5 Things To Know About Atypical Pneumonia

by JR Thorpe

It was the cough heard round the world — Hillary Clinton has pneumonia. Cue the expansive pieces about mucus, oxygen machines and doctors standing around a hospital bed talking in hushed tones. It turns out, though, that the particular type of pneumonia Clinton has reportedly contracted is relatively mild. She's got herself a case of "walking pneumonia," if reports are to be believed, which means that a considerable amount of information about normal pneumonia doesn't actually apply to her situation. And that means we need to reevaluate our preconceptions regarding what her pneumonia diagnosis means about her future health, her contagiousness, her likelihood to develop complications, and many other aspects of the situation. Let's get medical for a minute.

The problem with any presidential candidate's illness is that it will be immediately politicized; opponents will catastrophize as much as possible without seeming indelicate, while supporters may minimize what's actually happened in an attempt to make the candidate seem healthier than they are. In the case of Clinton, though, she's been dealt a strange card: a disease that sounds much worse than it actually is, but is still significant enough to require antibiotics and a concerted effort to rest. What she chooses to reveal to the public about the extent of her illness remains to be seen, but based on the disease profile itself, Democrats don't have very much to worry about.

1. There Are Viral And Bacterial Types Of Pneumonia

Pneumonia is actually an umbrella term for an inflammation of lung tissue due to infection, and can be caused by several different things. In all cases, though, the tiny air vessels of one or both lungs, which are called alveoli, fill with pus and fluid instead of air, and the body responds with a flood of white blood cells as part of an immune defense. The result? Lungs that can't function properly, making air flow a labored issue.

There's a conception that all pneumonia develops from the flu or from colds, but that's inaccurate. The World Health Organization documents that two distinct types, viral pneumonia and bacterial pneumonia, exist, and within those categories are multiple potential causes that can develop into pneumonia. Bacterial pneumonia, for instance, can be down to an infection by the bacteria Streptococcus pneumoniae, Mycoplasma pneumoniae, or Haemophilus influenzae, while viral pneumonia can be caused by a multitude of viruses, from the flu to rhinovirus and the respiratory syncytial virus (RSV). This diversity is, in part, what causes the confusion; antibiotics are no use against viral pneumonia, and vice versa. There are also significant variations in severity. Some people, like Clinton, are able to work successfully while managing it, while others require hospitalization, oxygen and emergency treatment.

There's also a distinction between "community-acquired" and "hospital-acquired" pneumonia; some people manage to contract pneumonia in hospitals, often through ventilators or other patients. (Where Clinton got hers is a mystery, but her is bacterial, and those kinds are highly contagious, which means that she could have easily picked it up while campaigning.) However, Clinton's was diagnosed outside of any hospital, so she's got nothing else that could complicate the issue.

2. "Walking Pneumonia" Is One Of the Strangest Bacteria In The World

It's been reported that Clinton is suffering from "walking pneumonia," a non-technical term for a very mild case of pneumonia that will clear up in as little as a week. It's a bacterial pneumonia, meaning that Clinton is probably on antibiotics; but the bacteria itself, she may be glad to know, is one of the most unusual in the natural world. "Walking pneumonia" is often caused by Mycoplasma pneumoniae, which was only discovered back in 1944; it's also referred to as "atypical" because the symptoms actually differ from normal pneumonia cases, being milder. In a further twist, the discoverer came across it by accident, and initially thought it was a fungus.

Mycoplasma pneumoniae bacteria are highly unusual cells; they're the smallest organism in the living world capable of "living and reproducing on its own," according to the Center for Disease Control. While other bacteria are capable of causing walking pneumonia, this tiny mover and shaker is the prime candidate. Hurrah for Hillary's innovative lungs.

3. It's Not Nearly As Severe As Typical Pneumonia

The symptoms of typical pneumonia, viral or bacterial, read like a horror show. Coughing up bloody or green mucus! The lungs "crackling" when somebody listens to them through a stethoscope! Clinton's variety, however, is a lot more chilled out, which may have delayed initial diagnosis, as it can approximate a case of flu. The New York Times' Health Guide lays out the most common symptoms as chills, coughs, a bit of a fever and difficulty in breathing easily, and the coughs are usually "unproductive," meaning they don't bring up any nasties. It's good for Clinton's campaign that she doesn't have typical pneumonia, because the Trump campaign would rapidly seize on one of the symptoms of ferocious typical pneumonia in people over 65: mental confusion and shifts in thinking. (Clinton, while clearly in possession of all her marbles, is 68, and therefore would be in the danger zone for this particular concern.) Walking pneumonia can cause central nervous system problems in rare cases, but Clinton would have to be extremely unlucky.

Walking pneumonia is actually a tough thing to get good statistics on, because of its mildness; it's estimated that a high proportion of infected people believe they've got a cold or simply ignore it entirely. We do know that Clinton is at prime "atypical time," as outbreaks in the USA tend to cluster around the late summer and early fall months; and the Center for Disease Control guesses, roughly, that between one and 10 of every community-acquired pneumonia case is walking pneumonia. The prognosis is extremely good.

4. It Is Only Briefly Contagious

Considering that the incubation period for atypical pneumonia is, according to the Cleveland Clinic, up to 4 weeks, we'll likely never know who exactly passed on the bacteria to Clinton. But people coming to see her on her next campaign trail stop can be assured that it's likely her contagious period will be over shortly; it's only contagious for about 10 days. And that's assuming that she's got the mycoplasma type. There are two other common causes of atypical pneumonia, Chlamydophila pneumonia (derived from chlamydia, but not sexually transmitted) and Legionella pneumonia (or Legionnaire's disease). The first is spread by coughing and sneezing, like mycoplasma, but the second, Legionella, isn't spread by humans at all; it tends to be inhaled via infected water systems, like showers, humidifiers or whirlpool spas. Nobody could catch it from her even if they wanted to.

5. There's A Vaccine, But Not For This Specific Type Of Pneumonia

A vaccine does exist for pneumonia — but unfortunately for Clinton, it only prevents certain bacterial types, and atypical ones are not among them. You may have heard of a "pneumonia vaccine," but what people really mean is the pneumococcal vaccine, which specifically targets the development of pneumonia and other diseases via infection from Streptococcus pneumoniae bacteria. Even if Clinton has had that (and as an adult over 65 it's likely been recommended to her as a good idea), it won't have done her any good against atypical pneumonia. Neither will the flu shot, as walking pneumonia is bacterial, not viral.

As with any pneumonia diagnosis, we need to be realistic about possible complications, which, in the case of atypical pneumonia, are the real threat as opposed to the illness itself. It can "deepen" into a more severe pneumonia, cause renal problems, or create brain swelling; but many of these are based on scenarios when care wasn't given immediately or wasn't available. Being a nominee for President gives you many things, and prompt access to the world's best healthcare is among them.

Overall, Clinton's public comments that she'll be back to work and is feeling better are completely fitting with the diagnosis; and as long as she stays away from hot tubs and sneezing people, she'll likely be fine for the remainder of the electoral cycle. Fingers crossed.

Images: Giphy