Dr. Earl Rubin

By Dan Laxer
The Suburban

There has been an uptick in the number of children coming down with walking pneumonia, not just in Montreal, but across North America. But doctors say that parents needn’t worry.

Dr. Earl Rubin, a pediatric infectious disease specialist at the Montreal Children’s Hospital, says there have been “a lot more” cases since the last spring / early summer. But specific numbers are not available. As of yet walking pneumonia is not tracked the way that other illnesses are, so it is a difficult thing to monitor. So the rise in cases, which is corroborated all across Canada, and in the U.S., is anecdotal, but significant.

Walking pneumonia is a milder form of the lung infection, brought on by the bacteria mycoplasma pneumoniae, the number 1 cause of pneumonia in school-aged kids, adolescents, and young adults. And although it is quite contagious, it is less of a cause for concern than full-blown pneumonia. “it’s called ‘walking pneumonia’,” Rubin explained, “because you’re not wiped out and hospitalized and really sick. You’re still functional.”

Rubin and others have said that it is plausible that the surge in the number of cases may be due to the Covid-19 pandemic; masking, distancing, and isolating led to fewer instances of cold, flu, or anything from one another, leading to a lower immunity. “There’s no science or proof of that,” says Rubin, “but that’s the working hypothesis for almost anything post-pandemic.”

The disease has been affecting a higher number of kids, of late, and younger kids at that, some as young as two to four years old. Rubin has been a summer camp doctor for more than 30 years. He says that all the summer camps had outbreaks this past summer.

Since walking pneumonia doesn’t lead to an immune response, it is possible for those who have had it to catch it again. And it is very infectious, Rubin says. “If it gets introduced into a household, about one third of the people in the household will get it.” And it is difficult, because of the incubation period, to know where you caught it.

Diagnosis of walking pneumonia requires clinicians to be aware that the illness is out there to know to look for it, and to know what type of antibiotic to prescribe. Symptoms include low energy, cough, low-grade fever, and it comes on gradually. There may be some wheezing, and some heaviness in the chest.

Only about 25% of kids who are infected with the bacteria will actually develop pneumonia (inflammation of the lung tissue), as opposed to a simple upper respiratory condition, which generally gets better without treatment. Those who do present symptoms can see their physician (if they have one) and don’t need to go to the ER.

As communicable as it is, a child with walking pneumonia is usually not contagious after a five-day course of antibiotics, says Rubin. But that doesn’t mean you should send them to school if they’re not feeling up to it. n