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M. pneumoniae causes respiratory illness outbreak in care facility
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An outbreak of respiratory illness at a long-term care facility in Nebraska was linked to Mycoplasma pneumoniae. During the outbreak, 55 patients experienced symptoms of the illness, 12 were hospitalized and seven died, according to a report in MMWR. PCR testing of nasopharyngeal swabs, oropharyngeal swabs and autopsy specimens identified M. pneumoniae DNA in 40% of the samples.
“M. pneumoniae usually is not associated with fatalities, and outbreaks are not commonly reported among geriatric populations,” the investigators wrote. “However, older persons are at increased risk for death, and diagnosis of M. pneumoniae infection can be delayed because older patients, who might have dementia and other comorbidities, often do not have fever or classic pneumonia symptoms.”
The facility notified the East Central District Health Department (ECDHD) and the Nebraska Department of Health and Human Services of the outbreak in June 2014. At the time, the facility had 143 residents and 132 staff members. The outbreak originated in the Alzheimer’s unit on June 2. By June 20, the facility reported 22 residents with a respiratory illness of unknown etiology.
On June 28, M. pneumoniae was first reported in one specimen. Local health care providers in eight affected and adjacent counties were notified and asked to notify the ECDHD of patients with a fever of 100.4°F or higher, a pneumonia diagnosis and an epidemiologic link to the facility. The CDC performed PCR testing on 35 of the 55 people with probable illness; 14 were positive for M. pneumoniae. Twenty of the cases were facility residents, 22 were staff members, and 13 were community members.
The ECDHD closed the facility to new admissions on June 24 and suspended group activities. Ill residents were confined to their rooms, and the facility isolated affected hallways, requested no visitors and implemented droplet precautions. Facility admissions restarted on September 14, 1 month after the onset date of the last illness.
“Long-term care facilities should consider M. pneumoniae during respiratory illness outbreaks,” the investigators wrote. “These facilities need to be alert to outbreaks and plan for prompt diagnostic testing, isolation or cohorting of ill residents, and screening of staff members for illness.” – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.
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