San Diego sees spike in walking pneumonia cases

While flu season is underway and the COVID virus is still around, another respiratory illness is making a comeback. Doctors across the country — including in San Diego — are seeing a surge of the infection commonly known as walking pneumonia.

Recently, the San Diego County Health & Human Services Department released an advisory warning local health care providers of a significant increase. And by Nov. 18, county officials say there had been 547 reported cases, up from 332 in 2023.

“These numbers are just a fraction of the actual number of cases out there right now,” says Dr. Ahmed Salem, a pulmonary disease doctor with Sharp Community Medical Group affiliated with Sharp Memorial Hospital. “Many people with walking pneumonia don’t go to the doctor, so it’s tough to pinpoint an exact number. But the fact that reported cases are spiking so much tells us that a lot more people will get sick as we get into winter.”

The two pneumonias

Pneumonia is an infection of the lungs, usually caused by a bacteria or virus. It’s spread through respiratory droplets released into the air. Walking pneumonia, also known as atypical pneumonia, is lesser known by the general public than the illness typically referred to as “pneumonia” and is most commonly caused by mycoplasma bacteria.

“It’s less severe than what we call typical pneumonia,” says Dr. Salem. “But if not treated, it can progress into a more severe form of pneumonia.”

It’s the reduced severity that gives walking pneumonia its nickname. “Usually, when people get pneumonia, they’re so sick they’re stuck in bed or have to go to the hospital,” Dr. Salem says. “Walking pneumonia means they can still function.”

Dr. Salem points out that this means many infected people continue going to work or school, spreading the contagious illness.

Symptoms of both forms are similar and include:

• Shortness of breath

• Cough

• Fever

• Wheezing

Why the spike?

Dr. Salem says the current spike in walking pneumonia cases may be connected to the COVID-19 pandemic. From the initial onslaught of the virus in 2020 and for the next few years, people were more conscientious of gathering in groups when showing symptoms and more likely to stay home. Additionally, parents often kept their children home from school when sick.

“It’s also easy to forget that while wearing masks helped limit the spread of COVID, it also helped prevent the spread of other respiratory illnesses,” says Dr. Salem. “Masking is effective.”

While walking pneumonia cases are rising to a level not seen since before 2020, Dr. Salem suggests that the spike may signal that the illness is returning to what was considered normal pre-pandemic.

When should you see a doctor?

According to Dr. Salem, the illness is most dangerous in young children, older adults and those who are immunocompromised.

Because the symptoms are similar to those of other respiratory illnesses, such as COVID-19, flu and even the common cold, it’s nearly impossible for those who are sick to diagnose themselves. A polymerase chain reaction (PCR) test administered via a nasal swab is the only way to diagnose walking pneumonia.

Dr. Salem suggests that if you or a loved one is suffering from shortness of breath, wheezing or coughing up mucous, that’s a signal to see your doctor. You should also talk with your doctor if you have cold symptoms lasting for more than a week. Common colds and other respiratory illnesses, such as RSV, can develop into walking pneumonia if they last seven days or more.

If your doctor diagnoses walking pneumonia, they’ll most likely prescribe antibiotics, a key difference from other respiratory illnesses.

“For colds, flu and even COVID, we stay away from antibiotics,” Dr. Salem says. “However, bacterial pneumonia is a case where they really are the best way to treat the illness.”

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