Walking pneumonia : An expert explains the what, why and how of it

CEBU CITY, Philippines — Have you ever wondered what a “walking pneumonia” is? How is it different from influenza?

Should we be alarmed especially with the gatherings these Christmas season? Are there cases of “walking pneumonia” here in the region?

Dr. Eugenia Mercedes Cañal, regional epidemiologist of the Regional Epidemiology and Surveillance Unit of the Department of Health in Central Visayas (Resu of DOH-7), said that there had been no cases recorded of “walking pneumonia” in the region.

Cañal said the four reported cases of the disease in the country were recorded from the Cordillera Administrative Region and National Capital Region.

READ: ‘Walking pneumonia’: DOH logs 4 cases in PH this year

What is walking pneumonnia

“Walking pneumonia” is an “atypical pneumonia” usually caused by a bacteria called mycoplasma pneumoniae.

She said that several doctors and clinicians were not alarmed with the mycoplasma pneumoniae because it had been “very common.”

“It’s just that siguro si epidemiology bureau nakakuha siyag specimen ato, na test niya. Mao tong naa tay reported four cases of that. Pero si mycoplasma pneumoniae, walking pneumonia ang tawag sa iyaha because wala kaayo siya simptoma. Dili kaayo siya (the person afflicted with it or the patient) mohigda gyud kay gi-ubo,” she said.

(It is just that perhaps the epidemiology bureau got a specimen for that, and tested it. That is why we have four cases of that. But mycoplasma pneumoniae, it is called ‘walking pneumonia’ because it really does not show any symptoms. The patient or the person afflicted with it would not lie down in bed to rest because he or she has a cough.)

READ: Amid growing concerns, health experts allay fears over ‘walking pneumonia’

Dr. Eugenia Mercedes Cañal, regional epidemiologist of the Regional Epidemiology and Surveillance Unit of the Department of Health in Central Visayas (Resu of DOH-7) explains what walking pneumonia is during an Openline forum on Tuesday, December 19. | Screengrab from Openline forum

Symptoms

Cañal said that the patient would experience a low-grade fever, the cough would be non-productive or it would not have a phlegm or dry cough.

Cañal said as for mycoplasma pneumoniae, she was confident that our doctors here could give the proper diagnosis and could handle it.

“Maong wala kaayo tay kaso diri or maybe wala lang gyud na report tas wala nakuhaan og samples maong wala siya [cases],” she said.

(That is why there are no cases here or maybe it just was not reported and no samples were taken and that is why there are no cases.)

READ: Pneumonia cases on the rise, DOH urges vulnerable groups to keep masks on

Practice ‘Universal precaution’

Amid all these, Cañal advised the public to always do the “universal precaution” which is the hand washing, cough etiquette, wearing of mask, and eating healthy foods.

These precautions could always go a long way to protect one from this kind of disease.

She also said that the RESU of DOH-7 had been monitoring influenza-like illnesses (ILI) in the region.

READ: DOH chief allays fears amid reports of respiratory illnesses in China

Influenza vs walking pneumonia

But Cañal also said that you could not compare influenza to walking pneumonia because influenza is a viral disease while walking pneumonia is a bacterial disease.

Hence, it is “not equatable,” she further said.

“Mycoplasma pneumoniae (the bacteria that causes walking pneumonia) lacks the cell wall. Kumbaga murag wala siyay skin to cover. So that makes (it unique) because of that special niya nga physiologic makeup…mycoplasma pneumoniae needs a special culture media to grow para makuha nato,” she said.

(Mycoplasma pneumoniae lacks the cell wall. It’s like that it does not have a skin cover. Because of that special physiologic makeup…mycoplasma pneumoniae needs a special culture to grow so that we can get them.)

READ: Fighting for breath: Pneumonia continues to kill children worldwide

Challenge in diagnosing

For example, if a person has a cough, the doctor would test his or her phlegm to see what pathogenic organism it is.

“Lisod si mycoplasma pneumoniae. That is why not all the time nga maka-test si doctor ana because most of the time pod, ang presenting symptoms ni case or ni patient would be dry cough and fever. Wala tay expectorate nga makuha. It’s just purely bothersome, nagging cough, and [will last for] two weeks,” she said.

(Mycoplasma pneumoniae is difficult. That is why not all the time that the doctor can test that because most of the time, the presenting symptoms in the case or of the patient would be dry cough and fever. We don’t have an expectorate (or spit) that we can get. It’s just purely bothersome, nagging cough and [will last for] two weeks.)

READ: Vigilance is better than cure

Incubation period

She said that the incubation period of mycoplasma pneumoniae would range from two to four weeks with an average of two to three weeks.

