Michigan is currently witnessing a staggering four-fold increase in the number of children hospitalized with pneumonia compared to the same period last year, prompting urgent warnings from both the Michigan state health department and the CDC regarding a significant rise in Mycoplasma pneumoniae infections.
Pediatric infectious disease specialists and public health authorities express growing concern, not just about any single type of bacteria or virus. Instead, their focus is on a combination of troubling patterns as children approach the cold and flu season:
- This year’s post-pandemic “wild card” infection is the resurgence of Mycoplasma, a bacterial infection known to cause respiratory ailments, including chest colds and pneumonia. After remaining largely dormant during the COVID-19 pandemic, the infection is now making a comeback. Although many cases are mild, the CDC is investigating early reports suggesting it may lead to increased severe illnesses and complications in children. Pediatric hospitalizations related to Mycoplasma have notably increased in Michigan and across various states.
- The CDC recently reported a “grim milestone”: 200 children in the U.S. died from influenza during the 2023-2024 season, with approximately 80% of these children being unvaccinated.
- Additionally, cases of whooping cough in the U.S. have surged to five times as high as the previous year, due to declining vaccination rates.
- Respiratory Syncytial Virus (RSV) is expected to peak in late fall and early winter. Dr. Andrea Hadley, division chief of pediatric acute care at Helen DeVos Children’s Hospital, noted, “Pediatricians and children’s hospitals consistently prepare for a significant influx of RSV cases during this time, particularly affecting our youngest patients, including infants and small children,” highlighting that RSV has historically been the leading cause of hospitalizations within this demographic.
What does this mean?
The overriding concern is to avert a repeat of last year’s tumultuous virus season, when simultaneous spikes in flu and RSV overwhelmed children’s hospitals, leading to excessive ER wait times, overcrowded conditions necessitating doubling up on rooms, and in some instances, hospitals were forced to turn patients away.
Dr. Jason Newland, division chief of infectious diseases at Nationwide Children’s Hospital in Ohio—one of the largest children’s hospitals in the U.S.—reiterated, “The alarming aspect for 2024 is the resurgence of vaccine-preventable diseases like pertussis, attributed to declining vaccination uptake among both adults and children.” He added, “Factors like unexpected pathogens, such as Mycoplasma, contribute to a justified concern regarding the potential scenarios similar to the crisis we witnessed a couple of years ago.”
On a positive note, there are increasingly effective tools available to help ensure children’s safety and mitigate the pressure on pediatric healthcare resources. There are vaccines for flu, COVID-19, and whooping cough; as well as monoclonal antibodies to reduce RSV hospitalization rates; and antibiotics for treating Mycoplasma infections—it’s crucial to stay informed about these options.
What is Mycoplasma?
Mycoplasma pneumoniae is a bacterium frequently responsible for respiratory infections that are usually mild. In adults, it typically manifests as a benign chest cold featuring symptoms like fever, headache, and cough. However, its presentation can differ in children under five, who may experience diarrhea, sneezing, sore throat, vomiting, and wheezing. If the illness escalates into a lung infection, it is often termed “walking pneumonia,” since those affected do not feel sick enough to remain bedridden. Nevertheless, in rare instances, it can pose a significant health risk, particularly for children.
“What we know for certain is that our communities didn’t see some of these viruses [and pathogens] for two or three years,” stated Dr. Natasha Bagdasarian, the chief medical executive for Michigan. “This hiatus will unequivocally alter how our immune systems respond to these pathogens.”
During the pandemic, Mycoplasma was virtually nonexistent for approximately three years, much like other respiratory illnesses that were subsequently less prevalent due to lockdowns and social distancing measures. However, it is now rapidly re-emerging with early reports indicating an uptick in severe complications among children. Chris Edens, CDC’s lead for Legionella and Atypical Pathogens, remarked, “We have been receiving numerous anecdotal accounts from hospitals and state and local health departments regarding significant pneumonia cases among children, with many experiencing extended hospital stays.”
