‘Mind boggling’ surge in pneumonia cases among children, teens and young adults

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Perth emergency physician Dr. Alan Drummond has never seen anything like it.

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Drummond has treated five or six patients with pneumonia during almost every shift he has worked in the past month, many of them children, teens and young adults. Sometimes he has diagnosed multiple members of the same family.

“This is my 41st year in Perth and I have never experienced a month like this in my life. It is mind boggling.”

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What Drummond is seeing is also being seen across the province and around the globe this year: A steep rise in cases of Mycoplasma pneumonia. The bacterial pneumonia is spreading rapidly in Ontario this year, especially among children and teens.

The illness is sometimes called walking pneumonia because patients with milder symptoms may not stay home or in bed. Drummond said some of the cases he is seeing are milder, typical of walking pneumonia, while others are more dramatic and concerning. The good news, he said, is that it is treatable with antibiotics and the majority of patients recover at home.

CHEO, in the midst of a busy respiratory season, is also seeing more cases of children testing positive for Mycoplasma pneumonia infection than in a typical year, said hospital spokesperson Rob Wilkinson.

This week Public Health Ontario issued a notice warning of a “marked increase” of cases this year. Ottawa’s Associate Medical of Health Dr. Laura Bournes forwarded it to local doctors and nurse practitioners.

Positive tests for Mycoplasma pneumonia and the percentage of positivity in Ontario are all higher than during the same period last year, according to Public Health Ontario.

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“Disease activity as measured by these indicators began increasing … in May and June, with more rapid increases in July and August. Activity has remained high since August,” according to Public Health Ontario.

Infections are highest among children and adolescents — with highest rates among children and teens from 10 to 19, followed by children between five and nine and then young children and babies one to four years old. Fewer cases are being seen in adults.

Public Health Ontario characterized the increase in cases among very young children as notable, saying that historically children under four have had very few Mycoplasma pneumonia infections.

The information from Public Health Ontario is aimed at putting health care providers on alert to watch and test for Mycoplasma pneumonia even in younger children who typically have low rates of the illness.

Common symptoms are fever, headache and a slowly worsening cough, which can be similar to other viral and bacterial illnesses.

At CHEO, occupancy rates on medical units are at or over 100 per cent and the hospital emergency department has seen between 200 and 225 patients daily in recent weeks. Those volumes are typical for this time of year, said Wilkinson, and can mean patients with less acute issues sometimes have long waits.

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Wilkinson said CHEO is monitoring the spike in cases of Mycoplasma pneumonia closely, adding “Our teams are well-prepared to provide care for these mycoplasma infections.”

Spikes in Mycoplasma infections tend to be cyclical, but Drummond said the amounts he is seeing are like nothing he has seen in previous years.

“This is the first time in 40 years, my entire clinical life, that every time I go for a shift I treat half a dozen pneumonias. It has been a stunning surge in infections to be sure.”

He recommended people wear masks, wash their hands frequently and avoid crowds if they have symptoms to reduce spread or to avoid coming into contact with it.

“I think people are forgetting that these techniques were remarkably helpful (for COVID-19).”

Those with symptoms are advised to see their primary health care provider, if possible, before heading to hospital, depending on the severity of the illness.

Guidance about when to go to emergency is available on CHEO’s website, CHEO.ca

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