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“White Lung” Pneumonia – What You Need to Know

December 7, 2023 – How concerned must you be about outbreaks of white lung syndrome pneumonia in children reported in Ohio, Massachusetts and several other countries in Europe?

WebMD asked experts this query, asking whether the cases are related to the same outbreak in China, what symptoms are most typical, and what advice they've for stopping infections of their families and stopping this infection from spreading further.

White lung pneumonia isn't an official medical illness. Rather, it is an indication of pneumonia that shows up as white areas on a lung x-ray and should require further testing to find out whether the pneumonia is viral, bacterial, or attributable to exposure to pollution or chemicals.

We asked Vandana Madhavan, MD, MPH, a pediatric infectious disease expert at Mass General for Children in Boston, and William Schaffner, MD, an infectious disease expert at Vanderbilt University in Nashville, to share their thoughts on white lung pneumonia.

Q: How concerned should we be in regards to the cases of “white pneumonia” reported in Ohio, Massachusetts and a few European countries?

Madhavan: “We are seeing more respiratory infections circulating because it is December and we are in North America and the Northern Hemisphere. Is this a natural seasonal increase? It’s hard to say, but at the moment we are not seeing such a worrying number of specific viral or bacterial infections.”

Schaffner: “Similar things have been observed in Denmark, the Netherlands and here in the United States. That's no surprise. This type of respiratory viruses and Mycoplasma bacteria that are in circulation are very common. Some of them penetrate deeper into the chest and cause pneumonia.”

Q: What are the principal symptoms and are they different from other respiratory infections?

Schaffner: “There are symptoms that affect the upper respiratory tract, such as nasal congestion, runny nose, sore throat and cough when the virus enters the bronchi.” If the virus or bacteria enters the lung substance, it could actually cause difficulty respiration or sputum that suddenly looks greenish or smeared with blood. If any of these items occur, if you have got difficulty respiration, should you develop a high fever, it's possible you'll well have pneumonia. Please contact your doctor immediately.

Madhavan: “Watch for signs of dehydration. Younger children in particular have fewer reserves and are more likely to dehydrate more quickly.” Parents could set up a humidifier in the child's room or let them breathe in steam while showering. For older children, honey in a warm drink may be helpful.

Q: Is there a link to similar illnesses reported in China?

Schaffner: “There was a lot of uproar about white pneumonia. It started with a report in northern China that there was an increase in pneumonia. The Chinese have learned something since COVID – because everyone was afraid we've seen this movie before.” Chinese officials met with experts at the World Health Organization, where the Chinese health ministry said there was no new virus. “This was nothing like COVID. Instead, it was an early, seasonal increase in respiratory infections, including pneumonia, caused by a variety of respiratory viruses over the winter.”

Q: How serious are the cases reported within the United States?

Schaffner: “There is a spectrum. Many people, children and the elderly, have minor respiratory infections that can be treated at home. But every year we have to admit some children and some adults to the hospital because they suffer from pneumonia and difficulty breathing.” Some even need short-term ventilation, he said. “The vast majority of people are doing better. That should be reassuring.”

Q: Is there any advice on steps parents can take to guard their children and stop further spread of this disease?

Madhavan: “Wash your hands, make certain your child doesn't exit in the event that they're sick – and ask if everyone seems to be OK once you go to a celebration or holiday gathering.” Wearing a mask in crowded public areas could also help, she said. “Also, make sure your family is up to date on vaccinations for influenza, COVID and respiratory syncytial virus (RSV).”

Schaffner: “I want to remind everyone that we have some vaccines available.” Vaccines for flu, RSV and COVID-19 can be found for a lot of, many individuals, he said. “Beyond vaccinations, we should try to be careful and avoid people who cough and sneeze. The second thing, which is also difficult in some households, is not sending your child to daycare when someone is sick. You can just pass it on to everyone else.”