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Denmark SSI Declares A Mycoplasma Pneumonia Epidemic - ECDC Update Dec 1st

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  • Denmark SSI Declares A Mycoplasma Pneumonia Epidemic - ECDC Update Dec 1st

    Denmark SSI Declares A Mycoplasma Pneumonia Epidemic






    #17,787

    While all eyes remain firmly fixed on China's outbreak of respiratory illnesses - which are said to be a mixture of flu, RSV, COVID, and Mycoplasma Pneumonia (MP) - there are reports of upticks in MP in other countries around the globe as well.

    Last week the Netherlands reported (see FluTrackers thread) what they described as a`. . . striking number of children and young people with pneumonia.' (see NIVIL chartbelow).



    Today Denmark's SSI has released a similar report (see below), declaring that Mycoplasma Pneumonia has now reached an epidemic level.






    First their statement, after which I'll return with a postscript.

    There is an epidemic of mycoplasma infections - also known as cold pneumonia

    Since the summer, there has been an increase in the number of respiratory infections with Mycoplasma pneumoniae, and the occurrence has now reached an epidemic level with significantly more cases than usual.


    Last edited on November 29, 2023Mycoplasma

    In recent weeks, an increasing number of Danes have been tested positive for Mycoplasma pneumoniae (MP), also known as 'cold pneumonia'.

    The number is now so high that it is an epidemic, assesses the Statens Serum Institut.

    "In the past five weeks, the number of new cases has increased significantly,I and we are now seeing significantly more cases than usual, and that there is widespread infection throughout the country", says senior researcher Hanne-Dorthe Emborg from the Statens Serum Institut.
    In week 47, 541 new cases of MP infection were detected, which is more than threefold since week 42, when the number of detected cases was 168. The real number of cases is probably much higher, as not everyone with mild symptoms is tested.

    The disease often presents as mild flu-like symptoms with fatigue, headache, sore throat and prolonged dry cough, especially nocturnal cough. The vast majority have a fever, but often not as high a fever as with influenza and other more classic pneumonia. This has given it the nicknames 'cold pneumonia' or 'atypical pneumonia', as regular penicillin has no effect on the infection either.

    Epidemics every four years

    In Denmark, there have historically been nationwide epidemics of MP infections approximately every four years, and the incidence is typically highest in autumn and early winter.

    "Mycoplasma infections come in waves, where the disease affects the groups in the population that have not yet built up immunity. Therefore, it is also typically a disease seen among school children aged 6-12", explains Hanne-Dorthe Emborg.

    The most recent epidemic was in 2015-2018, when there was high incidence in three consecutive seasons. Also in 2019 to 2020 - immediately before the covid-19 pandemic - there was a high number of cases, but during the covid-19 pandemic the number of cases fell to an unusually low level due to the shutdowns, explains Hanne-Dorthe Emborg.

    "For the past four years, the number of mycoplasma infections has been extremely low, and it is therefore not unusual that we have an epidemic now. We have actually been waiting for it since we closed the country after the covid-19 pandemic", says Hanne-Dorthe Emborg, and adds:

    "Precisely because the number has been so low in the past 3.5 years, and there is therefore a group of children who have not built up immunity, we can probably also expect a higher incidence this season than what has been seen during previous MP- epidemics before the pandemic", she says.

    However, MP epidemics do not usually result in many hospitalizations and therefore not significant burdens on the healthcare system.

    The increase is also seen in other countries

    The incidence of MP infections is also currently increasing in many other countries both in and outside Europe. A study with data from several countries in the world has shown that Denmark has the highest number of registered cases, followed by Sweden and Singapore.

    In China, an increase in cases of respiratory infections among children has been observed in November, attributed to the lifting of restrictions against covid-19 with the subsequent circulation of known respiratory diseases such as influenza, RSV, covid-19 and MP. The WHO has asked China to share information on the circulating respiratory diseases and is following developments closely, as is the ECDC in Europe.

