Outbreak of Mycoplasma pneumoniae at a military academy
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LETTER TO THE EDITOR
Open Access
Outbreak of Mycoplasma pneumoniae at a military academy Xin Zhang1†, Min-Na Han2†, Jing-Hui Dong3, Xiao-Xi Li4, Xian-Yun Hu2, Zhi Wang2, En-Qiang Qin1, Jing Li5, Jun-Yuan Tan5, Fu-Sheng Wang1* and Lei Huang1*
Abstract In 2019, an outbreak of Mycoplasma pneumoniae occurred at a military academy in China. The attack rate (10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic. Keywords: Mycoplasma pneumoniae, Epidemiological survey, Disease control and prevention Dear editor, Mycoplasma pneumoniae may be the causative agent of 70% in crowded populations such as military personnel and students [1]. In the winter of 2019, a M. pneumoniae outbreak occurred at a military academy in China. Here we report the result of epidemiological investigation and disease prevention/ control measures. The outbreak occurred among training freshmen, the barracks were devoid of heating equipment, with residence area of 2.8–3.2 m2 per capita. All cadets ate at one cafeteria. Since late November 2019, total 15 cadets developed cold-like symptoms, all of them tested positive for M. pneumoniae IgM antibody, and several had CT scan-confirmed pneumonia. As the outbreak continued to spread, the patients were isolated in a temporary ward in early December. As strict prevention and control measures were timely implemented, new cases quickly declined, and the last case was reported on January 1st 2020.
* Correspondence: [email protected]; [email protected] † Xin Zhang and Min-Na Han contributed equally to this work. 1 Center for Infectious Disease, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Full list of author information is available at the end of the article
The attack rate was 10.08% (60/595), with a total of 36 confirmed cases and 24 suspected cases (case definition see Additional file: Appendix I). The outbreak lasted 102 days, with four peaks. The interval between each peak was nearly the incubation period (Fig. 1). The 60 cases were distributed among five companies: 12 in company G, 10 in company H, 17 in company I, four in company J, and 17 in company K. The highest attack rate was in company K (17/110, 15.45%) and the lowest in company J (4/118, 3.39%). There were significant differences in attack rate between companies H and K (χ2 = 3.515, p = 0.048), G and J (χ2 = 3.871, p = 0.042), I and J (χ2 = 9.351, p = 0.002), and J and K (χ2 = 9.910, p = 0.001; Additional file: Appendix Table S1 and Appendix Figure S1). We obtained complete medical records for 33 cases, including 19 confirmed and 14 suspected cases. The most common symptoms were cough (30/33) and fever (27/33). Other symptoms included runny nose (27, 81.82%), rhinobyon (23, 69.70%), sore throat (22, 66.67%), sneezing (21, 63.64%), fatigue (21, 63.64%) and headache (18, 54.55%
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