What the Healthy Tennis Player Should Know about Walking Pneumonia
Young Ju, Ph.D.
Pneumonia and Walking Pneumonia (1, 2)
Pneumonia is a respiratory infection caused by various organisms, usually bacteria, viruses or fungi. It causes your airways (trachea and bronchi) (Figure 1) to swell and the air sacs (alveoli) to fill with mucus and fluids. It could affect one or both lungs. Pneumonia can fall into two categories: community-acquired and hospital-acquired. Walking pneumonia (also called atypical pneumonia) is a common type of community-acquired pneumonia. Typically, walking pneumonia is caused by bacteria Mycoplasma pneumoniae. The name of this mild form of pneumonia derives from the fact that you may feel well enough to walk around without noticeable symptoms. But walking pneumonia can sometimes be severe. (Note that hospital-acquired pneumonia, also called pneumonia, is considered more dangerous and more likely to be resistant to antibiotics.)
The Centers for Disease Control Prevention (CDC) estimates that about 2 million cases of walking pneumonia occur every year, resulting in about 100,000 hospitalizations of adults in the US. It can occur at any time of the year, but it occurs most often during the fall and winter. During the COVID-19 pandemic, walking pneumonia incidences were low but began to increase in 2023. Since Spring 2024, walking pneumonia cases have been increasing among all age groups but especially among children.
Pneumonia and walking pneumonia can cause both upper and lower respiratory infections (Figure 1).
Figure 1. The respiratory passages are divided into the upper respiratory tract and the lower respiratory tract (3).
Both pneumonia and walking pneumonia are very contagious, spreading through droplets from breathing, coughing, and sneezing. They have to get into the airway to cause infection. The incubation period is up to 3-4 weeks from exposure. This makes it difficult to determine exactly when and where an individual was infected.
Symptoms (4-7)
Walking pneumonia symptoms are much milder than those of pneumonia and may last 4-6 weeks; a cough is usually the longest-lasting. While most cases of walking pneumonia are not dangerous, it’s important to pay attention to symptoms. If untreated, some walking pneumonia can become a more serious form of pneumonia which is a common cause of hospitalization. It can cause organ damage and be complicated by cardiac and kidney problems and permanent lung damage. If you begin to feel sick again after you start to feel better, you should contact a healthcare provider.
Susceptible Populations (1, 2, 4-7)
While anyone can get pneumonia and walking pneumonia, some people are more likely to get it and might need longer recovery time:
Younger children and adults aged 65 or older
People with a weakened immune system or who take immunosuppressants
People with lung diseases or asthma
People who live or work in crowded places, such as schools, dormitories, nursing homes, military
Smokers
People who use inhaled corticosteroids
Diagnosing Pneumonia (1, 2, 4-7)
Blood tests for certain types of pneumonia are not always effective for diagnosis, because they often cannot identify the specific organism causing the infection. Swab tests to detect Mycoplasma pneumoniae for walking pneumonia can be done with mucus samples from the nose or throat. These can provide results for treatment decisions and predict antibiotic susceptibilities.
A doctor may order a chest X-ray to check if there is an infection in the lungs. An X-ray can also help differentiate between walking pneumonia and other types of pneumonia.
Protection and Treatment (1, 2, 4-7)
There are vaccines primarily for children 5 years old or younger and adults 65 years or older for certain types of pneumonia. In infants, protection from the vaccine lasts only several months while babies develop immunity. For adults, multiple doses of the vaccine a few months apart would be needed; 1-3 doses of the vaccine will last for life.There is no vaccine against walking pneumonia. Usually, walking pneumonia is self-limiting without treatment.
For pneumonia caused by bacteria, antibiotics may be used. In that case, make sure to finish the full course. If not, walking pneumonia may come back and become more difficult to treat. Some cases may go away without antibiotics; however, recovery may take longer. If symptoms are not improved after several days of antibiotics, see a healthcare provider.
Antibiotics don’t work for viral pneumonia; over-the-counter medications may help relieve congestion, cough, and mucus buildup. If an individual has a fever, nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen) and more fluids and rest will be helpful. Severe cases may need additional treatments, such as oxygen treatment, fluid therapy, or corticosteroids, etc.
Prevention (1,2, 4-7)
You can reduce your risk of getting walking pneumonia and pneumonia by following a few steps:
Frequently wash hands with soap.
Cover your nose and mouth when you sneeze or cough.
Wear a mask around sick people if you have a respiratory condition or other chronic health conditions.
Get a pneumonia vaccine for some types of pneumonia if you’re eligible.
Get a flu vaccine.
Do not smoke or allow others to smoke around you.
Get regular physical activity and eat healthy to keep the immune system strong.
Conclusions
In 2024, the CDC saw a significant increase in cases of walking pneumonia and an increase in pneumonia-associated emergency department visits. Good hygiene practices and staying up to date on all recommended vaccines, including RSV (Respiratory syncytial virus), flu, COVID, and pneumonia, can help reduce the risk of getting pneumonia. Here’s to a 2025 filled with good tennis and good health!
Dr. Young Ju is a Ph.D and Associate Professor of Human Nutrition, Foods, and Exercise at Virginia Tech.
References
National Institute of Health. What is pneumonia? https://www.nhlbi.nih.gov/health/pneumonia#:~:text=Pneumonia%20is%20an%20infection%20that,or%20fungi%20may%20cause%20pneumonia.
CDC. Mycoplasma pneumonia infection https://www.cdc.gov/mycoplasma/php/surveillance/index.html
National Institute of Health. Seer Training Module. Conducting Passages https://training.seer.cancer.gov/anatomy/respiratory/passages/
Cleveland Clinic. Atypical (walking) pneumonia. https://my.clevelandclinic.org/health/diseases/15744-pneumonia-atypical-walking-pneumonia
Yale Medicine. Pneumonia https://www.yalemedicine.org/conditions/pneumonia
Yale Medicine. Walking pneumonia: What you should know. https://www.yalemedicine.org/news/walking-pneumonia#:~:text=Walking%20pneumonia%20is%20a%20nonmedical,%2C%20and%2C%20sometimes%2C%20fever.
Mayo Clinic. Walking pneumonia: What does it mean? https://www.mayoclinic.org/diseases-conditions/pneumonia/expert-answers/walking-pneumonia/faq-20058530
This information is provided for your reference and you use at your own risk; you should rely on your medical professional for medical advice.
