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Walking pneumonia’s surprising rise in young children

Written By: Vicki Powers, UT Physicians | Updated: January 31, 2025
Doctor is examining young boy

Parents often struggle to distinguish walking pneumonia from the common cold. Symptoms can vary based on age.

A recent increase in walking pneumonia cases, particularly among children ages 2 to 4, has caught the attention of medical professionals and parents. This respiratory infection, while typically mild, has shown some concerning patterns.

Misti G. Ellsworth, DO
Misti G. Ellsworth, DO

“We’ve definitely seen more hospitalizations for kids with walking pneumonia than we have in the past,” said Misti G. Ellsworth, DO, a pediatric infectious disease specialist at UT Physicians Pediatric Specialists—Texas Medical Center.

The Centers for Disease Control and Prevention (CDC) reported that cases of Mycoplasma pneumoniae, or “walking pneumonia,” increased in 2024 for the first time since the COVID-19 pandemic. Children ages 2 to 4 showed the highest increase from 1% to 7.2% from March 31, 2024, to Oct. 5, 2024. This age group isn’t typically affected, with the highest rates generally occurring for school-age children and teens exposed to other students.

Ellsworth noted that the surge may be linked to COVID-19’s impact on typical disease patterns. Walking pneumonia disappeared during that time, according to the CDC. Ellsworth said physicians didn’t start to see Mycoplasma pneumoniae again until the end of 2023, leading into the summer of 2024.

Recognizing symptoms

Parents often struggle to distinguish walking pneumonia from common colds. Ellsworth said that in mild cases, symptoms will be similar — such as a runny nose and dry cough.

“About 10% of kids who get Mycoplasma pneumoniae will develop the more severe symptoms of fever, cough, or difficulty breathing,” said Ellsworth, associate professor of pediatric infectious disease at McGovern Medical School at UTHealth Houston.

Another challenge is that symptoms can vary by age. Children younger than 5 can present differently than older children. Younger kids can have diarrhea, sore throat, vomiting, watery eyes, stuffy or runny nose, or wheezing.

“Kids over 5 have what we typically think of as walking pneumonia, including fatigue, cough, fever, and headache,” she said.

Making the diagnosis

Physicians typically diagnose walking pneumonia in children through a nasal swab PCR test, similar to COVID-19 testing. Chest X-rays may be ordered if pneumonia is suspected. While some mild cases might clear up without treatment, antibiotics often are necessary.

While serious complications are rare, parents should watch for signs of respiratory distress and seek medical attention if symptoms worsen or don’t improve.

Preventing illness

Walking pneumonia spreads through breathing in contaminated respiratory droplets, similar to flu and COVID-19, so basic hygiene practices can help reduce the spreading of it. Ellsworth said handwashing and covering your mouth when coughing or sneezing are key preventive measures.

As the clinical practice of McGovern Medical School at UTHealth Houston, UT Physicians has locations across the Greater Houston area to serve the community. To schedule an appointment, call .