RVA Parenting: Is Pneumonia Contagious?

Parents get confused. They say, Oh, what do I do? My kid’s got pneumonia. How do I protect my other children?”

“Well, pneumonia is not really contagious. Although I have seen where multiple family members have gotten pneumonia,” says Dr. Jeff Bennett, D.O., FAAP of KidMed.

Typically, your immune system kind of takes a hit when you have a cold virus. “The bacteria that live in our bronchi and bronchioles can become overgrown, become infected with more bacteria, and then inflammation comes in. So, that's what we see on X-ray. We see a lot of inflammation. We see a white, cloudy appearance on some of those kids,” says Dr. Bennett.

Dr. Bennett says the most important thing is actually trying to figure out who has pneumonia and who doesn't have pneumonia.

“Pneumonia's not always easy to diagnose with a physical exam, and I think a real problem is one, it can be over-diagnosed, because crackles do not mean you have pneumonia. So if you listen with your stethoscope and you hear crackles, mucus plugging and wheezing can cause crackles, so not everybody that crackles has pneumonia,” says Dr. Bennett. “And on the other side, people that don't have any abnormal breath sounds can have pneumonia.”

“I've always gone with a theory ... because the respiratory infections that are viral, typically over the course of three days, the fever typically will come down,” says Dr. Bennett. “So, if you have an ascending fever or a fever that doesn't go away after three days with a cough, I usually get an X-ray; and the American Academy of Pediatrics also recommends a chest X-ray for kids that have had fever for five days, even without a cough.”

People can have pneumonia and never even cough, so chest X-rays are a really important tool, because physical exam, especially in a little kid, it's hard to get a little kid to take a deep breath, says Dr. Bennett. “But, even the kids that are cooperative and can take a deep breath, even after seeing the pneumonia on X-ray, you can go back and listen with your stethoscope and still not hear the pneumonia.”

So it's not just physical exam, says Dr. Bennett, “It's really a clinical situation where the kids are coughing and having a high fever and the fever's not getting better … or even coughing for a prolonged period of time, because 5% of kids don't even have fever with pneumonia.”

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