    At Statens Serum Institut, respiratory infections are continuously monitored and updated weekly with figures and interpretations, which you can find
    here.



    Given that epidemics in Europe have a way of turning up on our doorstep after a few weeks, we may see a similar uptick in cases here in the United States or Canada as well. While concerning, for now we're not seeing any indication that these outbreaks differ from past events.

    Parents, in particular, may want to familiarize themselves with the symptoms and handling of MP. The CDC's FACT SHEET follows.




    #17,787 While all eyes remain firmly fixed on China's outbreak of respiratory illnesses - which are said to be a mixture of flu, RSV, COVID...
    Last edited by Michael Coston; December 2, 2023, 07:38 AM.
    All medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.

  • #3
    ECDC On Increased Mycoplasma Pneumonia Reported In EU/EEA Countries




    Credit CDC


    #17,796

    While tabloid, social, and even some mainstream media outlets seem determined to present the recent uptick in respiratory illnesses in China - and around the world - as scary precursors to the next pandemic, so far we've seen no indication of anything `novel' at work, or any direct link between China's outbreaks and those being reported in Europe or the United States.

    Admittedly, global surveillance, testing, and data sharing are limited - and new information could change that assessment - but right now we appear to be dealing with an uptick in known, seasonal respiratory illnesses.

    The `Mystery Pneumonia' which has been identified in China and many other countries is by all accounts Mycoplasma pneumoniae, which sparks minor epidemics every few years. Exact numbers are hard to come by, since this in not a `reportable' disease in most countries, but the CDC estimates:

    Estimated incidence

    M. pneumoniae infections are common, but the true number of people affected is unknown. An estimated 2 million cases of M. pneumoniae infections occur each year in the United States.

    Trends over time

    The number of M. pneumoniae infections varies over time, with peaks of disease every 3 to 7 years. This illness can happen any time during the year but may be more common in summer and early fall.

    Outbreaks

    Outbreaks occur mostly in crowded environments like college residence halls and nursing homes. Outbreaks can be prolonged due to the long incubation period of M. pneumoniae.


    It is always possible for a new strain to emerge, or one that has increased antibiotic resistance, but so far we haven't seen any reports suggesting either in the EU/EEA or the United States.

    Yesterday the ECDC published their weekly Communicable Disease Threats Report, where they reported on upticks in M. pneumoniae in the EU/EEA in recent months.

    Increase in respiratory infections due to Mycoplasma pneumoniae in the EU/EEA during the season 2023/2024

    Overview:

    Epidemics of M. pneumoniae occur periodically, typically every one to three years [1]. Transmission requires close contact with an infected individual, with slow-onset and often atypical respiratory symptoms once infected. Infections typically present with mild, self-remitting upper respiratory tract symptoms; however, patients presenting with prolonged or atypical, severe lower respiratory tract symptoms require antibiotic treatment.

    Six EU/EEA countries have reported recent increases in M. pneumoniae infections at the national level or in specific hospitals. Increases have been reported in all age groups but are predominantly observed in children and adolescents. Additionally, one country observed an increase in severe cases admitted to the intensive care unit.

    There are currently no reports of atypical strains or evidence of resistance to first-line macrolide antibiotics.

    ECDC assessment:

    M. pneumoniae is not notifiable in most EU/EEA countries, leading to limited available information regarding diagnosed cases, proportion of detections amongst respiratory laboratory samples, or historical detection data. As a result, making country-level comparisons should be done with caution. M. pneumoniae epidemics occur cyclically in Europe every one to three years [1].

    Various factors contribute to this cyclical pattern, such as the decline of population immunity over time or the introduction of new strains into the population. The reported increases are observed following a three-year period of very limited transmission and detection of M. pneumoniae in the EU/EEA, following widespread implementation of non-pharmaceutical measures during the COVID-19 pandemic,resulting in reduced population immunity, particularly amongst those with little or no pre-existing exposures to M. pneumoniae.

