What to Do About Walking Pneumonia

It comes on like a nagging cold and cough — and it won’t quit. You’re half-surprised because cold and flu season isn’t in full swing yet, though the flu vaccine is available. Also, you’re able to be up and around, but still the symptoms are no joke, and you’re not sure what to make of them.

While you won’t know what’s going on without a medical checkup, observational data shows one suspect — sometimes referred to as walking pneumonia, or atypical pneumonia — tends to be more common in late summer and early fall. Although, to be sure, a person can develop it any time of year. The reasons for this aren’t entirely clear, but the answer may come from the bacteria that typically cause atypical pneumonia: mycoplasma, Chlamydophila and Legionella. The latter is really common around late summer, says Dr. David G. Hill, a volunteer medical spokesperson for the American Lung Association. “That’s because [Legionella] is very frequently waterborne — comes from heating and air-conditioning systems with water that get contaminated,” he says. “In young people we see a lot of mycoplasma or Chlamydophila, and then in any population, but more classically in the elderly or the immunocompromised, we see the Legionella.”

That’s not to say atypical pneumonia is an easy diagnosis to make. And while it’s generally milder than the most common form of the disease — pneumococcal pneumonia, an infection caused by Streptococcus pneumoniae bacteria, or pneumococcus — it can leave a person feeling miserable, just the same.

[See: 10 Cold and Flu Myths Debunked.]

“It’s widely misunderstood in terms of how severe it is, what do you do for it, how’s it different from other respiratory infections,” says Dr. Brian Coté, medical director of urgent care at Holland Hospital in Holland, Michigan. “Even when we’re dealing with a case of suspected walking pneumonia — even when we’re evaluating the patients — there is some degree of uncertainty still because it’s one of those respiratory conditions that sort of blends in and hides in the crowd of all the other respiratory infections that we encounter as well.”

To make matters more confusing, Hill points out that often — even among primary care doctors — the nonclinical term walking pneumonia is used to describe any mild pneumonia, even those caused by virus. “We start to see [viral pneumonias] in the beginning of flu season when kids go back to school,” says Hill, a pulmonologist, who is also an assistant clinical professor of medicine at Yale University and Quinnipiac University medical schools.

But where walking pneumonia describes atypical pneumonia, it’s caused by bacteria, though it still closely resembles viral respiratory illnesses like the common cold. This bacterial pneumonia affects both the upper respiratory system — basically from the neck up — and the lower respiratory system, Coté says. “So things like sore throat, runny nose, sinus congestion, earaches, pressure — you basically feel like you have a head cold; and that’s how it classically starts,” he explains. “But then what eventually happens is a gradual progression, where that head cold settles down into the lower respiratory components — which are the bronchial tubes, the lungs — and you start to get a classic cough, and typically it’s a very dry cough.”

Rather than being severe and short-lived, clinicians say, symptoms like the dry cough tend to be milder but persist, dragging on for weeks and sometimes continuing for well over a month without treatment. So while there’s no test, per say, to diagnose atypical pneumonia and it can resolve on its own, experts say it’s important to seek medical attention for persistent symptoms. “If a diagnosis is made, treatment with antibiotics is definitely recommended,” Hill says. Antibiotics help lessen the severity of the disease, shorten the time to recovery and decrease the chance of spreading atypical pneumonia to others. Even though people may not be sick — or feel so sick that they think to stay home from work or school — it’s important to do so for at least a few days while the antibiotics work to prevent spreading the disease to others.

[See: 11 Ways to Recover From a Sore Throat.]

Other treatments are described as supportive, rather than curative. “Just like we would use in anyone who’s got a common respiratory ailment: decongestants, Tylenol, ibuprofen, cough elixirs when necessary — sometimes over-the-counter, sometimes prescription cough elixirs — things that make the patient more comfortable,” Coté says. “We always recommend rest, good nutrition, lots of hydration — things like that.”

You can also take these simple steps to reduce your risk of developing walking pneumonia and other common contagions:

Get other vaccines. While there isn’t vaccine for atypical pneumonia, experts say you can — and should — get a flu shot. “Even though the flu vaccine doesn’t cover the organisms that cause atypical pneumonia, getting influenza can weaken the immune system and set you up to get a secondary pneumonia,” Hill notes. He also recommends considering getting the pneumococcal vaccination, which protects against bacteria that most commonly cause pneumonia. “Everyone over 65 should get the pneumococcal vaccine,” he says. “And then there’s patients in select groups — people with a history of lung disease, asthma or COPD, diabetes, heart disease or who are otherwise immunocompromised — all those patient groups should get pneumococcal vaccine.”

Wash your hands — thoroughly and often. Take extra care with this especially if you’re around others who are sick. That includes scrubbing them for at least 20 seconds, according to the Centers for Disease Control and Prevention (which also endorses humming the “Happy Birthday” song twice to keep track, if you don’t have a timer).

Cover your mouth and nose when coughing or sneezing. Do it into the crook of your arm, rather than a hand you might touch a doorknob, surface or shake someone else’s hand with. Need the visual to follow through? The germs that cause walking pneumonia are dispersed — and “shared” with others — the same way those which cause the common cold are: They’re spread via respiratory droplets that go airborne when people cough and sneeze, Coté explains.

[See: 9 Ways to Boost Your Immune System.]

Don’t light up — or quit if you do. “Smoking is definitely associated with a higher risk of atypical pneumonia,” Hill explains. “So not starting smoking and stopping if you are smoking are good ways to prevent it.”

While experts say there’s no 100 percent sure way to prevent atypical pneumonia, as with lots of common maladies, it’s worth making the effort to stay healthy — and to keep others from catching a nagging illness as well.

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What to Do About Walking Pneumonia originally appeared on usnews.com