The rise of walking pneumonia in kids—what parents need to know

With the colder months arriving, many parents are seeing headlines about rising cases of viral pneumonia among young children. As a parent, even a minor cough or sniffle can set off worry, especially when you hear the word “pneumonia.” But understanding the symptoms, causes, and prevention can go a long way in easing concerns.

The CDC recently reported a concerning increase in Mycoplasma pneumoniae infections, often known as “walking pneumonia,” which is now impacting our youngest children, ages 2 to 4. This trend is unexpected, as this type of pneumonia usually affects older kids and teens.

Here’s what to watch for, why cases are on the rise, and ways to keep your little ones safe.

What causes pneumonia?

Pneumonia is an infection that inflames the air sacs in the lungs, making it difficult for kids to breathe comfortably. It can be caused by bacteria, viruses, or even fungi, though bacterial and viral infections are most common in children. Recently, Mycoplasma pneumoniae—the bacteria behind walking pneumonia—has shown an uptick in younger children, marking an unusual trend this year.

Pneumonia vs. walking pneumonia: what’s the difference?

While both types of pneumonia affect the lungs, “walking pneumonia” is often milder and referred to as atypical pneumonia. Children with walking pneumonia can usually “walk around” despite symptoms, but they may still experience coughing, a sore throat, fatigue, and a lingering dry cough. Both types are caused by respiratory infections, yet they differ in severity and symptom presentation.

How does pneumonia spread?

Pneumonia germs can spread quickly in close-contact settings, like schools and daycares. Respiratory droplets from coughs or sneezes are the main culprits. This season, relaxed COVID-19 protocols may also be contributing to the faster spread.

Between March and October 2024, emergency visits for M. pneumoniae in kids aged 2 to 4 rose significantly, from 1% to 7.2% of cases. Dr. David Buchholz, medical director at Columbia Primary Care, explains, “It’s common to see these peaks every four to seven years, but younger kids are being affected more this time.”

Recognizing symptoms of pneumonia in kids

Recognizing symptoms early can be crucial, as children sometimes show only mild signs that may mask the severity of their illness. Here’s what to watch for:

• Fever and chills (often with higher fevers)
• Persistent cough (sometimes lasting weeks)
• Rapid or labored breathing
• Chest pain, wheezing, or shortness of breath
• Fatigue and loss of appetite

Dr. Mark Kline from Children’s Hospital New Orleans highlights that children with pneumonia often display breathing difficulties, such as rapid breathing, flaring nostrils, or chest retractions with each breath.

In younger children (under 5), symptoms can look different and may include:

• Diarrhea
• Sneezing
• Sore throat
• Stuffy or runny nose
• Vomiting
• Watery eyes
• Wheezing

These symptoms can appear alongside, or in place of, more typical cold symptoms.

How long does pneumonia last?

Pneumonia recovery can take time, with symptoms like coughing often lingering for weeks, even after treatment. Walking pneumonia, though milder, can also last for an extended period, sometimes for several weeks. Proper rest, fluids, and any prescribed medications can help children feel better, but patience is key.

Pneumonia myths vs. facts every parent should know

Myth: Pneumonia always causes a high fever.
Fact: Not all children with pneumonia will have high fevers, especially if it’s viral. Some may have only mild symptoms, making it easy to miss.

Myth: Cold weather or getting wet causes pneumonia.
Fact: Pneumonia is caused by bacterial, viral, or fungal infections, not by cold temperatures. While chilly weather can lower immunity, the infection itself comes from germs.

Myth: Only severe symptoms need a doctor’s attention.
Fact: Even mild symptoms like a persistent cough or labored breathing warrant a doctor’s visit to rule out pneumonia.

Myth: Pneumonia only affects the lungs.
Fact: While pneumonia targets the lungs, it can cause systemic symptoms, such as fatigue, appetite loss, or digestive issues like vomiting in young children.

Myth: Antibiotics are always necessary for pneumonia.
Fact: Antibiotics help bacterial, not viral, pneumonia. Only a doctor can determine which type of pneumonia your child has.

Myth: Pneumonia symptoms disappear quickly with treatment.
Fact: Even with treatment, some symptoms like coughing or fatigue may persist for weeks, so follow-up care and rest are essential for full recovery.

Protecting your family’s health this season

Keeping your child healthy this season means taking simple yet effective steps to reduce the spread of pneumonia and other respiratory illnesses:

• Encourage handwashing. Frequent handwashing is one of the best ways to reduce germs.
• Teach kids to cover coughs and sneezes. Show them how to use a tissue or their elbow to limit the spread of droplets.
• Keep sick kids at home. If your child is feeling unwell, a day at home can make a difference in recovery and in protecting others.
• Consult your pediatrician early. If symptoms persist or worsen, trust your instincts and reach out for expert guidance.

For children dealing with pneumonia, rest, fluids, and fever-reducing medications (as advised by your doctor) can help ease discomfort.

The bottom line: This season’s rise in viral pneumonia reminds us of the importance of staying alert and proactive in caring for our kids. Early recognition, good hygiene, and community awareness are small but powerful steps to navigate the cold months safely.

Sources:

1. Increasing cases of M. Pneumonia. October 2024. CDC – National Center for Immunization and Respiratory Diseases. Mycoplasma Pneumoniae Infections Have Been Increasing.
2. Causes of pneumonia. American Lung Association. What Causes Pneumonia?