It’s noteworthy that this infection appears to significantly impact younger children, despite being predominantly regarded as a “school-age disease.” Edens explained, “Our data now shows comparable Mycoplasma diagnoses in children aged two to four, which is a significant shift from pre-pandemic trends.” This could be due to increased testing for Mycoplasma in younger children or changes in immune response following a prolonged lack of exposure to these pathogens.
Dr. Bagdasarian emphasized, “Communities have not encountered some of these viruses for two or three years, which will change the way our immune systems react to them.”
Mycoplasma is resistant to certain antibiotics, yet responds effectively to a class known as macrolides. Edens noted, “Macrolide antibiotics work remarkably well; they can shorten hospital stays and aid in quicker recovery. This specific treatment approach is crucial when a viral infection is suspected. It is essential for doctors to think about Mycoplasma—particularly for younger age groups.”
How can you keep your kid safe this year?
- Prevention
Adhering to familiar health recommendations is paramount: stay home if feeling unwell, prioritize frequent hand washing, and consider keeping COVID tests within easy reach.
“Regardless of the underlying cause of the illness,” advised Dr. Bagdasarian, “maintaining a homebound approach is crucial. Keep COVID tests available as well, as we have effective antivirals for it. A flu test is also wise, given that we have effective treatments available for influenza. If interaction with others is necessary, particularly while coughing or sneezing, wearing a mask is vital for the protection of those around you.”
- Immunizations and vaccinations
It is essential to ensure both you and your children are current on vaccines for flu, COVID-19, and pertussis (whooping cough).
Vaccination rates declined significantly during the pandemic due to school closures and limited access to pediatrician visits. Alarmingly, rates for conditions like whooping cough have yet to recover to levels seen prior to the pandemic, according to Dr. Bagdasarian.
“Vaccines have been politicized,” she observed. “Anti-vaccine sentiments have emerged as political statements for many, alongside the spread of misinformation regarding COVID-19 vaccines affecting other vital vaccinations.”
For any concerns about vaccinations, it’s critical to consult with your healthcare provider or pediatrician. Dr. Newland pointed out the dangers of pertussis, stating, “Pertussis can have fatal consequences for infants who are too young to be vaccinated.” Thus, surrounding individuals must be vaccinated.
Moreover, vaccines have gained approval for pregnant individuals and adults over 60. Just last year, the FDA greenlit RSV immunizations for pregnant women and infants, demonstrating effectiveness ranging from “80–90% effective” against hospitalization for RSV, according to the CDC.
Dr. Newland expressed hope for a future unimpeded by RSV-related strife: “I look forward to the day when our hospitals are not brimming with RSV cases affecting children, who can become gravely ill and present great concern.”
And your children are up to date with vaccinations. This includes vaccines for influenza, COVID-19, and pertussis (whooping cough). Vaccination is a powerful tool in preventing severe illnesses and reducing the burden on healthcare systems during peak respiratory illness seasons.
Dr. Newland stresses the importance of not only protecting children but also ensuring that adults receive booster shots to maintain community immunity. “Vaccination helps not only the individual but also protects those who may be vulnerable or unable to receive vaccines,” he said.
- Awareness and prompt action
Be vigilant for symptoms that may indicate a respiratory infection, such as coughing, wheezing, or difficulty breathing. If your child exhibits these symptoms or if you notice significant changes in their behavior or health, consult a healthcare provider promptly. Early intervention can make a critical difference in managing their health and preventing complications.
“Children with respiratory symptoms should be seen quickly,” emphasized Dr. Hadley. “Early diagnosis and treatment can lead to better outcomes and potentially lessen hospitalizations.”
- Community engagement
Encourage your community to prioritize health measures, including vaccination campaigns and public health education initiatives. Engaging with schools and local health organizations can help raise awareness about the importance of maintaining public health measures and increasing vaccination rates.
“It’s vital for parents to talk to each other, share information, and engage in community vaccination efforts,” Dr. Newland noted. “A collective effort will better protect not just individual children but the community as a whole.”
Being proactive about health and vaccinations, staying informed, and acting quickly can significantly reduce the risks associated with the resurgence of respiratory infections like Mycoplasma this year. It’s crucial for everyone to play a part in safeguarding the health of our children and communities.