By Alicia Brennan, MD
After a dip in certain pediatric respiratory conditions during and following the COVID-19 pandemic, infections are on the rise again across the United States.
The Centers for Disease Control and Prevention (CDC) report that the number of children with pertussis, also known as whooping cough, is at least five times greater this year than it was in October 2023.
Additionally, cases of Mycoplasma pneumoniae, commonly referred to as walking pneumonia, have increased over the past six months and remain high, according to the CDC.
With young children especially at risk, parents should talk with their pediatrician about how to protect their kids from getting sick and should keep an eye out for symptoms that may require medical care.
At Penn Medicine Princeton Medical Center pediatricians from Children’s Hospital of Philadelphia are always on-site to consult on emergency cases involving infants, children and adolescents. If a child needs to be admitted, he or she is cared for in PMC’s inpatient pediatric unit, where a CHOP pediatrician is on-site 24 hours a day, seven days a week.
Whooping Cough
Whooping cough is a highly contagious bacterial infection of the respiratory system that causes severe and uncontrollable coughing fits. It gets its name from the distinctive whooping sound that often occurs with a sharp inhale after a prolonged bout of coughing.
Whooping cough can affect people of all ages, but infants under six months are particularly vulnerable, as they are either not yet fully vaccinated or too young to be vaccinated. Older children and adults can also get pertussis, especially if their immunity has weakened over time or if they haven’t received a booster vaccine.
Whooping cough usually begins with symptoms like those of the common cold, such as a runny nose, mild cough, and fever. As the illness progresses, the cough becomes more severe.
Infants may not cough at all exhibit and instead may have trouble breathing or may stop breathing altogether.
Walking Pneumonia
As its name hints, walking pneumonia is a milder form of pneumonia. It is most commonly caused by the bacterium Mycoplasma pneumoniae, though it can also be triggered by other bacteria or viruses.
The symptoms of walking pneumonia often resemble those of a bad cold or flu and include fever, cough and sore throat.
Walking pneumonia is more common in children, teenagers, and young adults, especially in group settings like schools and dorms, where it can spread easily.
In comparison to typical pneumonia, which can cause high fever, severe cough, chest pain, and difficulty breathing, walking pneumonia may have more subtle symptoms that develop gradually and are less intense.
Current Outbreaks
The CDC notes that incidences of whooping cough are returning to pre-pandemic levels where more than 10,000 cases are typically reported each year.
As of Oct. 12, more than 18,500 cases of whooping cough have been diagnosed in the United States, compared to 4,157 the same time in 2023. This number is higher than what was seen at the same time in 2019, prior to the pandemic.
Like whooping cough, cases of walking pneumonia have also been on the rise this year, with the highest increase among children.
The CDC reports that the percentage of children diagnosed with walking pneumonia between March 31 and Oct. 5 grew from 1% to 7.2% among children ages 2 to 4 years old and from 3.6 to 7.4% among children ages 5 to 17 years old.
The increase in children ages 2 to 4 is notable, according to the CDC, because walking pneumonia has historically not been recognized as a leading cause of pneumonia in the age group.
The CDC notes that protective measures taken during COVID such as masking, remote learning, and increased hand washing, helped lower transmission rates of other infections like whooping cough and walking pneumonia.
In addition, a disruption in routine vaccinations during the pandemic as well as overall vaccine hesitancy, are also contributing to the surge.
Treatment
If your child shows symptoms of a respiratory infection, such as whooping cough or walking pneumonia, see your pediatrician right away. If they are struggling to breathe, seek emergency care.
In its early stages, whooping cough may be treated with antibiotics. As the infection, progresses treatment focuses on managing the cough with measures like hydration, humidifiers and rest.
In severe cases, especially in infants, hospitalization may be necessary for intravenous fluids, breathing support and close monitoring.
Treatment for walking pneumonia may also involve antibiotics. It is important to note, however, that walking pneumonia is resistant to certain antibiotics that are typically used to treat other kinds of pneumonia.
If your child is taking antibiotics and not showing an improvement in symptoms, they may need a different type. Rest, staying hydrated and over-the-counter medicines, like acetaminophen or ibuprofen, can also help manage symptoms.
Prevention
The best way to prevent whooping cough and its spread is through vaccination. The CDC recommends vaccination for babies, children, preteens, pregnant women, and adults.
The CDC also recommends vaccination against pneumonia for children younger than 5 years and adults 65 years or older. While this won’t prevent walking pneumonia, it can help prevent it from progressing to a more dangerous type of pneumonia.
Other preventative measures include making sure children:
- Wash their hands regularly
- Cover their coughs and sneezes
- Keep their hands away from their face and mouth
- Stay home when they’re sick
The increase in whooping cough and walking pneumonia cases among children post-COVID is concerning for parents and pediatricians. However, vaccines and other steps can help prevent infection.
Talk with your pediatrician about your child’s vaccination schedule and other steps you can take to safeguard their health as they return to normalcy after the pandemic.
To find a pediatrician with Penn Medicine Princeton Health, call (888) 742-7496 or visit www.princetonhcs.org.Â
Alicia Brennan, MD, is board certified in pediatrics and medical director of Children’s Hospital of Philadelphia Pediatric Care at Penn Medicine Princeton Medical Center.
