October 23, 2024, 11:41 am | Read time: 4 minutes

There is currently an increasing number of cases of pneumonia in children and adolescents – caused by a specific bacterium: mycoplasma. The symptoms that these pathogens can cause are similar to those of a cold and manifest themselves in tiredness, coughing, and, in children, diarrhea, wheezing, and vomiting. FITBOOK editor Julia Freiberger explains the causes, symptoms, and the course of a mycoplasma infection.

What are mycoplasmas?

Mycoplasmas are bacteria that can cause infections in the urinary tract, genital tract, and lungs. As these special bacteria do not have a cell wall, they are resistant to antibiotics such as penicillin, which would attack the cell wall. The dangerous thing about the pathogen “Mycoplasma pneumoniae” is that it can cause so-called atypical pneumonia or pneumonia.

Depending on the species, mycoplasmas can cause different infections in humans (and animals). Due to their high adaptability and small size, they are difficult to combat and, therefore, require special diagnostic and treatment options.²

How common is the disease?

Pneumonia caused by mycoplasma can occur in all age groups. However, it affects children, adolescents, and young adults more frequently. Approximately ten percent of pneumonia cases that occur outside the hospital are due to mycoplasma. Mycoplasmas are easily transmitted, so they spread particularly in groups. Especially when people are in confined spaces, care facilities, schools, or within the family.³

How do you get infected?

A mycoplasma infection is also known as a droplet infection. This means that the pathogen can be transmitted through bodily fluids, such as saliva. This means that an infection usually occurs when two people are in close proximity to each other. Schoolchildren aged between five and fourteen are, therefore, particularly at risk. In addition, people with a weakened immune system are considered susceptible to infection.

It is also possible to become infected by touching objects that are contaminated with infectious bodily secretions. The time between infection and the appearance of the first symptoms (incubation period) can be between two and four weeks.

These are the symptoms

Although the disease is usually mild, it can also be severe in some cases. The problem is that the symptoms often resemble those of flu and include a sore throat, diarrhea, breathing difficulties, or vomiting. As a result, they are often not recognized as symptoms of a mycoplasma infection. In more severe cases, asthma attacks or pneumonia also occur.⁴

Another problem is the gradual progression of the disease, which also makes diagnosis difficult. Compared to typical pneumonia, which is characterized by high fever, severe coughing, and chills, a mycoplasma infection takes a different course. Instead, those affected have a slight fever, shortness of breath, and a dry cough.⁵

The first signs of atypical pneumonia include

• Runny nose
• headache
• Irritating cough or dry cough
• Mild to moderate fever
• “Crackling” when breathing

As these symptoms can also occur with other illnesses, mycoplasma pneumonia is often only recognized late by those affected.

Causes of the disease

“Mycoplasma pneumoniae” behaves like a parasite. The bacterium attaches itself to the special epithelial cells of the respiratory tract, the so-called cilia in the human body. The bacterium has protein structures on its surface that enable it to attach itself to the mobile cilia. The pathogen then migrates from there to the roots of these cilia and multiplies. In doing so, it produces hydrogen peroxide, which enters the cells of the cilia and damages them. As a result, the cilia are restricted in their function – which usually consists of transporting mucus or foreign substances out of the lungs.

In addition, mycoplasmas have various mechanisms with which they can bypass the immune system and protect themselves from defensive reactions. This allows the bacteria to survive longer in the body. In addition, the pathogen cannot carry out certain metabolic processes necessary for reproduction on its own. Instead, the cilia are deprived of the nutrients they need to multiply and survive.⁶

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Current situation in Germany

There is currently only one federal state in Germany where mycoplasma infections must be reported: Saxony. According to the German Society for Pneumology, there were 1238 reported cases there in 2018 (before the coronavirus pandemic). In 2023, this figure rose to around 2019 cases. By mid-September 2024, 12,248 infections had already been registered – a tenfold increase compared to the pre-coronavirus period.⁷

Why are there currently more infections?

According to a report in the scientific journal Lancet, this is apparently a so-called catch-up effect after the coronavirus pandemic.⁸ Measures such as wearing masks or observing social distancing rules during the pandemic are said to have led to a significant reduction in mycoplasma infections. In addition, the contact restrictions and strict hygiene measures are said to have weakened the “herd immunity” of the population, which is now associated with an increased susceptibility to infections.