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Shelby County, Indiana: Pneumonia outbreak under investigation - cases test positive for Mycoplasma, enterovirus, and metapneumovirus

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  • Shelby County, Indiana: Pneumonia outbreak under investigation - cases test positive for Mycoplasma, enterovirus, and metapneumovirus

    http://www.wishtv.com/dpp/news/local...-investigation

    Shelby County pneumonia outbreak under investigation
    Updated: Monday, 07 Nov 2011, 12:16 PM EST
    Published : Monday, 07 Nov 2011, 11:42 AM EST

    SHELBYVILLE, Ind. (WISH) - The Shelby County Health Department is working to determine the cause of an apparent outbreak of pneumonia in school-aged children.

    According to a news release from the health department, at least 20 students have shown similar chest x-ray patterns and several have been admitted to the hospital for treatment.

    The health department notes that the cases are spread out across the county meaning it is not associated with any one particular school.

    The Indiana State Department of Health is providing kits to local physicians to help them test for Mycoplasma pneumoniae, the primary bacteria associated with walking pneumonia, in hopes of determining the specific cause of the Shelby County outbreak.

    The onset of Mycoplasma pneumonia comes with the development of a cough, sore throat, headache, low grade fever, chills and muscle aches.

    “Mycoplasma is transmitted via droplets usually transmitted by cough or other contact with saliva,” the health department’s release reads, “One of the primary ways to contain the outbreak is to keep ill children home from school if they are sick. If your children have a cough and any of the symptoms above, please keep them home from school and seek evaluation from your primary care physician.”

  • #2
    Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

    Source: http://www.fox59.com/news/wxin-pneum...,4964539.story

    Outbreak of pneumonia found in Shelby County students
    The disease is not associated with one particular school because the affected students are distributed throughout the county.

    Press Release

    1:05 p.m. EST, November 7, 2011
    Shelby County—
    The Shelby County Health Department said they have been made aware of an outbreak of pneumonia in school-aged children.

    The department said 20 students, primarily elementary and middle school students, have shown a similar chest X-ray pattern, and several students have required hospital admission and treatment.

    The disease is not associated with one particular school because the affected students are distributed throughout the county.

    The exact cause of the pneumonia s presently unknown, but the primary concern is for the atypical bacteria, Mycoplasma pneumoniae, the cause of “walking pneumonia”...

    Comment


    • #3
      Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

      Dozens of children hospitalized with pneumonia
      Updated: Nov 07, 2011 11:51 PM EST
      By Richard Essex - bio

      SHELBYVILLE - An outbreak in Shelby County that started with a simple cough has sent dozens of children to the hospital.

      Doctors have diagnosed at least 25 students in the county with pneumonia. The strain, doctors say, has not been responding to traditional drugs.

      Dr. Paula Gustafson looked over x-rays Monday of an otherwise healthy elementary school student hospitalized with a nasty case of pneumonia.

      "We have had, in the past couple of weeks, about five children that have had to be hospitalized," she said.

      That is in addition to another two dozen with similar conditions.

      ...
      http://www.wthr.com/story/15982693/d...with-pneumonia
      Twitter: @RonanKelly13
      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

      Comment


      • #4
        Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

        http://www.indystar.com/article/2011...Ctext%7CLiving

        Pneumonia breaks out among Shelby County children
        Nov. 8, 2011 | Comments

        An outbreak of a usually mild form of pneumonia has been reported among school-age children in Shelby County, southeast of Indianapolis.

        Several of the children, primarily in elementary and middle schools, have been hospitalized, the Shelby County Health Department reports.

        "At least 20 students have shown a similar chest x-ray pattern, and several have required hospital admission and treatment with intravenous antibiotics," said a news release from Shelby County health officials. "The affected students are distributed throughout Shelby County, and thus the disease is not associated with any one school or other specific location or activity."

        The exact cause is unknown, but it is believed to be a type of "walking pneumonia," which comes from specific bacteria that does not respond to drug treatments including penicillin and cephalexin. The bacteria can be fought with drugs including erythromycin (also known as Z-Pak), fluoroquinolones (also known as Cipro, Levaquin), and tetracyclines.

