Children suffering from persistent coughs that last for weeks may be experiencing a type of walking pneumonia that has seen a marked increase in the United States this year, as noted by infectious disease experts.
Dr. Buddy Creech, a pediatric infectious disease specialist at Vanderbilt University Medical Center, highlighted that since early summer, there has been a substantial rise in the number of children diagnosed with this specific kind of pneumonia. In August, he received inquiries from multiple pediatricians in the Nashville area who were puzzled by the high number of coughing children during the summer months. These doctors reported that the usual antibiotic treatment for pneumonia, amoxicillin, was not effective for their patients.
This pneumonia is attributed to Mycoplasma pneumoniae bacteria, and according to the Centers for Disease Control and Prevention (CDC), there has been a notable spike in cases, particularly among preschool-aged children. The CDC issued a bulletin to alert parents and healthcare providers about this increase last week.
Currently, Mycoplasma pneumonia is one of several lung infections that are causing concern as the fall season progresses. The incidence of whooping cough, also known as pertussis, has surged to five times the levels recorded last year, and the respiratory syncytial virus (RSV) is also on the rise in various regions of the country.
Historically, testing for Mycoplasma has been challenging, as these bacteria do not thrive in Petri dish environments, which are typically used for bacterial infection testing. Dr. Creech mentioned that advancements in diagnostic testing are allowing for quicker and more reliable identification of these bacteria. Given the various infections causing coughs this fall, it is imperative for doctors to utilize these improved tests for accurate diagnoses.
The CDC emphasizes the need for awareness regarding Mycoplasma infections since the standard first-line antibiotics for children, such as amoxicillin and penicillin, are ineffective against this particular bacteria. Fortunately, it can typically be treated successfully with other antibiotics like azithromycin.
Recent data from the CDC shows that the percentage of children aged 2 to 4 who visited emergency rooms for pneumonia and tested positive for Mycoplasma has surged from 1% in April 2024 to 7.2% by early October—a sevenfold increase. Among older children, the diagnosis rate doubled from 3.6% to 7.4% during the same period.
While Mycoplasma cases appear to have peaked in mid-August, they are still prevalent, and Dr. Creech anticipates that they will remain high for another month before tapering off as fall progresses.
In X-ray images, Mycoplasma infections often present as a cloudy or “white lung” appearance. Last year, similar increases in this type of pneumonia among children were reported in China, Denmark, and France.
According to Dr. Geoffrey Weinberg, a pediatric infectious disease specialist at the University of Rochester Medical Center, the current rise in cases can be attributed to three primary factors. Firstly, the rates of Mycoplasma infections are returning to pre-Covid-19 pandemic levels, as there was a significant decline in infections during the height of the pandemic.
Secondly, infections tend to cycle, meaning certain years will naturally see higher rates. Dr. Creech noted that spikes in Mycoplasma pneumonia are typically observed every three to seven years as immunity wanes.
Lastly, advancements in medical testing, particularly multiplex tests that can simultaneously detect various viruses and bacteria, are likely contributing to a greater recognition of these infections.
Mycoplasma pneumoniae bacteria are primarily transmitted through respiratory droplets, making them easily spread in crowded environments such as schools and nursing homes. These bacteria can linger in the body for one to four weeks before symptoms develop, often leading to difficulties in tracing exposure sources.
Mycoplasma infections generally begin with nonspecific symptoms such as headaches, sore throats, low fevers, and chills. Although individuals may feel unwell, they can manage regular activities, hence the term “walking pneumonia.” The associated cough is usually dry and intensifies gradually over two to three weeks.
Not every case of Mycoplasma infection requires treatment; as many as 75% of affected children and young adults may recover without medical intervention. However, in some instances, the infection can worsen pre-existing conditions like asthma.
In rare cases, Mycoplasma bacteria can affect areas outside the lungs, leading to infections in the lining of the brain and spinal cord or impacting the nerves connected to the eyes and those responsible for leg and bladder function. Notably, these patients may not exhibit respiratory symptoms.