What is “walking” pneumonia and why is it increasing?

Mycoplasma pneumoniaealso known as walking pneumonia, is usually a mild bacterial infection that mostly affects children and teenagers and is usually treated with antibiotics.

The infection got its unofficial name because people infected with it usually don’t get as sick as people with other types of pneumonia.

“It’s called ‘walking pneumonia’ because a lot of people aren’t sick enough to lie on their backs at home or in the hospital,” said Dr. Isaac Bogoch, an infectious disease specialist at Toronto Hospital.

“Many people are able to carry on with their daily routine, feeling unwell but not sick enough to stay at home. That being said, it’s just a colloquial term and of course we know some people can get very sick.”

In October in US Centers for Disease Control and Prevention (CDC) reported an increase in cases Mycoplasma pneumoniae infections, especially in young children. The increase began in late spring, and the number of cases remains high.

In Canada, the number of cases of walking pneumonia is not tracked, but in some cases, doctors say they have seen an increase in cases.

Dr. Earl Rubin, a pediatric infectious disease specialist at Montreal Children’s Hospital, said he has seen patients admitted to the hospital with a positive test since the summer.

“Talking to colleagues across the country in pediatric infectious diseases, everyone feels the same way,” Rubin said.

“We have received some signals of increased traffic in Quebec and are monitoring the situation,” the province’s health ministry said in a statement.

Halifax hospital IWK Health reported 11 cases last year. This year, 113 cases were recorded, including 28 pediatric patients.

The BC Center for Disease Control said its observations show the province is seeing more respiratory infections due to M. pneumoniae than in previous years — especially among people under 20 — and she’s keeping a close eye on the situation.

BC Children’s Hospital in Vancouver has also seen an increase in the number of children presenting to emergency rooms with walking pneumonia since August.

What causes it?

Respiratory infection is caused by bacteria Mycoplasma pneumoniae.

It spreads through the air, Bogoch said. This includes when a person coughs or sneezes, according to the CDC.

Who gets?

Infections can occur at any age, but are most common in children ages 5 to 17 and young adults. The CDC called the increase since March in children ages two to four “notable because M. pneumoniae has not historically been recognized as a major cause of pneumonia in this age group.”

Adults can also be affected. If someone has the infection, you can expect a third of the household to get it, Rubin said.

What are the symptoms?

M. pneumoniae infections are usually mild and mostly manifest as a cold with fever, cough, and fatigue.

About a quarter of cases can lead to pneumonia, meaning the lungs are affected, Rubin said.

Nausea, vomiting, or loose stools may also occur.

What is the treatment?

Doctors usually diagnose an infection based on the patient’s signs, symptoms, and history without waiting for confirmatory laboratory results.

Most people recover on their own, doctors say.

Rubin said the bacteria are considered atypical because they lack the cell wall that some other pneumonia antibiotics work against.

“Azithromycin is a very common, widely available antibiotic that can be used to treat this infection,” Bogoch said. “There are other options.”

Why is the number of cases increasing?

There are several lines of thought as to why there are more cases M. pneumoniae are currently being observed in compliance with the precautionary measures of the COVID-19 pandemic.

“One potential hypothesis is that there are more people who don’t have immunity to it and are therefore more susceptible,” Rubin said. “When you combine that with something that’s quite contagious, you can expect the numbers to go up.”

There is no evidence that the bacteria themselves have changed, he said.

Is there anything to pay attention to?

Pediatricians say that most children can be treated at home. They should be kept hydrated, given age-appropriate antipyretics as needed, and rested.

Rubin said the infection has been associated with wheezing that mimics asthma or can exacerbate existing asthma.

“If someone has respiratory distress, if someone is much sicker than they’re used to seeing with a common cold, then definitely … see a doctor,” he advised.

Dr. Carly Jensen, an emergency room and family physician at Oak Valley Health Uxbridge Hospital, north of Toronto, said pneumonia can sometimes develop after a viral infection, like a cold.

Therefore, if someone gets better and then suddenly gets sick again, especially in the chest, or has a fever, it is worth getting checked out, she said.

As a rule, doctors advise that difficulty breathing, dehydration or lethargy are signs that the child should be seen by a doctor.

Enhanced prevention advice

British Columbia health officials recommend that people stay up-to-date on immunizations, including updated COVID-19 and flu shots, as well as routine childhood vaccines.

“There are vaccines to protect against certain types of pneumonia caused by strep bacteria. Although these vaccines will not directly prevent M. pneumoniaethey can reduce the chance of secondary bacterial infection through to M. pneumoniae or the possibility of a more serious illness due to a concomitant viral infection,” a spokesperson for the BC Centers for Disease Control said in an email.

To prevent all respiratory infections, people are advised to wash their hands regularly, stay home when they are sick, especially if they have a fever, wear a mask in closed public spaces if they can and can do so safely, and cough and sneeze into their elbows.