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Take heed of coughs, colds, fever; it could be ‘walking pneumonia’
View(s):Infection spreads rapidly within the home, the school, the workplace and ultimately the community; more virulent in children
By Kumudini Hettiarachchi
Ill but not very ill, that is why it is known as “walking pneumonia”.
The “barking”, rasping or hacking cough which wracks the whole body is an indication of what it is – mycoplasma infection that is all around us.
“This infection is caused by a micro-organism, the smallest self-replicating entity, which is a cross between a bacterium and a virus,” says Prof. Pujitha Wickramasinghe, Professor in Paediatrics, Faculty of Medicine, University of Colombo.
Mycoplasma pneumonae is the common cause of community acquired pneumonia, the Sunday Times learns. Among children and adolescents, whom it is more prevalent, about 10-40% of community-acquired pneumonia is caused by the mycoplasma infection.
As this infection is not debilitating, men, women and children get about their business. With droplets when a person suffering this illness coughs and sneezes as well as his sputum carrying the germs, the infection spreads rapidly within the home, the school, the workplace and ultimately the community. Close contact is the culprit responsible for its spread, according to Prof. Wickramasinghe who is also an Honorary Consultant at the Lady Ridgeway Hospital for Children in Colombo.
Although the symptoms, very similar to those of the flu, are in many cases confined to the respiratory tract, they can also vary from person to person. The symptoms include low-grade, “coming and going” fever, hovering between 99-101F (37-38C) once in 24 hours; coughing, sneezing, runny nose, sore throat, body including joint and muscle aches and pains and general lethargy and malaise.
“Even though the primary site of the infection is the upper airway, it can also affect other organs to a varying degree,” explains Prof. Wickramasinghe, pointing out that the patient may suffer from a tummy-ache and a tummy-upset and pass stools twice or thrice a day. The consistency of the stools may not be normal but at the same time not as fluid as someone suffering from gastroenteritis. Sometimes there could also be a skin rash varying from what looks like a simple sweat rash to large, red ulcerated skin lesions.
Rarely, according to him, the person may have meningitis-like symptoms of severe headache and difficulty looking at light. Once the symptoms surface, there is no need to rush for blood tests but resort to the usual management of giving paracetamol, sponging with tepid water and making the patient comfortable. Fluids should be given as most children with sore throats are off-food because it is painful to swallow.
“Don’t worry about the child taking less food, but give more fluids,” he says.
So how much fluid should be given? The rule of thumb is that a child who is ill should be given in millilitres four to five times his weight in kilograms, per hour. Citing an example, he says that if the child is 10kg, then a minimum of 40-50 ml should be given per hour. This is while coaxing the child to take a little food when the temperature is under control. Warm drinks would help to soothe the sore throat as also fomenting the neck with a warm towel. Steam inhalation would help where there is severe congestion in the nostrils.
Rest is vital, urges Prof. Wickramasinghe, as otherwise complications of mycoplasma infection can lead to the heart muscles getting affected. With the incubation period being 1-3 weeks, the infection would circulate among family members easily and rapidly while also re-infecting those who have recovered. As the infection has a self-limiting course, older siblings or adults may have had symptoms that were not too bad and even may not be linked to a younger child who is affected later. “It is more virulent in children,” he points out.
If the coughing bouts are bad, a doctor should be consulted as a course of antibiotics may be needed. No specific test is available to identify mycoplasma infection but a full-blood count would be helpful, 48 hours after the onset of the illness.
There is no vaccine and the best way to prevent the spread of mycoplasma infection is to isolate the patient. In homes, windows should be thrown open to keep the interior well aerated with fresh air. There is no lifelong immunity after one attack, but repeated bouts make it less severe, which is why adults don’t get virulent attacks.
Hospitalisation is not required, unless there are complications, even though it is called pneumonia. But if the fever persists for three days, seek medical advice, he adds.
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