Doctors say walking pneumonia is treatable

Doctors are warning parents not to panic as treatment options are available despite an unusual spike in cases of walking pneumonia in parts of Canada, especially among children.

Walking pneumonia is a mild type of pneumonia with symptoms such as fever, cough, and fatigue, but in some severe cases, patients may need oxygen, become short of breath, or develop a high fever that does not go away.

Dr. Earl Rubin, head of infectious diseases at Montreal Children's Hospital, said he has noticed more cases among young children than in the typical school-age and young adult populations that bacterial infections usually affect.

“The numbers are increasing, and the number of severe cases that require hospitalization and have complications are also increasing,” said Rubin, who has been monitoring the situation since late spring and early summer.

This “unusual” increase may be due to weakened immunity following the pandemic, making more people susceptible to infection. It is also highly contagious, infecting one in three people in a household, with an incubation period of up to a month, and there is no vaccine to prevent it, Rubin said.

In the United States, the Centers for Disease Control and Prevention reported in October that cases of walking pneumonia, especially among young children, had increased over the past six months, peaking in late August.

Public health agencies don't track walking pneumonia in Canada, but health care providers in Ontario, Quebec and British Columbia told The Canadian Press that cases are on the rise.

Although there is no formal laboratory-based surveillance for the pathogen, the Public Health Laboratory Network of Canada has noted unusual activity of Mycoplasma, the bacterium that causes walking pneumonia, the Public Health Agency of Canada says.

B.C. Children's Hospital says it has recorded an increase in children with walking pneumonia in its emergency department since August, but said it will take a significant amount of time to compile the corresponding data and release numbers.

McMaster Children's Hospital began seeing an increase in the incidence of walking pneumonia a few months earlier, in May and June, and in September after not having had any cases for the past two years, said Dr. Jeffrey Pernica, an infectious disease specialist at the hospital. It is said that it reached its peak in .

“These may decrease as winter approaches,” Pernica says.

Dr. Camille Lemieux, director of family medicine at the University of Toronto Health Network, said doctors need to be aware of this increase, which is the first she has observed in her 30 years of practice. This is because this increase requires different antibiotics than normal pneumonia, which the patient does not receive. It won't get better without it.

“I've never seen such a rapid, sudden and clear rise,” Lemieux said.

Usually, if a child's chest x-ray shows signs of pneumonia, doctors prescribe amoxicillin or a similar drug that blocks the growth of bacteria that cause infection.

However, because mycoplasma is atypical and does not have a cell wall, the drug is ineffective. However, it may be treated with other types of antibiotics, such as macrolide antibiotics.

Lemieux says walking pneumonia is now “one of the first things we consider” when diagnosing patients with the disease. “If a child has mild or cold-like symptoms but doesn't get better, especially if the symptoms persist, fever is my biggest concern right now,” she said. says.

Doctors test for walking pneumonia using a nasal or throat swab and send it to a laboratory.

Dr. Warren Thirsk, an emergency physician in Edmonton and president of the Alberta Medical Association's emergency medicine division, said this unusual increase is not currently being seen in Alberta.

“COVID-19 and influenza are definitely going to be more severe,” he says. In contrast, Thirsk said walking pneumonia is a “drop in the ocean” during the respiratory phase and most people can recover at home without intervention.

People should seek medical attention if they have a fever for more than five days, symptoms for more than three weeks, or need oxygen, Thirsk said.

“The message is not to panic. It will only create more awareness of what is going on. If you think your child or your relative may be one of those facing this problem, please contact me. Talk to your doctor so they can help you,” says Dr. Alan Grill, Director of Family Medicine. at Markham Stouffville Hospital.

But 2.5 million people in Ontario don't have a family doctor, which could impact emergency room wait times, Grill said.

“Where do people go when they get sick and don't have a primary care physician? They go to the emergency room. So there could be a ripple effect with more cases of walking pneumonia.”

Although there is no vaccine for walking pneumonia, Grill says staying up to date with flu, COVID-19 and RSV vaccines will strengthen your immune system and make you less susceptible to bacterial infections.

This report by The Canadian Press was first published Nov. 5, 2024.