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Do you have a runny nose and nagging cough that has persisted for weeks but you’ve still managed to drag yourself to work and school?
You may be among a surging caseload of people with mycoplasma pneumonia, also known as walking pneumonia.
The Centers for Disease Control and Prevention says there’s been an outbreak of cases among very young children, but older children, adolescents and adults are also falling ill.
Although walking pneumonia can be hard to detect and hard to shake, health experts at Northeastern University say it can be vanquished with antibiotic treatment.
“There’s been a pretty significant increase in cases,” says Neil Maniar, director of Northeastern’s master of public health program.
Milder than traditional pneumonia, walking pneumonia is a bacterial infection of the upper respiratory tract, says Brandon Dionne, associate clinical professor of pharmacy and health systems science.
Symptoms are similar to those that occur with the common cold, such as a runny nose, sore throat, fever and cough, and can be spread through coughing or sneezing, Dionne says.
Younger children may also experience diarrhea, wheezing or vomiting, the CDC says.
But unlike viral infections like the common cold, symptoms — especially coughing — don’t go away after a few days or even weeks, Dionne says.
“It doesn’t usually cause very severe illness” and may look similar to acute bronchitis, Dionne says. “But without treatment it can kind of linger for a while, for weeks to months.”
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Unlike viruses, walking pneumonia has a lengthy incubation period, Dionne says.
He says if people get sick after being exposed to a cold virus, symptoms usually appear within days and they start to feel better after five to seven days.
But it may take a week to a month to show symptoms after exposure to walking pneumonia, Dionne says. The lengthy incubation period can make it hard to follow transmission patterns, he says.
And since people are contagious during the incubation period and as long as they show symptoms, anybody with the illness has ample time to spread the infection. According to the CDC, the mycoplasma bacteria can persist in the respiratory tract for months.
The typically mild symptoms mean that people may not stay home or in bed, the CDC says, thus leading to the non-medical term “walking pneumonia.”
Walking pneumonia can be tested through PCR and antibody tests, but testing is relatively rare since most cases are mild, Dionne says.
The fact that most sufferers do not stay at home or in bed is what led the infection to be termed “walking pneumonia,” the CDC says.
Preventing walking pneumonia calls for frequent handwashing, Maniar says.
And while there is no vaccine for mycoplasma pneumonia, getting vaccinated against COVID and the flu and getting the pneumococcal vaccine can help prevent opportunistic illness from setting in, Maniar says.
“When you’re battling one type of infection, it’s easier to contract something else because your immune system is weaker; your body is generally weaker,” he says.
While most cases of walking pneumonia get better on their own, antibiotic treatment can hasten recovery and stop the illness from spreading, Dionne says.
He says in suspected or confirmed cases, physicians may prescribe Z-Pak, also known as Zithromax or azithromycin. It is part of a class of drugs known as macrolides that are used to treat and manage bacterial infections.
Unlike other pneumonias, mycoplasma pneumonia is resistant to treatment with penicillin antibiotics such as amoxicillin, which is often used to treat strep throat, Dionne says.
“You have to use specific antibiotics that target mycoplasma,” he says.
While warning against overuse of antibiotics, the CDC says physicians may want to consider adding second-line fluoroquinolone antibiotics such as Cipro or tetracyclines if vulnerable patients aren’t getting better.
The federal health agency said in an October advisory that what makes this outbreak of walking pneumonia unusual is its increase in the 2- to 4-year-old age group when the illness traditionally is more common among children ages 5-17 and young adults.
Diagnostic discharge data from March 31 to Oct. 5 show an increase in cases among all age groups. The CDC says the reemergence of cases stems to 2023, “after a prolonged period of low incidence of infections since the start of COVID-19.”
During lockdown people were not exposed to illness and lost or did not build up natural immunities to certain illnesses, Maniar says. “I don’t think that’s the entire reason for the spike, but it may be contributing to it.”
Dionne says that most of the time walking pneumonia resolves on its own. People who are considering taking antibiotics should consult with their physician, he says.
“You get the infection, you develop the antibodies and then, hopefully, the next time you’re exposed your immune system is able to prevent an infection,” Dionne says.