Walking Pneumonia Is Spiking. Here’s How To Stay Safe

IRA FLATOW: This is Science Friday. I’m Ira Flatow. A bit later in the hour, we’re going to talk about how a little science can help in your cooking, and what’s living on your toothbrush and showerhead. Prepare to be surprised. And speaking of being surprised, when I recently heard of a case of walking pneumonia in a child in my neighborhood, I couldn’t believe it. Kids getting pneumonia?

Well, I soon found out that across the US, there has been an uptick in cases of mycoplasma pneumonia, walking pneumonia. And yes, it’s happening mostly in kids. With Thanksgiving and the holiday season upon us, we’re thinking about how to keep you and your family– right– all of us, safe for the holidays. So what do we need to know about this spike of walking pneumonia? Is it something to worry about? What can we do?

Joining me to talk about it is Dr. Preeti Sharma, pediatric pulmonologist at Children’s Health in Dallas, Texas. She’s also an associate professor at UT Southwestern. Welcome to Science Friday.

PREETI SHARMA: Thank you so much for having me.

IRA FLATOW: You’re welcome. Let’s start with the basics. Describe what is mycoplasma pneumonia.

PREETI SHARMA: So mycoplasma is a very common bacteria that’s sometimes called atypical. It’s not the usual bacteria as we think about that cause other types of infection. And as you pointed out a moment ago, it’s really common. But it’s more common in older kids, adults, and we so rarely saw it in younger children that it’s not the first thing we think about when kids are sick.

IRA FLATOW: Do you have any reasons why we’re seeing a spike in it now– and in kids?

PREETI SHARMA: That’s a great question, because commonly, we think of mycoplasma and walking pneumonia as being present mostly in older kids and adults. I think some of it is because we have an age of children who didn’t get exposure to as many illnesses. With COVID, many of them were not in group child care. And so their immune systems are still getting regulated to all the things they’re exposed to.

IRA FLATOW: Yeah. Yeah. OK. So let’s dive right into this. Give us the ABCs. First, what are the symptoms?

PREETI SHARMA: Yeah. So mycoplasma often starts out like a regular cold. Sore throat, nasal congestion, sneezing, maybe headache, fevers, and it’s one– it looks one of those colds that just doesn’t resolve. And over time, kids start having a cough. And a cough that doesn’t seem to get better like you’d expect, because most people, when they get a respiratory viral illness like a cold, they start improving in about 5 to 7 days.

And with many of these cases of mycoplasma, that seven-day mark, parents are still looking at their kids and saying, they’re still coughing quite a bit, or they’re still having fevers after that time frame. And so that’s when– that’s a good time to have somebody investigate– have your health care provider investigate a little bit more and try to see what else might be happening.

IRA FLATOW: Yeah. And so you should go– that’s when you should call the doc. And you should expect that it’s spread among kids by droplet infection breathing on each other?

PREETI SHARMA: Yeah. So it’s mostly by droplet exposure. So unlike some of the illnesses that are– a casual exposure can lead to illness, it really takes more close contact to acquire mycoplasma. And it has a really long incubation time. So even in families, we’ll see one person is sick, and just when you think you’re out of the woods because nobody else has gotten sick, the next person will get it because it can be communicable even four weeks after the first person has it.

IRA FLATOW: Wow. And the first thing people are going to do is say, maybe I’ll take a COVID test.

PREETI SHARMA: Right.

IRA FLATOW: And that’s going to be negative. And then you should investigate.

PREETI SHARMA: Yeah. Exactly.

IRA FLATOW: Yeah. The CDC put out a report last month saying that there was a spike across the country that spiked beginning in the spring. How much of an uptick in cases have you seen as a practitioner in Texas?

PREETI SHARMA: Yeah. So we started to see an uptick here really more dramatically in the summertime. So late June, July, we started to see more and more cases. And we really thought that at the end of August, we were going to kind of see our peak because kids around here start school mid to late August. And then usually we see things start to decline. And we saw that spike in August, and we’ve been sort of sustained at that higher level and haven’t really started to see a dramatic decrease in case.

IRA FLATOW: Mm-hmm. And are the cases serious? I mean, is this life threatening, having this?

PREETI SHARMA: So the good news is for the vast majority of kids, it’s not anything that needs to be managed outside of the house. In some instances, kids can recover without any antibiotics or any special treatment. But for those kids who do get antibiotics, they recover at home and they recover really well. For those people who have underlying medical problems or lung problems or their immune system is compromised, they may struggle more and require hospitalization or require other medications to help them resolve the infection.

IRA FLATOW: And how common is that, for a child to be hospitalized for this?

PREETI SHARMA: Fortunately, not very common at all.

IRA FLATOW: Yeah. But it is something to be taken seriously, though.

PREETI SHARMA: Absolutely.

IRA FLATOW: Yeah. And what point do you know that you should be seeking help?

