Eugene Mymrin / Getty Images Infections with a common type of bacteria that can cause walking pneumonia are increasing in the United States among all age groups, especially children, U.S. health officials say. Called Mycoplasma pneumoniae, the germ typically causes a chest cold, with symptoms ranging from a sore throat to a headache. But it can cause more serious illness in kids and adults alike. One study found that Mycoplasma pneumoniae is the second most common bacteria that causes pneumonia in hospitalized adults. Subscribe to AARP's Your Health Newsletter A healthy dose of news, expert tips, Medicare updates and more for your health. According to the Centers for Disease Control and Prevention (CDC), cases started climbing in the spring and have remained high. (There was also a spike in late 2023.) Here’s what you need to know about Mycoplasma pneumoniae, including how to best protect yourself from an infection this fall and winter. 1. Mycoplasma pneumoniae isn’t new Though you may not have heard of it before, Mycoplasma pneumoniae, which can damage the lining of the respiratory system, has been around for decades — scientists identified it in 1944, according to the CDC. Each year, it causes at least 2 million infections in the U.S., though health experts say that number is likely much greater, since many cases go undiagnosed. 2. An uptick in cases isn’t surprising Andrew Pekosz, a professor of microbiology at Johns Hopkins Bloomberg School of Public Health, says we typically see surges of Mycoplasma pneumoniae every few years — three to seven, according to the CDC — so it’s not unexpected to see one now. The COVID-19 pandemic may also play a role. “We’ve actually seen a lot of recurrences of infections that were common before the pandemic that we saw temporarily suppressed to some extent during the time where we were using precautions [and things were shut down],” says Beth Thielen, M.D., an assistant professor and specialist in adult and pediatric infectious diseases at University of Minnesota Medical School.
“With a lot of these infections, the natural history is that you get infected, you get some transient boost in your immunity, and then that immunity wanes over a period of years, and then over time, you’re susceptible until the next time you’re exposed. And so it may very well be that we’re seeing a sort of rebound to some of these infections that people haven’t seen in a few years because of all the COVID precautions,” she says. The CDC says Mycoplasma pneumoniae began to re-emerge globally in 2023 “after a prolonged period of low incidence of infections since the start of the COVID-19 pandemic.” 3. It can cause a milder ‘walking pneumonia’ Mycoplasma pneumoniae infections are most common in children and young adults, but anyone can be affected, the CDC says. Typically, symptoms are mild and may include a sore throat, headache, fatigue, fever, a cough and sometimes a rash. But Mycoplasma pneumoniae can cause pneumonia, or inflammation of the lungs, and is the most common cause of “walking pneumonia” in the U.S. (Walking pneumonia, also called atypical pneumonia, is a milder form of the disease that usually doesn’t require bed rest, though symptoms tend to be “a little bit more lingering,” Thielen says.) Sometimes an infection can turn severe and lead to more serious pneumonia, asthma attacks, kidney problems and other health issues. People at higher risk for a severe case of Mycoplasma pneumoniae include those with an underlying lung condition, individuals with a weakened immune system and people who are recouping from a respiratory illness, the CDC says. Most people recover from a Mycoplasma pneumoniae infection without requiring a prescription from the doctor. However, specific types of antibiotics can be used to treat pneumonia caused by the bacterium. 4. Staying up to date on vaccines can help Like COVID-19, influenza and many other common respiratory illnesses, Mycoplasma pneumoniae is spread through small droplets produced when an infected person coughs or sneezes. This means most of us are already familiar with the actions that can help prevent an infection, such as staying home when you’re sick and washing your hands often. “All the same things hold true,” Pekosz says, referring to COVID-19 and flu precautions.
