IWK Health Centre seeing uptick in walking pneumonia cases this year

The IWK Health Centre in Halifax has seen an uptick in cases of Mycoplasma pneumoniae — also known as walking pneumonia — so far this year.

According to the most recent data from the hospital that includes numbers up to October, there have been 161 cases reported, with 122 in the emergency department and 39 inpatients. In 2023, there were only 11 cases — nine inpatients and two in the emergency department.

The uptick is a trend being seen in pediatric hospitals across Canada and the U.S. 

"There's a natural sort of cyclical surge in Mycoplasma that's well known," Dr. Emma Burns, the chief of the IWK emergency department, told CBC News in an interview.

"It usually peaks every three to seven years, so we seem to be in a natural surge of Mycoplasma pneumoniae that you could have expected sort of looking back historically as well."

Walking pneumonia is generally a mild bacterial infection that largely affects children and teens.

Cases in preschoolers

Burns, who has worked at the IWK since 2011 and has been the chief of the emergency department since September, said she and others in the department are seeing more cases in younger patients, like preschoolers.

She said the most common way walking pneumonia presents in children is a runny nose, aches and pains and feeling unwell. She said children may or may not have a fever. It then progresses to a cough and difficulty breathing.

"And the two ways that people will end up in the emergency department is either that their breathing becomes bad enough that they present to see us to get an assessment of their breathing," she said.

"Or in some other children, it will be a prolonged cough and fever, so meaning longer than five to seven days that children's fever just really won't break and they're continuing to cough."

It can be diagnosed through a chest X-ray, though doctors in communities without imaging equipment can make a diagnosis through a clinical exam and patient history.

Walking pneumonia can be treated with antibiotics, but Burns said it's not always needed.

Some people recover without antibiotics

"The reason it got that term 'walking pneumonia' is because some people will actually recover without antibiotics on their own. So some people don't get particularly ill with it. And if your child is doing well and has a cough for up to two weeks, but is otherwise thriving, they don't necessarily need to come in for assessment," Burns said.

While the numbers for November and December haven't been released yet, Burns said anecdotally that it feels like the number of walking pneumonia cases is calming down while cases of respiratory syncytial virus (RSV) are going up.

"RSV and Mycoplasma look very similarly, both clinically and on chest X-ray, and it's more difficult to sort out. When there was no RSV and you got a chest X-ray, it was a little easier to decide if it was pneumonia or not."

Nova Scotia Health doesn't specifically track Mycoplasma pneumoniae, but it has seen more cases of pneumonia so far this year.

Pneumonia cases this year at Nova Scotia Health

In October, the health authority's emergency departments in the central zone — which includes the Halifax area, Eastern Shore and West Hants —  saw 753 cases of pneumonia, compared to 260 in October 2023.

In an interview with CBC's Mainstreet Halifax in November, Dr. Matthew Clarke, an emergency room physician in the central zone, told the show he was seeing pneumonia cases among all age groups, though he added he's noticing it more in children and young adults — "healthy folks who I don't usually see much pneumonia in."

Clarke said wearing a mask when sick and handwashing can help prevent the spread of the illness.