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C. pneumoniae responsible for Air Force Academy pneumonia outbreak
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An outbreak of pneumonia at the United States Air Force Academy may have resulted from the spread of Chlamydophila pneumoniae among close living quarters, according to recent data.
Researchers investigated a radiography-confirmed cluster of pneumonia cases identified through routine monitoring by the preventive medicine staff at the academy in Colorado Springs, Colorado, starting in October 2013. The facility houses approximately 4,000 cadets who receive health care at the academy clinic or other military installations; about 80% of the cadets are men.
Nine cases of pneumonia were identified among the football team during October, while only eight cases had been diagnosed among the entire cadet population the previous academic year. While this cluster had a relatively high prevalence of mild upper respiratory infections, there were no cases of pneumonia among cadets not on the football team.
Diagnosis of the first pneumonia case in an individual not on the football team was made in November 2013. Primary care providers at the cadet medical clinic collected nasal wash samples from all cadets with symptoms of upper respiratory infection, and infection control guidance was formulated. Due to the close living quarters in the dormitories, the preventive recommendations emphasized personal hygiene practices, social distancing, decontamination of common contact surfaces and the use of surgical masks.
The outbreak continued through May 2014, and resulted in 102 pneumonia cases among cadets. Pneumonia was confirmed in men (n = 74) and women (n = 28), and every class year and cadet group was affected.
Of 68 nasal wash samples tested, 15 were from cadets with pneumonia. Eleven cadets were positive for C. pneumoniae; one cadet was positive for influenza A (H1N1) virus, and three were negative for both. Of the 53 specimens collected from cadets with upper respiratory infection symptoms without pneumonia diagnoses, 36% were positive for C. pneumoniae.
While aggressive infection control precautions remained in place throughout the outbreak, the stoppage in new cases was likely attributable to the cadets’ departure from the academy after senior graduation.
According to the researchers, C. pneumoniae may go undiagnosed in close-quarters living environments, and, although the infection is generally mild, may be linked to chronic conditions such as atherosclerosis and asthma.
“We suspect that routine testing for C. pneumoniae in outbreak situations is rare,” the researchers wrote. “Therefore, it is possible that C. pneumoniae commonly emerges on college campuses, in prisons, and other military training environments without any reporting.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
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