Key takeaways:

• Pneumonia cases overall are drastically higher this year over last year
• Walking pneumonia cases are being seen more in young kids
• Severe illness in young kids with pneumonia is greater this year

Normally, school-aged kids, teenagers and young adults are the more likely suspects to have what’s called “walking pneumonia.”

It’s caused by Mycoplasma pneumoniae (M. pneumoniae), a bacterium that causes respiratory tract infections. The Centers for Disease Control and Prevention (CDC) reports test positivity for walking pneumonia increased in late spring of 2024 and remained high.

The term walking pneumonia was coined because it’s possible for someone to be walking around with the infection, and not even know it.

“They're walking around school and they're not feeling that sick. They do have pneumonia but it's not putting them in the hospital typically,” says Keith Hanson, MD, the medical director of the General Pediatrics Unit at OSF HealthCare Children’s Hospital of Illinois.

Dr. Hanson says every year some strains of illness, or a particular virus, are more common than others. Right now, it’s pneumonia.

"What's a little unusual about this year, is we're seeing that same bacteria causing pneumonia in kids that are younger than usual, and the severity of the illness is more. We're seeing more kids admitted to the hospital with pneumonia, and they're definitely younger than that typical age range like preschoolers and even some infants,” Dr. Hanson says.

Tracking cases nationally and across the region

The CDC is tracking the rise in cases, which have been seen both nationwide and locally in central Illinois.

Data from OSF HealthCare show a major increase in overall pneumonia cases for patients younger than 18 years of age this year over last, looking at the dates from August 1 through October 22.

In 2023, there were 171 patients with pneumonia and only three cases were reported to have come from the M. pneumoniae bacterium. In 2024, overall cases jumped to 641 with 143 having pneumonia due to M. pneumoniae. 81 of the cases in the 2024 range were reported from the hospital.

Signs and symptoms of walking pneumonia

"It's that cough, a prolonged cough especially, fevers and difficulty breathing in more severe cases," Dr. Hanson says. “They might be dehydrated and not able to drink as much, so they're not urinating as much. They can be sleepier and more fatigued, which is pretty common.”

Dr. Hanson says as is the case with bacterial infections, there are antibiotics to treat walking pneumonia. The hope of the antibiotics is to shorten the illness and make it less severe, while decreasing the chance of spreading the infection to others.

“This is one that would need antibiotics. Other respiratory infections like RSV or COVID-19 are viruses, where there's no particular medication to treat it," Dr. Hanson says. "So, if it is this Mycoplasma pneumonia, there is an antibiotic that can treat it. We want to make sure kids are staying hydrated and getting enough rest. You can do fever control with Tylenol and ibuprofen."

While most pneumonia cases don’t send kids to the hospital, it is possible for children with other medical conditions to be hospitalized. If they are admitted, they may need IV fluids for dehydration or oxygen to help with breathing. This is another reason Dr. Hanson recommends starting antibiotics right away, because if pneumonia goes untreated, there’s a higher chance you could end up in the hospital’s intensive care unit (ICU).

When pneumonia is connected to a viral infection

"We start thinking about bacterial infections after times that you're sick, you get better, then you get worse a few days later. That's because the virus was going on first, with a runny nose, low grade fever and some coughing. Then you feel better for a couple of days, and then it comes back. That's when we think there was a bacterial infection on top of the virus,” Dr. Hanson says. “That's because when we have the virus, we get mucus and secretions and we're not coughing things up very well. Things are settling there in the lungs and you're not very active. That increased inflammation and mucus is a setup for bacterial infections.”

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