Understanding the Rise in Pediatric Pneumonia Cases: What Parents Need to Know
It’s already been an interesting start to this respiratory season. In addition to the usual suspects like colds and viral infections, pediatricians are seeing more bacterial lung infections than usual—especially an increase in mycoplasma pneumonia and pertussis (whooping cough). These bacterial infections can cause more severe symptoms in kids and are part of the reason why many pediatricians, including myself, are on high alert.
With this rise in more serious respiratory infections, it's important for parents to know what to watch for—especially when it comes to distinguishing between a typical viral illness and something more concerning like pneumonia. Let’s break down what you need to look out for, how to tell if it’s pneumonia or just a bad virus, and when to make that call to your pediatrician.
Pneumonia vs. Viral Infections: What to Look For
Pneumonia is an infection of the lungs, and while it can be caused by bacteria or viruses, bacterial pneumonia tends to cause more intense symptoms. Viral infections - whether upper respiratory colds or even viral pneumonias - often clear up on their own, but distinguishing between viral and bacterial can be tough.
Often, a child will start with a viral respiratory infection, but the increased mucous and inflammation in the lungs can be the perfect set up for a bacterial infection to take hold.
Key signs of pneumonia that set it apart from viral infections:
Persistent fever: Viral infections can cause a fever for several days, but if your child’s fever lasts beyond 4-5 days or goes away only to come back, it might indicate bacterial pneumonia. This pattern can often suggest a secondary bacterial infection on top of a viral one.
Vomiting: Vomiting can be a surprising symptom of pneumonia and might initially seem like a stomach bug. If your child is vomiting alongside coughing or fever, it’s worth considering pneumonia.
Cough with mucus production: A wet, productive cough bringing up yellow or green mucus is more typical of bacterial pneumonia. A dry cough, on the other hand, tends to be more common in viral infections.
Fast or labored breathing: Watch for rapid breathing, nostrils flaring, or visible effort in each breath. These can be signs that the lungs are struggling, and needs to be evaluated no matter the cause. We see labored breathing in pneumonia, but also in severe RSV and Influenza infections, especially in young children.
Chest pain and lethargy: If your child mentions pain when breathing or coughing or seems more tired than usual, check in with your pediatrician.
When to Call the Pediatrician
Not every fever or cough requires a trip to the doctor, but here are some signs that it’s time to seek medical care:
Breathing difficulties: If your child’s breathing is rapid, labored, or they seem to be struggling to breathe, seek medical attention immediately.
Fever lasting more than 4-5 days or coming back after a brief break: Viral fevers usually resolve in a few days, but if a fever persists beyond 5 days or returns after it initially goes away, it could be pneumonia.
Vomiting alongside respiratory symptoms: If your child is vomiting, especially with a cough or fever, it’s a good idea to consult your pediatrician.
Severe coughing or mucus production: Viral and bacterial infections alike can cause some pretty nasty coughs. But a severe cough, especially one that brings up green, yellow, or blood-tinged mucus, OR prolonged coughing spells that are so severe they result in vomiting or difficulty breathing, need to be evaluated.
Dehydration: If your kiddo is not taking fluids well, whether that’s due to just feeling crummy from the infection, or coughing so much they aren’t drinking, check in with your pediatrician about when to get them evaluated. Keep in mind that fever and faster breathing increase a child’s fluid losses, so be extra vigilant about encouraging fluid intake and watching their urine output.
Why Early Diagnosis is Crucial
Catching pneumonia early can prevent serious complications, like lung abscesses or sepsis. If your child’s symptoms are lingering beyond what you’d expect from a typical cold or flu, or if you’re seeing any of the concerning signs above, don’t hesitate to get them checked out.
I promise: even if you’ve seen the pediatrician in the last week, your pediatrician is ALWAYS happy to see your child again if symptoms are not resolving like they should, or if your parent intuition tells you something is not right.
Treatment Options
Bacterial pneumonia, such as mycoplasma, requires antibiotics, while viral pneumonia is usually treated with supportive care (rest, fluids). In more severe cases, hospitalization might be necessary, but most kids recover fully with appropriate treatment.
Prevention is possible!
Did you know that getting your flu vaccine can help prevent pneumonia? One of the more severe sequelae of influenza is secondary bacterial pneumonia, which can be life-threatening, especially in young children or those with asthma or other lung conditions.
There’s also a vaccine for whooping cough! Make sure you and your kids are up to date on the Dtap (for young kids) or Tdap (for anyone 7 and up) vaccine. The “p” in those vaccines stands for the pertussis component.
And new last year, we even have a medication given by injection to help prevent severe RSV infection (which can also lead to secondary pneumonia) in babies through 7 months of age. If you have an infant, ask your pediatrician about it!
Your Pediatrician is in your corner
As we navigate this tricky respiratory season, remember that your pediatrician is here to help guide you through it. If you’re my patient, and your child’s illness isn’t improving, or if you’re worried about pneumonia or whooping cough, reach out! We’ll work together to keep your family healthy and safe this season.