Docs: Walking pneumonia cases up on Long Island, especially among very young

Doctors on Long Island and around the nation said they are seeing a surprising rise in respiratory infections in recent months leading to cases of "walking pneumonia," especially among very young children.

The Centers for Disease Control and Prevention said the culprit is a specific bacteria, Mycoplasma pneumoniae, which causes the infections. Between March 31 and Oct. 5, the percentage of pnuemonia-associated emergency department visits associated with the bacteria increased among children between the age of 2 and 4, from 1% to 7.2% nationally. For kids between the ages of 5 and 17, it jumped from 3.6% to 7.4% during that same time period, the agency said. For all ages, it rose from 0.5% to 2.1%.

Symptoms, which may not appear for one to four weeks after infection, can include sore throat, fever and a slowly worsening cough, the CDC said.

Young children may also experience wheezing, vomiting, diarrhea and watery eyes.

Dr. Eve Meltzer Krief a pediatrician at Allied Physician Group’s Huntington Village Pediatrics, said her office is seeing "so much" of this type of illness in recent months.

"It’s typically a pneumonia we see in school-aged children but we’re seeing it in younger children as well," she said. "We are on alert for it with any patients coming in with a history of prolonged cough, with or without fever, that can just be low grade."

The CDC called the large number of cases in children between the ages of 2 and 4 "notable" because this bacteria, in general, is not the leading cause of pneumonia for kids that young.

Meltzer Krief said typically, about 60% of pneumonia — a lung infection — in children tends to be caused by a virus, rather than a bacteria. But many children being tested in emergency rooms and pediatric offices are testing positive for Mycoplasma pneumoniae.

"We are seeing a fourfold increase from last year," said Dr. Lynda Gerberg, lead pediatrician at Northwell Health GoHealth Pediatric Urgent Care, which has centers across Long Island, New York City and Westchester County.

She said the surge may be related to the COVID-19 pandemic, when people were isolating and wearing masks.

"We weren't exposed to all these bacteria and viruses," Gerberg said. "Our immune system is just catching up. It left everybody a little more susceptible to these types of illnesses."

Gerberg said typical pneumonia generally starts with a sudden high fever of 102 or 103 degrees.

"It's like you got hit with a brick," she said. "Your chest is heavy, you have a wet, heavy cough and you really feel sick."

Walking pneumonia, she said, often starts with a slight cold, scratchy throat and a low-grade fever.

"Then there's that cough that just persists; it goes on and on and on, for 3, 4, 5 days, until you really start feeling a little worse," Gerberg explained. "That's why they call it walking pneumonia. You are walking around literally with pneumonia and you don't feel sick enough to be in bed."

The bacteria is spread through small respiratory droplets that are released when people cough and sneeze, the CDC said. Outbreaks can take place at schools, college residence halls, hospitals and long-term care facilities.

People with mild infections may not need medication, experts said. But those with more serious illness can be prescribed antibiotics. This specific bacteria is resistant to some antibiotics such as amoxicillin, the CDC said, but usually responds to treatment with azithromycin.

Gerberg said there are some warning signs for when people who are infected should see a doctor, such as high fever associated with a constant cough.

"If they are not drinking or eating well and have overall fatigue ... feel short of breath, chest pain or pressure — those are signs to go immediately to the doctor," she said.

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.