    There are currently no reports of atypical M. pneumoniae strains or resistance to first-line macrolide antibiotics from reporting countries. However, it remains important for countries to monitor and report the occurrence of atypical and/or severe forms of disease, evidence of resistance to antibiotics, and strains on the healthcare system related to M. pneumoniae cases as winter progresses and the combined burden of respiratory pathogens increase.

    Actions:

    ECDC continues to monitor the situation. Countries are encouraged to continue reporting to EpiPulse with additional information:
    2023-IRV-00008. In particular, countries with laboratory systems that routinely screen respiratory samples for M. pneumoniae are encouraged to report current and historic trend data for detections, as well as strain characterisation and antibiotic susceptibility data, if available

    Not surprisingly, we are also seeing reports of sporadic outbreaks here in the United States (see Warren Ohio Health Dept. Press Release), and additional outbreaks are to be expected. While there doesn't appear to be anything `novel' about these outbreaks, that doesn't make them benign.

    The CDC advises:

    People at Risk

    Mycoplasma pneumoniae infections are most common in young adults and school-aged children, but can affect anyone. People living and working in crowded settings are at increased risk. These settings include:
    • Schools
    • College residence halls
    • Military training facilities
    • Long-term care facilities
    • Hospitals
    Other people at increased risk for serious infections include those:
    • Recovering from a respiratory illness
    • With a weakened immune system
    Prevention

    Help protect yourself and others from Mycoplasma pneumoniae infection by practicing good hand hygiene.

    People can get infected with Mycoplasma pneumoniae more than once. While there is no vaccine to prevent M. pneumoniae infections, there are things people can do to protect themselves and others.

    Good hygiene

    Like many respiratory germs, Mycoplasma pneumoniae most commonly spread by coughing and sneezing. Some tips to prevent the spread of M. pneumoniae include:
    Cover your mouth and nose with a tissue when you cough or sneeze.
    • Put your used tissue in a waste basket.
    • If you don’t have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands.
    • Wash your hands often with soap and water for at least 20 seconds.
    • If soap and water are not available, use an alcohol-based hand rub.

    Preventive antibiotics

    Doctors generally do not prescribe antibiotics to help prevent someone else from getting sick (for example, a close contact of an infected person).
    Treatment

    Mycoplasma pnuemoniae infections are generally mild, but some people may need care in a hospital.

    Most people will recover from an infection caused by Mycoplasma pneumoniae without antibiotics. Ask your doctor or pharmacist about over-the-counter medicines that can help you feel better while you are recovering.

    However, if someone develops pneumonia (lung infection) caused by M. pneumoniae, doctors usually prescribe antibiotics. There are several types of antibiotics available to treat pneumonia caused by M. pneumoniae. Antibiotics can help patients recover from the infection faster if started early on.

    Some M. pneumoniae are resistant to some antibiotics used for treatment. Learn more about the potential danger of antibiotic resistance, and how to prevent it at CDC’s
    Be Antibiotics Aware website.

    Complications

    While M. pneumoniae usually cause mild infections, severe complications can occur that require care in a hospital. M. pneumoniae infections can cause or worsen the following complications:
    • Serious pneumonia
    • Asthma attacks or new asthma symptoms
    • Encephalitis (swelling of the brain)
    • Hemolytic anemia (too few red blood cells, which means fewer cells to deliver oxygen in the body)
    • Renal dysfunction (kidney problems)
    • Skin disorders like Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis


    We are entering what is likely to be a messy winter respiratory season, with a mixture of influenza viruses, COVID, RSV, adenoviruses, rhinoviruses, and bacterial pneumonia.

    Some can be reduced by vaccines, while others are susceptible to non-pharmaceutical measures like hand hygiene and face masks.

    As always . . .




    https://afludiary.blogspot.com/2023/...pneumonia.html
    All medical discussions are for educational purposes. I am not a doctor, just a retired paramedic. Nothing I post should be construed as specific medical advice. If you have a medical problem, see your physician.

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