What parents need to know about the rise in ‘walking pneumonia’ in children

Walking pneumonia is not a rarity this time of year or among school-aged children.

But this year, suburban pediatricians are taking particular note of the increase in cases — especially among young children.

"We are definitely seeing a lot more pneumonia, in general, across the board, from toddler to school-aged children and teenagers," said Dr. Molly Antoniolli, a Vernon Hills pediatrician with Endeavor Health.

The Centers for Disease Control and Prevention in early October reported the uptick in infections caused by the bacteria mycoplasma pneumoniae, which can cause walking pneumonia. According to recent CDC studies, the percentage of infection from this particular bacteria increased from 1% to 7.2% among children ages 2 to 4 years old and 3.6% to 7.4% in children ages 5 to 17 years old.

"That seems to be what we're seeing as well," said Dr. Deanna Behrens, a pediatric intensive care physician at Advocate Children's Hospital in Park Ridge, noting that cases at her hospital have been "higher than normal" among younger children.

Symptoms can include a fever, watery eyes, sore throat, a persistent cough, sneezing, runny nose and fatigue.

According to the CDC, the increase among 2- to 4-year-olds is noteworthy because in the past, the mycoplasma pneumoniae bacteria has not been recognized as the main cause of pneumonia in that age group.

"Mycoplasma is something we see every year, but we mostly see it in that older age range of children," said Dr. Adam Ratner, a member of the American Academy of Pediatrics committee on infectious diseases and director of the division of pediatric infectious diseases at New York University and Hassenfeld Children's Hospital.

The CDC estimates 2 million infections each year in the United States, but acknowledges the actual number may be higher because there is no national reporting system. During the COVID pandemic, the number of cases decreased, but mycoplasma pneumoniae infections began to rise in 2023.

Between March 31 and Oct. 5, CDC data shows an increase across all age groups. According to the data, infections peaked in August, but have remained high.

Behrens, who also is a spokesperson for the American Academy of Pediatrics, noted cases of walking pneumonia dramatically decreased during the pandemic as people stayed home more and took extra precautions such as social distancing and using face coverings. The reason for this recent uptick, however, remains unclear, she said.

While hospitals have seen a jump, Behrens and other experts say most cases are mild and can be managed at home.

Symptoms can last "anywhere from a couple of days to a couple of weeks," Behrens said, adding that watery eyes have been one of the main symptoms she has seen in younger patients.

There is no vaccine for walking pneumonia. Antibiotics such as amoxicillin that typically are used to treat general pneumonia are not effective with mycoplasma pneumoniae. However, it does respond to antibiotics like azithromycin.

While hospitals have seen increases, many cases of walking pneumonia resolve on their own or can be treated at home with the proper antibiotics when symptoms dictate.

"Most patients are able to start treatment and get better," Antoniolli said. "We have a good antibiotic that works and kids are getting better."

She said signs that it's time to seek medical attention can include a persistent, harsh or disruptive cough, a fever lasting more than a few days and difficulty breathing.

Experts say parents can follow simple steps — such as encouraging hand washing and covering coughs or sneezes — to help keep their families healthy. Ensuring your child is up to date on vaccinations, including for flu and COVID, also could help avoid double infection.