You Wanted to Know: Walking Pneumonia

sick woman with cough in bed

The cooler weather is here to remind us that flu season is around the corner. And while we should all be going out for flu shots to protect ourselves from the flu virus, bacterial pneumonia is a more insidious side to the cold weather that can also show up around this time.

Pneumonia is common and dangerous among older adults, but younger people can get it, too. One of our viewers asked me for more information on the risk factors for pneumonia and how you can protect yourself from repeat infections:


There are two types of pneumonia we talk about in medicine. The first is typical pneumonia or community-acquired pneumonia (CAP). This type generally affects young children and older adults and can make you very sick over a short period of time. The top three bacteria usually associated with this type of pneumonia are Streptococcus pneumonia (different from the Strep that causes Strep throat), Haemophilus influenza and Moraxella catarrhalis that account for about 85% of the two to four million cases per year.

Symptoms include cough, fever, chest pain when taking deep breaths, trouble breathing and a lot of mucus production. These infections are normally treated with antibiotics once the illness is found to be bacterial and may require hospitalization depending on how bad the symptoms are.

The other type is atypical pneumonia, more commonly known as “walking pneumonia.” It gets this moniker because the symptoms are generally less severe than typical pneumonia, allowing those infected to continue “walking” around. Infection may seem more like a bad cold that never really seems to go away.

The perpetrators typically responsible for this type of pneumonia are Mycoplasma pneumoniae, Legionnaires, and Chlamydophila pneumoniae (also known as Chlamydia pneumonia which is what our viewer had). These bugs tend to infect younger, healthier individuals. In particular, Chlamydia pneumonia affects young people and is exceedingly common. Almost everyone by 20 years of age has signs of previous infection with the organism and infections are generally mild.

Individuals become more vulnerable to infection when their lungs are damaged or if their immune system isn’t working well, which can happen in diseases like diabetes. Smoking is a major risk factor for pneumonias of all kinds. Smoking damages your lungs’ lining and natural protective mechanisms in a way that increases infection. Smoking can also lead to lung diseases like COPD that make it harder for your lungs to protect themselves. Quitting dramatically decreases your risk of pneumonia.

Viruses like the flu or pertussis that causes whooping cough can also damage your lungs, making them more vulnerable to infection with bacteria. This is why someone might start out with a viral illness that may suddenly get worse when their weakened lungs are infected with bacteria. While we all should have been vaccinated against whooping cough, immunity can wane over time so it’s still possible to get it. This is why it’s important to get all five initial doses and then a booster at 20 years old.

So the question is, if you get it once, will you get it again? That depends on whether any of your risk factors have changed from the first infection. Here are some things you can do:

  • Stay on top of any chronic illnesses you have. Diseases like diabetes can depress your immune system if not properly treated and make you more vulnerable.
  • Quit smoking if you smoke. I’ve put together some resources to help get you started.
  • Get the flu vaccine every year and make sure you’re up to date on all vaccinations.
  • Eat lots of fruits and vegetables and drink plenty of fluids.
  • Wash your hands in warm soapy water regularly throughout the day.

In this case, it’s not possible to completely protect yourself from ever getting pneumonia. But you can dramatically reduce your chances by taking these steps to protect your health.