for Humana Indiana Pathways, notes that the often mild symptoms mean infected people don't avoid contact with others, thereby unintentionally transmitting the disease.

"Factors that normally drive public health outbreaks are involved, such as crowded environments and increased contact, hence the unsurprising concentration of the infection among the young," Omenka said.

Public health events do not affect everyone the same way, Omenka said. Financial resources play a role in access to health care, and children depend on the financial resources of their parents, he said. Parents with insurance are more likely to bring their child to a physician when symptoms arise. Adults living paycheck to paycheck are less likely to take time away from work when they are sick.

The impact of the walking pneumonia outbreak depends on the same factors, Omenka said.

"Like preexisting health conditions determine how diseases affect people, preexisting life situations determine how the population is affected by an event such as walking pneumonia," Omenka said. "From seeking medical care to following the guidelines, such as staying home, people on the low socioeconomic spectrum are most likely to struggle the most."

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Pneumonia is an infection that causes the lungs to fill with fluid and can cause a bad cough or difficulty breathing. Mycoplasma pneumoniae bacteria, the infection that is now booming, is just one of an array of bacteria and viruses that can cause pneumonia.

Walking pneumonia, a less severe form of pneumonia, is primarily caused by mycoplasma pneumoniae. The bacteria can damage the lining of the respiratory tract, including the throat, windpipe and lungs.

Walking pneumonia can spread through droplets when someone coughs or sneezes. The germs linger in the air and others breathe them in, the CDC said.

Symptoms can include fever, cough, a sore throat and even chronic breathing issues. Although generally not life-threatening, the symptoms can last for weeks. And, while uncommon, serious complications from infection can occur that require hospital care, including new or worsening asthma, severe pneumonia and encephalitis − a brain inflammation that causes swelling and in extreme cases leads to brain damage or stroke.

It is those more serious complications that raise the stakes in the effort to control the spread of the infection, Russo said. About 5%-7% of cases result in the more serious outcomes, he said.

"Unfortunately, when you see a rise in the basic infection you will see a rise in those cases, too," Russo said.

Monitoring shifts in disease patterns is also important because they may signal broader public health implications, said Lisa Olson-Gugerty, an associate professor at Syracuse University and family nurse practitioner who specializes in public health.

"Understanding and analyzing such trends is fundamental to public health, biostatistics and epidemiology," she said.

There is no vaccine available because walking pneumonia "has not been a significant contributor to mortality rates," Olson-Gugerty said. "In other words, it is generally a mild condition." The disease can be treated with some antibiotics.

There are ways to avoid getting or spreading the disease using the same precautions you would for respiratory viruses. The Cleveland Clinic lists a lot of them, beginning with the basics: Cover your nose and mouth with a tissue when you sneeze or cough − or at least sneeze or cough into the inside of your elbow or your sleeve, just not into your hands.

Regularly wash your hands with soap and clean water for at least 20 seconds or use sanitizer. Also, don't smoke and do get a flu shot.

Health care professionals stress the importance of being up-to-date with shots for COVID-19, flu and RSV − respiratory syncytial virus. All three infections are likely to be on the upswing as people gather for the holidays. And protection from those illnesses also can have an impact on walking pneumonia.

"While these vaccines do not directly prevent mycoplasma pneumoniae infections, they can reduce the risk of complications associated with these illnesses," Olson-Gugerty said.