‘Walking pneumonia’ is on the rise among kids. What to know about infections in Miami

If your child has a wheezing cough, take note: There’s a rise in walking pneumonia in South Florida and across the country.

“We’re no exception to the rule,” said Dr. Marcos Mestre, senior vice president of clinical operations and chief medical officer at Nicklaus Children’s Hospital near South Miami.

The surge of respiratory infections this year caused by the common and contagious bacteria Mycoplasma pneumoniae, or M. pneumoniae, has affected people of all ages, but especially young children, according to a recent alert by the U.S. Centers for Disease Control and Prevention.

The bacteria generally causes a mild respiratory illness, although it can sometimes worsen into pneumonia. If it does, it usually tends to be a less severe form of bacterial pneumonia known as “walking pneumonia,” according to the CDC. For some, worsening symptoms can still lead to a trip to the hospital.

At Nicklaus Children’s, there’s been a six-fold increase in hospitalizations involving a mycoplasma infection this year compared to last year. The children’s hospital has had about 500 patients hospitalized so far with a mycoplasma infection compared to 80 last year, Mestre said.

At Joe DiMaggio Children’s Hospital in Hollywood, the increase hasn’t been as sharp. The hospital said it has yet to see any significant changes in M. pneumoniae infections compared to previous years, although infections did peak in spring.

Baptist Health South Florida said its seen a slight uptick in bacterial pneumonia cases, particularly among pediatric patients and young adults, at its urgent care centers.

Nicklaus Children is not seeing any significant changes to the total number of hospitalizations due to infectious illnesses compared to previous years, but the hospital is seeing more mycoplasma pneumoniae infections this year compared to previous years, Mestre said.

In “the big scheme of things,” the number of mycoplasma pneumoniae infections is “still not that significant” and people should not panic, Mestre said.

But some respiratory illnesses can circulate more then others during certain seasons or years.

While it’s cold and flu season, “seasonal influenza activity remains low nationally,” and COVID infections are “likely decreasing” in Florida, according to the CDC’s most recent data. RSV, another common respiratory illness, is increasing in some Florida counties but has remained stable in Miami-Dade, Broward, Monroe and Palm Beach counties, according to the most recent data from Florida’s Health Department.

MORE: Are you coughing? Do you have RSV? It’s the season in Florida for spread and symptoms

Of course, it’s still early in the season and the CDC is continuing to recommend people get their annual flu and COVID vaccines. It’s also recommending people 75 and older or who are pregnant speak with their doctor about getting the RSV vaccine.

While the M. pneumoniae bacteria infects millions of people a year in the U.S., tracking total infections can be complicated because there’s no national reporting or dedicated surveillance system for it.

What the CDC does know: Since late spring, more people who have gone to the ER have been diagnosed with M. pneumoniae-associated pneumonia or acute bronchitis, with infections peaking in August and remaining high. Also unusual: More kids under 5 are falling ill.

“The increase in children ages 2-4 years is notable because M. pneumoniae historically hasn’t been recognized as a leading cause of pneumonia in this age group,” the CDC said.

“Although this year is a little unusual that we’re seeing a spike of this particular infection, but thankfully, it’s an infection that can be treated and with a good response,” Mestre said. “So that’s why I always tell folks not to panic about it. That being said, always take the preventative measures that are possible. Again, going back to the basics, washing your hands, being courteous of others, not being around others when you’re sick, and that should limit the spread of the illness.”

How do you know if your cough is a sign of walking pneumonia? And how can it be treated?

Here’s what to know:

What are the symptoms of walking pneumonia? How is it treated?

Walking pneumonia can feel like a bad cold or a bad flu. And anyone can get it, regardless of age, though infections are most common among children ages 5 to 17 and young adults, according to the CDC.

Symptoms include coughing, chest pain or discomfort, a low grade fever of less than 101 degrees, mild chills, sore throat, fatigue, sneezing and headaches, according to the Cleveland Clinic.

It can take one to four weeks for symptoms to appear after someone was exposed to the bacteria, although some infected people might not have any symptoms, according to the CDC. Symptoms can last for several weeks.

“Most will recover without medicine, but some people need antibiotics to get better,” the CDC says.

Some people might need to be hospitalized to receive additional medical support, such as oxygen, aerosol treatments and anti-inflammatory treatments, according to Mestre, the Nicklaus Children’s doctor.

“If you’re noticing your child is having any difficulty with breathing and they’re having a hard time catching a breath, obviously any changes in color, noticing their lips or blue ... any difficulty breathing, any signs of respiratory distress, not drinking because coughing so much, those type of things that you can get dehydrated,” that’s when you need to call your child’s pediatrician or take them to urgent care or the ER depending on how severe symptoms are, Mestre said.

How does walking pneumonia spread? How does the infection differ from common cold, flu, COVID?

M. pneumoniae spreads through respiratory droplets released by coughing and sneezing, just like COVID, the flu and other respiratory illnesses.

Because all respiratory infections tend to cause similar symptoms, unless you get tested, there’s no way to know whether you have a mycoplasma infection or if you’re sick with the flu, COVID, RSV, or the common cold.

There are some differences.

Like COVID, a mycoplasma pneumoniae infection could cause fever, for example, but it will usually be a low-grade fever of less than 101 degrees, according to Mestre. A person sick with mycoplasma pneumonia could also have a wheezing cough and other symptoms longer then a person with a regular cold and might need oxygen or other respiratory support, he said.

Besides examining the patient and ordering a chest X-ray to check for pneumonia, “most healthcare providers don’t test for M. pneumoniae infection,” according to the CDC. If they do test for the infection, they’ll likely swab your nose or throat. They could also order a blood test, but that’s less common, according to the public health agency..

How is walking pneumonia different from pneumonia?

M. pneumoniae-associated pneumonia is normally mild enough to not require hospitalization. You’ll feel sick but not necessarily sick enough to stay in bed all day, doctors say.

“People with pneumonia caused by M. pneumoniae can appear to be less severely affected than expected for someone with a lung infection,” said Dr. Ernesto Sanz Martinez, who works for Baptist Health Urgent Care.

That means people with mild symptoms might decide to go to work, school or to the store. That’s why it’s generally referred to as “walking pneumonia” although symptoms can worsen enough to go into the hospital, according to Sanz Martinez

A key thing to remember: M. pneumoniae is contagious. So if you’re feeling sick, the best thing to do is stay home until you recover to avoid getting other people sick. Some people, such as those who are immunocompromised, could be more at risk for severe illness.

M. pneumoniae is also not the only infection that can cause pneumonia.

“Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe,” including the bacteria Streptococcus pneumoniae and viruses like COVID and the flu, according to the Mayo Clinic.