Wearing a mask when you’re in a crowded environment can also help reduce your risk. Another thing: Although there’s not a vaccine that can defend against Mycoplasma pneumoniae, getting vaccinated for flu, COVID-19 and RSV can be protective. “Sometimes people get a viral infection first and then go on to get bacterial infections after. The viral infection sort of opens the door and then lets these bacterial infections in,” Thielen says. Doctors refer to this as a secondary infection. “So I think anything people can do to generally protect the respiratory health and protect themselves from other types of infections that we see this time of year is helpful,” she adds. Symptoms of Walking Pneumonia Walking pneumonia symptoms, which can persist for weeks, include: Sore throat Fatigue Chest pain or discomfort Fever Cough Headache Runny nose Ear pain Source: Cleveland Clinic, Mayo Clinic Plus, COVID-19, flu and RSV can all cause pneumonia, too. And don’t forget about Streptococcus pneumoniae, or pneumococcus — the most common cause of bacterial pneumonia in the U.S. “And older adults are eligible for that vaccine as well,” Thielen says. The CDC recently updated its pneumococcal vaccine recommendations to say adults 50 and older should get the shot. Previous recommendations were for people 65-plus. 5. Precautions, not panic With reports of Mycoplasma pneumoniae cases on the rise, now is not a time to panic, Thielen says, but instead to remember all the precautions that can help protect you from this bug and others circulating this time of year. “There are some basic techniques that work pretty well against many respiratory pathogens,” Thielen says. “I say do the best you can as much of the time as you can during this high-risk season, and hopefully that’ll bring the burden of disease down for all of us.”
Getty Images Many think of alcohol as the main cause of liver complications. But contrary to popular belief, various factors impact liver health, including weight, certain medications, genetics and even viral infections. No matter the trigger, a major concern surrounding liver disease is its silent progression. Your liver could be losing its ability to filter out harmful substances from your blood long before symptoms appear. Most of the time you don’t know your liver has been harmed until you develop the advanced symptoms of cirrhosis. “That’s the tough part of treatment,” says Anurag Maheshwari, M.D., a gastroenterologist with the Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. “Convincing patients that they need to act now in order to avoid complications in the future can sometimes be a challenge, because they don’t feel any different today.” Early symptoms and warning signs of liver damage In the early stages of chronic liver disease there are often no symptoms. Occasionally people with early-stage liver disease experience fatigue, right-side abdominal pain, increased bruising or itching — symptoms that are usually missed because they could be caused by other ailments. Getty Images Where is the liver? The liver is located in the upper-right portion of the abdomen, below the diaphragm and on top of the stomach, right kidney and intestines. In adults, it weighs about three pounds and is shaped like a cone. “If you have discomfort on your side, for instance, it could be a million other things,” says Jamile Wakim-Fleming, M.D., director of the Fatty Liver Disease Program at Cleveland Clinic. Routine checkups, lab tests or imaging studies are typically how patients first find out if they’re developing a liver problem or disease. Signs of advanced liver disease As liver disease advances, the signs become clearer and warrant immediate medical attention. These symptoms include: Jaundice or yellowing of the eyes or skin. Pain and distention of the abdomen due to the release of fluid from the liver. Swelling of the lower legs due to fluid retention. Confusion or forgetfulness. When the liver isn’t functioning properly, toxins build up in the blood and can travel to the brain, affecting brain function. Dark-colored urine. Pale-colored stool. Chronic fatigue. Nausea or vomiting Liver disease and age Older adults who are in good health are not inherently more prone to liver disease. But older age can amplify the severity of symptoms associated with liver problems, making recovery more challenging. What’s more, treatments may not work as well in older people as they do in younger people. 5 causes of liver disease It’s always better to prevent liver failure than to treat it. Here are some common — and not so common — risks and how you can avoid or stop the damage.
