Increase in mycoplasma pneumonia cases in young children

Medscape Medical News We spoke with the CDC's Adam L. Cohen, MD, MPH, about what healthcare providers need to know about the increasing number and severity of cases among younger patients in the United States.

October 18, 2024, Centers for Disease Control and Prevention (CDC) share For bacterial infections mycoplasma pneumonia The number has been on the rise since this spring, peaked in August, and has remained high ever since. Infection is typically most common among school-age children, teens, and young adults, although cases of infection have been seen in children as young as two years old.

Medscape Medical News Adam L. Cohen, MD, MPH, a pediatrician and chief of the CDC's Division of Pneumonia and Streptococcal Epidemiology, talks about what health care providers need to know, who to test, and how to treat. I heard the story. pneumococcus.

Text has been edited for length.

Could you tell me more about pneumococcus?

and pneumococcus There are two things to note. one is that pneumococcus It is a common cause of pneumonia in respiratory diseases of all ages. It usually presents with symptoms of a respiratory illness, such as a cough and fever, but it is often known as “walking pneumonia” because it does not cause serious symptoms and you can get up and do things. They may just be tired and not 100%.

The other thing, and why we're more concerned about it now, is that during the pandemic, the virus was actually undetected in the United States for several years. In the past few months, it has really started to spread and become a more common cause of illness.

Importantly, the disease is now being seen in children as young as two years old. Although it can cause illness at any age, it has historically been most common in school-age children. This disease is less commonly identified in younger pediatric age groups.

During the summer, it was one of the leading causes of hospitalization for pneumonia in younger children.

Why are we seeing such a large increase, especially among children?

We don't really understand why this is happening. we know that pneumococcus Usually there are waves. This is what it looked like just before the pandemic pneumococcus Infections began to increase in the United States, and after that, all measures were taken to reduce the transmission of respiratory diseases. pneumococcus It was rarely identified in the United States. We are currently in the midst of a resurgence of other respiratory diseases. pneumococcus Last winter, it was held all over the world, especially in Asia and Europe. they are some pneumococcus Cases were seen in younger age groups.

We've been monitoring it since infections started coming back in the U.S. this spring, but remained at low levels until this summer, and then began to peak. We are seeing a situation similar to that seen in cases of young patients elsewhere around the world, but we don't really understand why this happens. We are actively looking at the data to see if we can understand what is causing this. [increased cases in young patients].

What symptoms do you have? pneumococcus infection?

The most common symptoms are respiratory illness, such as coughing, difficulty breathing, fever, and fatigue, but they are usually mild. However, it can cause additional symptoms. Although rare, they can cause a rash, affect the brain, and cause abdominal symptoms such as diarrhea, so we keep an eye on all of these.

Young children may develop respiratory and gastrointestinal symptoms such as vomiting and diarrhea. May cause mucositis, which is somewhat specific to: pneumococcusHowever, these symptoms usually do not appear without other respiratory symptoms.

How contagious is it?

pneumococcus It is transmitted from person to person through coughs and sneezes. That means the best way to prevent infection is to cover your coughs, cover your sneezes, and wash your hands.

In general, just being around someone casually may not cause you to become infected. will spend more time [around an infected person] That leads to communication. Infections have also been confirmed in settings where people live in close proximity, such as in university dormitories and nursing homes where people may be in close contact for extended periods of time.

With recent data on the rise in cases among young children, daycare centers may be areas of potential transmission.

For how long does anyone pneumococcus Is the infection contagious?

There isn't much data on this. pneumococcus It is less studied than other respiratory pathogens. we know that pneumococcus The incubation period is long, from 1 to 4 weeks, and people are still contagious to some extent during that time. It can also be contagious for a long time, especially since the cough and symptoms can last for several weeks and it is a respiratory illness that takes time to develop and cure.

Which patients are at highest risk of complications? pneumococcus infection?

We are particularly concerned about patients with underlying respiratory conditions such as asthma, who may be hit harder. Pneumococcus. Another group that may be at higher risk for respiratory disease complications is pregnant women.

Which patients should be tested pneumococcus Infection, and how?

We're really seeing this spike now in children and a broader age range than usual. Therefore, during a typical winter season, it is not uncommon to see some sights, pneumococcus It is now more prevalent in school-age children and teenagers (ages 5 to 17), especially in hospitalized children. pneumococcus Clinicians need to think about what to test and how to treat it..

We also recommend pneumococcus Considered for patients presenting with more severe pneumonia.

If the patient does not respond to β-lactam treatment for pneumonia, then certainly pneumococcus That should be something to consider. pneumococcus It's somewhat unusual for bacteria because it doesn't have a cell wall, but that also means beta-lactams like amoxicillin won't work on it.

pneumococcus It is often diagnosed through a multi-pathogen respiratory test panel. Clinicians are encouraged to check what tests are available in their area. Also, serological tests are not recommended because the results are not available immediately. [as panels] and can be difficult to interpret.

Which antibiotics are most effective for treatment pneumococcus infection?

First-line treatment pneumococcus The infection is macrolide-based.

Resistance to macrolides is at a relatively low level in the United States, and we monitor it, but when a patient is diagnosed with a macrolide; pneumococcus If macrolide therapy is unresponsive, tetracyclines and fluoroquinolones are the recommended second-line treatments.

What is the CDC doing to address the rising number of cases?

We are using every surveillance system we can to monitor this disease and understand when it is increasing and in which groups. We're also looking at antimicrobial resistance to see if that changes recommendations for antibiotic use. And we are analyzing how people present with this disease. So far, we know that this infection manifests as a typical respiratory infection, but we are wondering if there is anything unusual going on with the bacteria themselves or how they appear that could guide treatment and prevention. I'd like to check if that's the case. that.

Where can clinicians find more information and resources? pneumococcus infection?

We want to hear about unusual clusters or unusual presentations because they can give us insight into what's going on. Clinicians can contact us to share their cases or if they need help with treatment. Contact information streptococcus [email protected]

a Latest breaking news provides further information about pneumococcus Real-time recommendations.