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mycoplasma pneumonia, the infection on the rise in children in Australia and around the world

Cases of a bacterial infection that predominantly affects children have been increasing across Australia.

NSW has reported more than the average number of patients presenting with mycoplasma pneumonia for this time of year.

The situation has been reflected globally, with children affected in China, Taiwan, the Philippines, South Korea, North America and Europe, NSW Health said.

“Now that this has gotten going in communities around the world, it’s made its way to Australia and we are starting to see more presentations with this different form of pneumonia in the community, especially among kids,” Australian Medical Association (AMA) NSW branch president Dr Michael Bonning said.

NSW Health said there had been a rise in pneumonia presentations to emergency departments (EDs) recently “from a variety of causes”. 

Authorities have also reported 12 people have contracted Legionnaire’s disease — a separate bacterial infection that also causes pneumonia — after visiting Sydney’s CBD between December 14 and 26.

Mycoplasma pneumonia is a form of the inflammatory chest condition that is caused by the bacterial pathogen, mycoplasma pneumonaie.

The bacteria strain commonly causes mild respiratory infections, with a cough and weakness that could last for more than a month.

It can lead to atypical pneumonia, also known as “walking pneumonia”.

Dr Rebekah Hoffman, chair of the NSW and ACT branch of the Royal Australian College of General Practitioners, said that it’s called that because patients feel “quite well” but may experience an “annoying, irritating cough that persists and persists”.

Symptoms may develop over one to three weeks, and also include:

  • Fever
  • Headache
  • Sore throat
  • Malaise
  • Difficulty breathing

A spokesperson for NSW Health said it was not a notifiable condition, meaning it is not required by law to report cases. 

There were four mycoplasma pneumonia cases recorded in EDs for the week ending January 1, compared with an average of one in the years 2019 to 2023 during the same time period.

“Recently, the number of people presenting to EDs with pneumonia increased and the proportion due to mycoplasma has increased, particularly in children aged five to 16 years old,” a NSW Health spokesperson said in a statement.

Dr Hoffman said while the figure was more than usual, GPs don’t generally expect a large number of cases anyway. 

“This is a new outbreak that we haven’t really seen previously, and we want to try and make sure that GPs but also parents are aware that we might need to do some additional testing, particularly if they’ve had a persistent cough ongoing for several weeks,” she said.

Paediatric specialists in Queensland also recorded a trebling of cases since the end of November.

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How is it contracted?

Dr Bonning said mycoplasma pneumonia cases spike when immunity wanes in the population, every three to seven years.

“Mycoplasma pneumonia is passed by aerosols and droplets from one person to another,” he said.

Dr Hoffman added that the atypical pneumonia spreads from coughing, and can be prevented the same way as all other respiratory and airborne diseases.

“You can contain it by not going out when you’re unwell, by covering your mouth when you cough, by washing your hands regularly and by wearing face masks,” she said.

“All of the useful stuff that we got incredibly good at during COVID that perhaps have let slip in the past few months.”

NSW Health monitors presentations to EDs and hospital admissions for illnesses like pneumonia to help identify trends. 

“ED presentations for mycoplasma pneumonia likely represent only a proportion of cases in the community,” the spokesperson said. 

Who is at risk?

Young people under the age of 20 are more likely to contract the bacteria, but particularly three- to seven-year-olds who haven’t been exposed to it before.

Dr Bonning explained that COVID-19 lockdowns would have limited this age group’s exposure and transmission of respiratory illness bugs previously.

Additionally, the bacteria passes quickly between children before they show symptoms, particularly in childcare and the classroom.

“Young children are much more in close contact with one another and they’re very good at sharing their germs,” Dr Bonning said.

“Because of that, it means that we will again continue to see children in general practice and also in hospitals who are presenting with a pneumonia caused by mycoplasma.”

However, infection can still occur at any age, with Dr Hoffman saying symptoms are very similar.

“With all viral and bacterial illnesses, we always worry about population groups that have an increased risk,” she said.

“That’s going to be those that if they were going to catch pneumonia … they would be more likely to be hospitalised.

“So they would be people with any immunosuppressant or any other respiratory illnesses or diseases.”

What do available treatments look like?

Despite the name “walking pneumonia”, Dr Hoffman said it’s important to visit a doctor if someone has symptoms for mycoplasma pneumonia.

“It’s not a case of just ignore it and it will get better,” she said.

“But more importantly, if it’s getting worse, then that really is an indication to see your GP and organise some additional testing to be done.”

NSW Health added that a nose and throat swab PCR can help detect atypical bacteria, including mycoplasma. 

It said that mycoplasma pneumonia “generally resolves without serious complications”.

If diagnosed, a medical professional will prescribe antimicrobial medications like antibiotics, and make a decision about what to do next in terms of escalating care.

This could include a visit with an infectious disease specialist for further management advice.

“For the large part, your children will be perfectly fine, and this isn’t something that needs to cause significant concern at this point in time,” Dr Hoffman said.

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