Risk No. 1: Alcohol intake We all know that alcohol can be hard on your liver. But how much is too much? Maheshwari notes that a safe alcohol limit may seem surprisingly low: no more than one alcoholic beverage a day (or seven drinks in a one-week period) for women and two or fewer drinks for men (or 14 drinks over a week’s time). “When patients drink alcohol in excess, beyond the capacity of the liver to metabolize it, the excess alcohol is turned into fat and stored,” Maheshwari says. “Called steatosis, this fat interferes with the liver’s function and causes cell death.” The good news? Putting the brakes on alcohol consumption can stop the progression of fibrosis, and liver function may improve. “But it depends on when it was caught,” says Wakim-Fleming. “A lot of people who have alcoholic liver disease end up needing liver transplants because they don’t stop drinking until [too] late.” If you suspect you may have a problem, talk to your doctor, who may refer you to a specialist for evaluation and tests. Risk No. 2: Weight With obesity rates on the rise in the U.S., there’s been — along with an alarming increase in diabetes and other metabolic ills — a growing epidemic of nonalcoholic fatty liver disease (NAFLD), which occurs when too much fat is stored in the liver. “Obesity, diabetes, high blood pressure, high cholesterol — common features of metabolic syndrome — are all known major risk factors for the development of fatty liver disease,” says Craig Lammert, M.D., associate professor of medicine at the Indiana University School of Medicine and a practicing gastroenterologist and hepatologist at IU Health. As with alcohol-related liver damage, these conditions cause fat to be deposited in the liver. “The scary piece of this is, anywhere from 15 to 50 percent of the nation’s population may have too much fat in the liver,” says Lammert. Of those, he says, about 5 percent are at risk of inflammation that can damage the liver. “But we don’t always know who that’s going to be.” Inflammation hurts the liver by way of a condition known as nonalcoholic steatohepatitis (NASH), which damages and kills liver cells. “We’re hearing a lot about this because over the next few years, fatty liver disease will probably be near the top, if not the top, cause for liver transplantation in this country,” Lammert notes. If you’re carrying around excess pounds or battling diabetes, high cholesterol or high blood pressure, the risk of liver failure just adds another good reason to shed some weight and get your blood sugar, cholesterol and blood pressure under control. Although there is no cure for NAFLD, it can be reversed. Diet, exercise can reverse liver damage A new study published in the Journal of Hepatology found that diet and exercise are an effective way to treat and improve liver disease that’s often associated with excess weight. Researchers at the University of Missouri School of Medicine divided 24 patients with a type of liver disease caused by excessive fat buildup into two groups. One followed an intensive diet and exercise program for 10 months; the other followed the standard of care treatment. The diet and exercise group saw “significant and clinically meaningful” effects on their liver health, the researchers discovered with imaging and diagnostic biopsies. “Obesity and diabetes are going up in the country, and they are the two main risk factors for fatty liver disease,” said study author Elizabeth Parks, a professor of nutrition and exercise physiology at the University of Missouri School of Medicine. “We know diet and exercise can alleviate these health conditions. Liver disease is increasing too fast. We were able to show in our research how diet and exercise should be the mainstay of treatment for the disease.” Risk No. 3: Drugs and supplements Certain drugs and supplements can also injure your liver, depending on the dose and other factors. Taking too much acetaminophen (Tylenol) is the most common over-the-counter risk. “People who overdose with Tylenol overwhelm the metabolizing system and drive liver toxicity,” Lammert says. But patients should have few problems if they take the pain reliever as prescribed, which includes consuming no more than 4,000 milligrams in a day. Those with existing liver disease may be advised to take less than 2,000 milligrams. One caveat: If you’re taking acetaminophen at those levels, be sure to avoid alcohol, which would add to the cumulative burden on the liver, Lammert advises. Other painkillers, including NSAIDs like ibuprofen (Motrin) and naproxen (Aleve), can be similarly harmful under the same circumstances. If you are taking anything approaching the maximum dose of acetaminophen, be aware that the drug is often found in other products, such as multi-symptom cold and flu formulations, making it easy to unwittingly double the amount you are taking. So be sure to check product labels for