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February 23, 2024
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Cases of ‘walking pneumonia’ on rebound after falloff during pandemic

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Key takeaways:

  • Cases of M. pneumoniae, the cause of “walking pneumonia,” are on the rebound in the U.S.
  • Cases had declined during the COVID-19 pandemic.

An early analysis of data from the 2023-2024 respiratory season showed that cases of Mycoplasma pneumoniae are on the rebound in the United States after declining during the COVID-19 pandemic, according to data reported in MMWR.

M . pneumoniae causes mostly mild respiratory symptoms, sometimes referred to as “walking pneumonia,” Chris Edens, PhD, a scientist in the CDC’s Division of Bacterial Diseases in the CDC’s National Center for Immunization and Respiratory Diseases, and colleagues noted in their report.

IDN0224Edens_Graphic_01_WEB
Data derived from Edens C, et al. MMWR Morb Mortal Wkly Rep. 2024;doi:10.15585/mmwr.mm7307a3.

Like influenza and respiratory syncytial virus, cases of M. pneumoniae declined significantly in the first years of the COVID-19 pandemic. However, as the pandemic eased, all three have increased in frequency.

“After implementation of nonpharmaceutical interventions in response to COVID-19, the frequency of identified M. pneumoniae infections substantially declined beginning in 2020,” Edens and colleagues wrote. “This pattern was also observed for other respiratory pathogens. Beginning in the fall of 2023, China and other countries identified a reemergence of this bacterium.”

Edens and colleagues analyzed data from the CDC’s National Syndromic Surveillance Program (NSSP) and New Vaccine Surveillance Network (NVSN) on children and adolescents who visited more than 6,500 EDs in the U.S. with pneumonia-like symptoms.

Data from the NSSP showed that M. pneumoniae-related diagnoses decreased from 1.15% (4,681 of 407,514) in the pre-pandemic period from 2019 to 2020 to 0.35% (1,233 of 355,508) in 2020-2023 before increasing to 0.89% (597 of 66,736) from September to December 2023.

Similarly, data from the NVSN found that M. pneumoniae-related diagnoses decreased from 1.2% (165 of 13,800) in the pre-pandemic period to 0.04% (10 of 24,256) during the pandemic period before increasing to 0.53% (13 of 2,470) in the post-pandemic period.

“Providers should consider M. pneumoniae as part of the differential diagnosis for cases of community-acquired pneumonia during fall and winter respiratory illness seasons,” the researchers wrote. “Despite ongoing concerns regarding antimicrobial resistance, macrolides remain the recommended first-line treatment for M. pneumoniae infections in the United States.”