Understanding Mycoplasma: Cause of Recent Pneumonia Surges in Ohio and Abroad

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a rise in childhood pneumonia linked to Mycoplasma pneumoniae
Increase in pneumonia cases in Chine found to be linked with Mycoplasma pneumoniae.

China, Denmark, France, the Netherlands, and one Ohio county report a rise in childhood pneumonia linked to Mycoplasma pneumoniae. While no widespread increase is seen in the rest of the US, this bacteria typically triggers pneumonia outbreaks every one to three years.

With no major occurrences since pre-COVID-19, experts anticipate a potential increase this year, emphasizing the variability in Mycoplasma infection seasons. Dr. Buddy Creech from Vanderbilt University notes the likelihood of Mycoplasma infections in the US and Europe being more challenging this year.

In the past week, European surveillance across 45 sites in 24 countries revealed a resurgence of Mycoplasma cases, dropping below 1% during the pandemic but surging over fourfold by summer and fall, particularly in Asia and Europe, reported in The Lancet Microbe.

The US Centers for Disease Control and Prevention highlights antibiotic resistance as possibly contributing to the uptick in Chinese cases. Dr. Peter Hotez from the Texas Children’s Hospital Center for Vaccine Development notes periodic outbreaks, especially among 5—to 12-year-olds.

An ordinary infection stages a return. While Mycoplasma might not be a household name for parents, doctors recognize it as a frequent culprit of mild or “walking” pneumonia. This infection manifests with a persistent cough, often accompanied by a fever, headache, and a rash on the trunk, back, or arms.

Pneumonia, an inflammation that causes the lungs to fill with fluid or pus, has various causes, including viruses, bacteria, and chemicals. Nationwide, the surge in respiratory infections from COVID-19, flu, and respiratory syncytial virus (RSV) is contributing to an increase in pneumonia cases.

Health officials in Warren County, Ohio, reported an unusual increase in kids’ pneumonia cases, totaling 142 since August. While not considering it a new respiratory disease, the district attributes the surge to a significant uptick in typical pneumonia cases. Testing revealed Mycoplasma, Strep bacteria, and adenovirus among the detected agents.

While doctors are not required to report mycoplasma infections in many states, the CDC monitors them through emergency departments and laboratory data. CDC Director Dr. Mandy Cohen stated that pneumonia-related emergency department visits show no atypical trends currently.

What parents should know?

Many Mycoplasma-related pneumonia cases may not have surfaced yet, as they’re often treated in pediatrician offices due to their milder nature. Pediatricians commonly prescribe antibiotics like amoxicillin without initial cause testing. Dr. Creech notes that this may lead to underestimating Mycoplasma prevalence, as testing occurs only if the initial treatment fails, prompting hospital visits.

Front-line antibiotics for most pneumonia types don’t work for Mycoplasma. Instead, doctors prescribe different antibiotics, like azithromycin or a Z-Pak. However, Z-Paks aren’t effective for pneumonia caused by other agents, so doctors and parents must carefully consider treatment options.

Parents should note that when starting antibiotics for pneumonia, there should be a reasonable response in the first few days. If not, it’s crucial to check in with the pediatrician. While being alert, there’s no need for alarm as Mycoplasma cases may be higher this year.

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