acetaminophen. Surprisingly, “antibiotics are probably the most important cause of liver injury we see,” Lammert says. This is particularly true of Augmentin (a combination of amoxicillin and clavulanate), which is used to treat common bacterial problems like sinus and urinary tract infections. Liver complications affect an estimated 30,000 people a year taking this compound in the U.S. And although most of the harm is temporary, some is so damaging as to require a liver transplant. There are also reports of liver damage with certain supplements, including bodybuilding and weight-loss supplements that contain green tea extract, linoleic acid and androgenic anabolic steroids. Even two essential nutrients, vitamin A and niacin, can harm the liver if taken above the recommended doses. Risk No. 4: Viral infections Hepatitis B and C are viral infections of the liver that can lead to liver damage and even cancer. (The vast majority of people with hepatitis A recover with no lasting harm.) As with other liver diseases, people with hepatitis often don’t have symptoms and may not know they are infected, Wakim-Fleming says. People contract hepatitis B (HBV) through blood, semen and other body fluids and by sharing personal items (needles, razors) with someone who has the infection. Hepatitis C (HCV) is contracted through contact with the blood of someone with HCV, often through the sharing of drug paraphernalia or through a transfusion of contaminated blood or organ transplant prior to 1992, when blood started to be screened for the virus. More than half of people with HCV develop a chronic infection, and up to 25 percent develop cirrhosis over 10 to 20 years, according to the Centers for Disease Control and Prevention. Vaccines are available for HBV, and everyone ages 18 to 79 should get an HCV test at least once, particularly those born between 1945 and 1965. “The guidelines over the past 10 years or so are that all baby boomers should be screened for hepatitis C,” Lammert says. Despite this recommendation, too few people who are eligible seek testing. “The good news is we now have good treatments to eradicate the disease.” Risk No. 5: Genetics and autoimmune conditions Genetic conditions like hemochromatosis and Wilson’s disease can contribute to the development of liver disease. In these conditions, excess metals can build up in the liver, causing cirrhosis and organ toxicity. Additionally, autoimmune conditions may lead to liver disease and, to some extent, genetics may play a role as well. The exact cause of autoimmune liver disease is not fully understood by doctors; however, it is theorized that factors such as infection, medication or chemical exposure could act as triggers. While there may be a genetic predisposition, the specific role of genetics in causing autoimmune diseases remains unclear. Treatment for autoimmune liver disease typically involves long-term management, and while the majority of patients respond well to treatment, they often require lifelong medication.
When to see a doctor Given liver disease’s silent nature, patients should see a doctor as soon as they become concerned about their liver function, Maheshwari says. Make sure that routine liver tests are incorporated into physical exams so any abnormalities can be detected early. Note that AST and ALP blood tests, which assess liver function, don’t necessarily correlate with liver injury. If levels are slightly elevated longer than six months, a full evaluation may be necessary to determine the underlying cause. A specialist may administer a noninvasive test, such as an elastography, to better understand liver function. Treatment options for liver disease vary depending on the cause, with a liver transplant being the last resort. For some, eliminating alcohol or inflammatory medications may be necessary. In the case of viral hepatitis, medications may be required to combat the virus. Meanwhile, for individuals dealing with an autoimmune liver disease, a medication to suppress the immune system from attacking itself may be needed. Unfortunately, genetic conditions often have limited treatment options, and a liver transplant becomes the ultimate recourse for those with end-stage liver damage. The Four Stages of Chronic Liver Disease Hepatitis: Inflammation in your liver that can lead to scarring, known as fibrosis Fibrosis: The liver gradually stiffens and scar tissue replaces healthy tissue, restricting blood flow. Some amount of fibrosis can be reversible if detected early because liver cells can regenerate. Cirrhosis: Scarring of the liver becomes irreversible because there are no longer cells healthy enough to regenerate lost tissue. The damage can be slowed or stopped at this stage by consulting a liver specialist. Liver failure: The liver can no longer function adequately for the body’s needs and has lost the ability to regenerate and its function is slowly declining.