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Mycoplasma pneumoniae

What's Happening Now

October 2, 2024: Increase in Mycoplasma Pneumoniae reported among Indiana children

The Indiana Department of Health (IDOH) has received reports of increases in pediatric pneumonia cases, including those caused by Mycoplasma pneumoniae. This uptick has been also observed across various regions in the United States, particularly affecting young children.

  • M. pneumoniae usually peaks every 3 to 7 years, with variation of strain types contributing to this pattern.
  • M. pneumoniae infections began increasing in Indiana in late spring/early summer 2024, including emergency department visits across all pediatric ages.

Recommendations

  • Healthcare providers should have increased suspicion of M. pneumoniae among patients presenting with compatible symptoms or clinical presentations, including pneumonia.
    • Children younger than 5 years of age may have a milder, subclinical illness that does not result in pneumonia
    • Complications can include asthma exacerbation, severe pneumonia, hemolytic anemia, renal dysfunction, mycoplasma induced rash and mucositis, and others.
  • Diagnosis is often clinical. However, testing can be molecular (RVP), if available, or serology (IgM). Serologic testing for M. pneumoniae can have false positives but with the increase in cases, if pre-test probability is high, it is likely accurate.
  • The preferred treatment is with macrolides, including azithromycin. Other treatment options include tetracyclines and fluoroquinolones. Mycoplasma pneumoniae does not respond to beta-lactams and should also be considered in the differential for a patient failing this therapy.
    • Macrolide resistance is expected to be low (<10%) in Indiana, despite higher rates in other geographic areas. Reported cases have been responsive.
  • Reporting: Cases of M. pneumoniae are not reportable however outbreaks or unusual clusters of M. pneumoniae should be reported to your local health department or to the IDOH Infectious Disease Epidemiology and Prevention Division at 317-233-7125.
  • Prevention: Emphasize the importance of good respiratory hygiene and infection control practices to patients and their families to help prevent the spread of respiratory infections.

More Information

Mycoplasma pneumoniae (M. pneumoniae) bacteria can cause respiratory tract infections. They are generally mild but can sometimes progress into something more severe. M. pneumoniae infections are most commonly seen in school-aged children and young adults. Infection may appear more like a cold in children younger than 5 years old. Contact your healthcare provider if experiencing difficulty breathing or concerning symptoms.

Mycoplasma pneumoniae (M. pneumoniae) infection is a mild respiratory illness caused by the bacterium Mycoplasma pneumoniae. People of all ages are at risk for infection, but it is more common in school-aged children and young adults. Outbreaks can occur in crowded environments like military barracks, college dorms, nursing homes and hospitals. Outbreaks in these settings may persist for months.

What are the symptoms of M. pneumoniae?
  • Fever
  • Cough
  • Bronchitis
  • Sore throat
  • Headache
  • Fatigue
  • Ear infection

A common outcome of M. pneumoniae infection is pneumonia, sometimes referred to as "walking pneumonia" due to its mild nature and unlikelihood of requiring hospitalization. Approximately 1 out of 3 infected individuals may develop pneumonia. Infection may appear more like a cold in children younger than 5 years old.

When do symptoms last?

Symptoms generally begin 1 to 4 weeks after being exposed to the bacteria and can last anywhere from a few days to more than a month.

How do I know if I have M. pneumoniae?

See your healthcare provider. Your health care provider will review your symptoms and may utilize laboratory testing for a confirmatory diagnosis.

M. pneumoniae is spread through contact with droplets from the nose and throat of an infected individual. Transmission usually requires prolonged close contact, making outbreaks in households, schools, and institutions gradual. Diagnosis can be difficult, delaying outbreak reporting and prevention efforts.

While antibiotics may be prescribed, M. pneumoniae infections often resolve on their own, so treatment for mild symptoms may not be necessary.

There are currently no vaccines for M. pneumoniae infection. As with any respiratory disease, all people should cover their mouth and nose when coughing or sneezing, and wash their hands frequently.

CDC Mycoplasma pneumoniae Website

Reporting

Mycoplasma pneumoniae is not a reportable disease in Indiana, therefore data is not widely available. However, outbreaks are reportable to the Respiratory Team within the Infectious Disease Epidemiology and Prevention Division at 317-233-7125.

Page last reviewed/updated: November 2024