Amid a pneumonia outbreak among kids in Ohio, cases of the lung infection are rising nationally and other parts of the world — but it’s not unusual for this time of year in the U.S. and no reason to panic, experts say.
Pneumonia, which is an infection of one or both lungs, can occur year-round, but it’s more common in the fall and winter, aka respiratory virus season.
Recently, an outbreak of pneumonia across multiple schools in one Ohio county, as well as surges in Denmark, China and the Netherlands, have caused concern that the increases might be related and spreading — though experts say there's no evidence to suggest this. Children have been especially affected in these outbreaks.
Pneumonia outbreaks in US and around the world
While cases of pediatric pneumonia in the U.S. are rising, it's nothing out of the ordinary, experts say.
"In the U.S. ... we are not seeing anything that is atypical in terms of pneumonia-related emergency department visits,” U.S. Centers for Disease Control and Prevention Director Dr. Mandy Cohen said on a Dec. 1 press call. “We are seeing typical patterns, as well as typical pathogens that are causing sickness in our kids.”
The CDC data on emergency visits due to pediatric pneumonia show that rates in children between 0 and 4 are similar to previous years, and that while rates are slightly elevated in school-age children (5 to 17), they align with pre-pandemic years.
Overall, the level of pneumonia in the U.S. is within the expected range for this time of year, Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, tells TODAY.com.
However, one Ohio county is an outlier due to a recent pneumonia outbreak.
Since August, there have been 145 reported cases of pneumonia in children ranging from 3 to 14 years old in Warren County, Ohio. The most common symptoms are a fever, cough and fatigue, NBC News reported. Although the number of cases in the county is higher than usual, there have been no reported deaths and the severity of illness is similar to previous years, local officials said in a press release.
The cluster of cases in Ohio are not caused by a new virus, officials say, but rather the typical gamut of germs that cause pneumonia in kids and adults every year, including influenza, respiratory syncytial virus (RSV) and a bacteria called mycoplasma.
Officials have not identified a single cause of the outbreak or a link between the children and cases, which span multiple schools, NBC medical contributor Dr. Tara Narula explained in a TODAY segment aired Dec. 1.
Outside Ohio, multiple countries are reporting outbreaks and surges of pneumonia, including mycoplasma pneumonia. China, Denmark, and the Netherlands are currently battling waves of respiratory illness and child pneumonia, says Schaffner.
However, there’s no evidence the Ohio outbreak is connected to other outbreaks or increases in pneumonia nationally or internationally, Cohen said.
As officials monitor the outbreaks, experts say the recent spikes in pediatric pneumonia are no cause for alarm.
How do you catch pneumonia?
Pneumonia is a common infection that causes inflammation or fluid buildup in the air sacs of the lungs, says Schaffner. It can range from mild to severe to life-threatening. Infants, people over 65, and people with weaker immune systems or underlying lung conditions are at higher risk of developing complications.
It can be caused by viruses, bacteria or fungi. In the U.S., common causes of viral pneumonia include the flu, RSV and COVID-19, per the CDC.
Common causes of bacterial pneumonia include streptococcus pneumoniae, haemophilus influenzae and mycoplasma pneumoniae, especially among kids, Dr. Katie Lockwood, a primary care pediatrician at Children’s Hospital of Philadelphia, tells TODAY.com.
The respiratory viruses and bacteria that cause pneumonia are contagious and spread through contact with respiratory droplets produced when a person coughs or sneezes, the experts note. These germs thrive in communal settings, like schools, says Schaffner.
What is mycoplasma pneumonia?
Mycoplasma pneumonia is a lung infection caused by the bacteria mycoplasma pneumoniae.
The Ohio outbreak is in part driven by mycoplasma pneumonia, NBC News reported. The condition is sometimes referred to as “white lung syndrome,” but experts stress that that’s not a medical term, nor does it refer to a new illness.
Mycoplasma pneumonia is also called “walking pneumonia” because it’s often less serious and patients are more active, Lockwood explains. “In Ohio ... I was reassured when I heard that (mycoplasma) might be the type of pneumonia we’re seeing more of because traditionally it’s more mild,” she adds.
Mycoplasma pneumonia is common and tends to cause outbreaks among certain communities or geographical areas in cycles, says Schaffer.
"Every three to seven years, there may be an increase of mycoplasma infections that sustains itself for one to two years and goes down," he adds. "No one knows (why). It just happens."
What is 'white lung syndrome'?
“White lung syndrome” or “white lung pneumonia” is a new buzzword being used to describe mycoplasma pneumonia on social media. But the experts stress that it's just a colloquial name and not a medical term. It likely comes from the way mycoplasma pneumonia looks on a chest X-ray — white blotches on the lungs, says Schaffner. “The inflammation makes the tissue more dense, so the X-rays don’t go all the way through and the pneumonia appears white,” he explains.
Walking pneumonia symptoms
The symptoms of pneumonia can vary depending on the germ that causes the infection, but early symptoms of viral and bacterial pneumonia are often similar and mimic those of a cold or flu. These include a headache, cough and congestion, says Schaffner.
Walking pneumonia, aka mycoplasma pneumonia, symptoms are similar to that of other types of pneumonia but milder.
Signs and symptoms of pneumonia include:
- Fever
- Chills
- Cough that produces yellow, green or brown mucus
- Shortness of breath
- Fatigue
- Rapid or shallow breathing
- Fast heart rate
- Wheezing
- Chest pain with coughing or breathing
- Loss of appetite
- Abdominal pain
- Nausea and vomiting
In infants, pneumonia may cause poor feeding, poor coordination, and harder breathing, says Lockwood. "Sometimes you see their chest muscles contracting or their chest rising and falling faster," Lockwood adds.
Another "red flag" that an illness could be pneumonia, according to Lockwood, is when respiratory symptoms (such as a cough) persist for more than seven to 10 days without any improvement or they return and worsen after getting better.
Pneumonia is often diagnosed using a chest X-ray, and blood tests can determine which germ is causing the infection. Typically pneumonia lasts about one to two weeks, but walking pneumonia can last up to four to six weeks, per the Cleveland Clinic.
When to see the doctor
Individuals at a higher risk of developing severe pneumonia or complications (infants, the elderly, immunocompromised people) should see a doctor if they have any symptoms, per the Mayo Clinic.
Everyone else should seek medical attention if they have severe, persistent symptoms or if they experience any of the following:
- Difficulty breathing
- High fever (over 102 degrees Fahrenheit)
- Persistent fever
- A cough that produces blood or pus
- Blue lips or fingers due to lack of oxygen
- Severe dehydration
The experts recommend parents call their child’s pediatrician if they have any concerns or questions.
Treatment for pneumonia depends on the cause, but often involves medications, such as antibiotics or antivirals, and supportive care like rest, fluids and over-the-counter medications, Narula says.
Most people can be treated for pneumonia at home, but some require hospitalization depending on the severity or their underlying health. Less than 1% of children end up in the hospital, says Lockwood.
"Reassuringly, pneumonia is something that the vast majority of kids are treated for outpatient and recover fully from," Lockwood adds. "It's not something most parents need to be very worried about, but they (should) know what to look out for."
There are vaccines available to protect against pneumonia caused by streptococcus pneumococcus, which are routinely given to children in the U.S. and available for certain adults, Schaffner notes.
The experts encourage everyone to stay up-to-date on vaccinations, including the new COVID-19 booster and seasonal flu shot.