Incubation period means the time of the person’s exposure to the bacteria up to the time when they get the symptom.

The bacteria can also be transferred through direct contact like droplets.

Regular pneumonia and mycoplasma pneumonia have presenting symptoms. Both can cause damage to the lungs, according to Cañal.

A presenting symptom is a symptom that can prompt a patient to consult a doctor.

How this is treated

The problem with mycoplasma pneumoniae is that since it does not have a cell wall, a mere amoxicillin will not be effective for it, she said in mixed English and Cebuano.

“Unlike other typical pneumonia kung tagaan kag amoxicillin, mo-okay ka. Si mycoplasma pneumoniae doesn’t respond to penicillin. So ang iyaha is more on macrolides. Ang example sa macrolides, mga erythromycin, azithromycin,” she said.

(Unlike other typical pneumonia if you are given amoxicillin, you will be okay. Mycoplasma pneumoniae does not respond to penicillin. So for that it is more on macrolides. The example of macrolides, erythromycin, azithromycin.)

(Amoxicillin is a penicillin-type antibiotic while azithromycin is a macrolide antibiotic.)

READ: No outbreak of ‘walking’ pneumonia in PH, says Herbosa

Influenza-like illnesses or ILI

As for the number of cases of ILI in the country,  based on the latest DOH figures, a total of 171,067 ILI infections were reported from Jan. 1 to Oct. 28 this year. 

The number is an increase of 49 percent from the 114,536 ILI cases recorded during the same period last year.

“It is really increasing [ang cases] because kung naay mga reported diha sa atoang barangay up to the regional level, ato na silang gina-minotor ang ILI because influenza-like has the potential to also nga magkaoutbreak ta,” she said.

(It is really increasing [the cases] because if there are reported cases here in the barangay up to th regional level, we are monitoring that because influenza-like has the potential to also lead to an outbreak.)

Not like COVID

“But then again, self-limiting, there’s nothing to worry because it’s viral. It’s not like the COVID nga mo-mutate siya so self-limiting. In three days, maokay naka,” she added.

(But then again, it is self-limiting, there’s nothing to worry because it’s viral. It’s not like the COVID that it will mutate, so it is self-limiting. In three days, you will be okay.)

She clarified that the cases would eventually increase because they would have to record them.

Another factor that has contributed to ILI is because of the climate change where people can experience intense heat and cold weather.

Vaccines from DOH

With this, Cañal advised the public to have their flu and pneumonia shots.

She said that for the pneumonia shots, DOH-7 had the pneumococcal conjugate vaccine (PCV) 23 shots which would be for adults aged 18 years old and above.

She said that it would not recommend this for children because they also had a separate shot for pneumonia.

Free vaccination

Last week, DOH-7 conducted a free vaccination drive against flu, pneumonia, and human papillomavirus (HPV).

There were 826 individuals who received their flu shots, 352 for pneumonia, and 27 for HPV, while those who were not able to get their shots can go to their local government units for free.

“Ang atoang surveillance sa mga diseases murag wala na siya ni cover sa kay Pasko ni, taas ani, murag kaning mga flu and other diseases are just throughout the year. Wala nata gaingon nga ‘kay dengue ni, motaas gyud ni siya sa rainy season,” Cañal said.

(Our surveillance of the diseases, it seems this did not cover Christmas season. What is high here are flu and other diseases are just throughout the year. We did not say that because this is dengue, it will increase during the rainy season.)

Factors

She added that the susceptibility of an individual for any pathogenic organism, may it be influenza, depends on some factors.

First is immunity. If the person’s immune system is low, this means that after three days, the illness might come back.

Another is the person’s physiological and genetic makeup, and anatomical stature.

“Kung naay uban nga gagmay, masakiton, gyud siya but dili bitaw vertically challenged. Naa tay mga genetically nga mga gagmay gyud nga prone pod sila,” she said.

(There are others, who are sickly, but he is not vertically challenged. We have those genetically they are really small and they are prone to sickness.)

Nutrition

One’s nutrition is a factor as well.

“Kung magsige lang ta’g pancit canton, magsige lang ta’g hotdog, so all these are processed foods rich in phosphates,” she said.

(If we often eat pancit canton, we often eat hotdog, so all these are processed foods that are rich in phosphates.)

She also acknowledged that instant foods had become the go-to foods of those in the workforces, saying that these foods had become “a commodity” for them.

“I hope also that they would consider eating healthy foods,” she said.

Fruits and vegetables may be expensive but in the long run, by eating these foods, people can save money from buying medicines or paying hospital bills. | With a report from Inquirer.net