PREETI SHARMA: So I think when kids are having symptoms past what seems to be the normal recovery period of a viral illness. So most kids have a cold have those symptoms that we see will start to improve in about five days. And I think if kids are having fevers for longer than that, or they’re feeling under the weather for longer than that, that’s a good time to seek attention. But also, if earlier in the course, they’re really having other difficulties. So if ever difficulties breathing, chest pain, other symptoms that really seem unusual to parents, out of the ordinary, that’s a good time.

IRA FLATOW: Right. Good advice. I know you experienced walking pneumonia very similarly, very intimately this year because your daughter had it.

PREETI SHARMA: Yeah.

IRA FLATOW: Tell us what that felt like, you being a physician.

PREETI SHARMA: It was really unusual because fortunately, she’s a pretty healthy kid. She got what looked like a summer cold, some congestion and a little bit of a cough. And when it didn’t resolve and it kind of got to be disruptive, she wasn’t sleeping quite as well, and the symptoms just weren’t getting better like I expected, that was when I started to think that maybe something was different. And that’s when we found out and ended up having to treat her.

IRA FLATOW: Yeah. And I guess people will mistake it for just a common cold if they just think it’s running its course, right? But it can get worse.

PREETI SHARMA: Absolutely. It can. Exactly.

IRA FLATOW: Yeah. Do you do the same things you would do for a cold, like the fluids and things like that?

PREETI SHARMA: Absolutely. Those supportive things are really helpful, especially early on. And then for those kids who do have the lingering symptoms, or where it felt that that’s what’s happening, that mycoplasma infection is at hand, they recover with antibiotics pretty readily.

IRA FLATOW: And what about telling the kids’ playmates and parents about this? I would think that’s pretty important.

PREETI SHARMA: It is. And that’s a hard one because our guidelines are that when kids are not having fevers any longer without the use of any medicines to control fever, that they can return to school. And if they feel up to it, they can return back to their normal activities. But that’s sort of where things spread. But it’s always wise to let people know that potentially, this is what’s going on.

IRA FLATOW: Yeah. Especially now, right, the holiday season is coming up. There are going to be a lot of gatherings with kids and adults of different generations. Do you have any tips to help people stay safe and prevent the spread of walking pneumonia?

PREETI SHARMA: Yeah. The holidays are hard, and that’s when we see a lot of viral illnesses or other illnesses kind of spread around. And so if you’re attending a gathering and you have symptoms like cold symptoms or you’ve been sick recently, it’s always wise to tell people in case there’s somebody who is at higher risk to avoid their exposure. And lots of hand washing, lots of teaching kids particular how to cover their cough, but also, if it’s feasible, wear a mask, because that’s going to definitely decrease spread of all kinds of illnesses.

IRA FLATOW: If you’re a parent or a caregiver who has a child who you are fearful about going to a meeting that where a kid has had walking pneumonia, should you express that fear and say, you know, I’m just going to be safe and not send my kid to this party?

PREETI SHARMA: I think that depends on the kid and the family and what their circumstances are. Certainly, if there’s somebody in the home who’s at higher risk, it’s probably reasonable to say, this might be something we have to skip. And it just– it depends on their own tolerance of what might happen.

IRA FLATOW: Yeah. You mentioned that COVID-19 is probably a contributing factor to why we’re seeing spikes in walking pneumonia now. Have you seen this with other illnesses as a practitioner?

PREETI SHARMA: Mm-hmm. In the last couple of years, we’ve seen kind of very interesting patterns with illnesses. So nothing that we’ve seen are novel illnesses. We’ve seen mycoplasma and RSV and all of these things for ages. But we’re seeing them at different times of year, and we’re seeing them in different amounts.

So the first year that kids were kind of back in normal school, we saw a spike in flu cases and we saw spikes in RSV. So we certainly are seeing it.

IRA FLATOW: Yeah. I can’t let you go as a pediatric pulmonologist [LAUGHS] for children and not ask you questions about other respiratory illnesses that are on your radar this holiday season.

PREETI SHARMA: Yeah. COVID is always out there. We tend to see some spikes in cases around the time people gather. So holidays, back to school, those kinds of things. For young infants and people who are vulnerable, we certainly do worry about RSV. So always wise for older adults, vaccinate against RSV, and for young infants, talk to your pediatrician about the antibody shot for RSV protection.

And then the other is influenza. We’re headed into the season where we see more and more cases of the flu. And so we always recommend vaccination against the flu to protect yourself and protect your family members.

IRA FLATOW: Yeah. There’s some great words of free medical advice today for our listeners. [LAUGHS] Dr. Sharma, thank you for taking time to be with us today.

PREETI SHARMA: Thank you so much for having me. I appreciate it.

IRA FLATOW: Dr. Preeti Sharma, pediatric pulmonologist at Children’s Health in Dallas, Texas. She is also an associate professor at UT Southwestern.

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