        Typical symptoms include fever, cough, bronchitis, sore throat, headache and tiredness, according to the Indiana State Department of Health's epidemiology resource center, which said walking pneumonia usually is mild and rarely requires hospitalization. Infections of the middle ear also can result.

        Symptoms may persist for a few days to more than a month, according to the state center. Symptoms begin 15 to 25 days after exposure and generally develop slowly, over a period of two to four days.

        The State Department of Health provided local physicians with testing kits for the bacteria mycoplasma to help determine if it is the cause of the ailment, Shelby County authorities said. The bacteria are transmitted via droplets from coughs or other contact with saliva.

        There are no vaccines to prevent mycoplasma pneumonia, the state reports.

        Children with the ailment should stay home from school, the health department said.

        "If your children have a cough and any of the symptoms above, please keep them home from school and seek evaluation from your primary care physician," the release said. "As always, cough into your sleeve, wash your hands frequently or use antibiotic hand gel, and dispose of tissues properly."

        Comment


        • #5
          Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

          Has there been lab confirmation of bacterial infection? Are there any reports of testing for influenza?

          I'm surprised that the reports don't even mention potential viral infection, especially with no response to antibiotic treatment.
          "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

          Comment


          • #6
            Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

            I actually called the pediatrician's office featured in the story to ask if any patients had been tested for influenza, and the nurse told me that the Indiana State Department of Health is dealing with it. It was too late to call them, but I will try tomorrow.
            "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

            Comment


            • #7
              Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

              We will see what testing reveals. The 15-25 day incubation period is distinct enough from that of influenza that it shouldn't be that easy to confuse Mycoplasma with flu.

              Comment


              • #8
                Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

                I noted that the article stated the incubation period, but it's odd that so many have shown symptoms within a week to 10 days. That, coupled with the fact that the kids are not in the same schools, makes me wonder. I didn't see where they confirmed that these children were exposed 2-4 weeks ago. I guess if it's flu or another viral agent, cases among these kids's contacts will appear in the next week or so.
                Originally posted by alert View Post
                We will see what testing reveals. The 15-25 day incubation period is distinct enough from that of influenza that it shouldn't be that easy to confuse Mycoplasma with flu.
                "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

                Comment


                • #9
                  Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

                  Here's a story with some specific information on one serious case.

                  http://www.wthr.com/story/15982693/d...with-pneumonia

                  Several children hospitalized with pneumonia
                  Posted: Nov 07, 2011 11:51 PM EST
                  Updated: Nov 08, 2011 8:27 AM EST
                  By Richard Essex

                  SHELBYVILLE - An outbreak in Shelby County that started with a simple cough has sent dozens of children to the hospital...

                  ...Which is exactly what happened to two-year-old Jaden.

                  "It just kept getting worse, where he was getting more lethargic and not better and medicine was not helping and the fevers were getting higher," said Jaden's mother, Erin Murphy.

                  The pneumonia was discovered on his third trip to the pediatrician.

                  "But his breathing was fine and we went back again on Thursday and she was like, 'We just have to do a chest x-ray' and that is when they saw all of the pneumonia," Murphy said.

                  It's so serious, to help clear the infection, Jaden had to undergo surgery and is on a constant stream of antibiotics.

                  "There is some bacterial going around, where the sinus infection is turning into a pneumonia and they have seen a lot of pneumonia cases in their office and they don't know what this bacteria is," Gustafson said.

                  Jaden is recovering, but is expected to be in the hospital for another two weeks. If your child's cough and fever have persisted for more than a week, take them to a doctor.
                  "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

                  Comment


                  • #10
                    Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

                    Mycoplasma pneumoniae can cause severe illness in young adults with pneumonia and sometimes hospitalization may last in three weeks since the isolation of the causative agent is not always simple and haematological issue could appear to complicate the situation.

                    See the dedicated Merck Manual page: http://www.merckmanuals.com/professi...coplasmas.html

                    (IOH)

                    Comment


                    • #11
                      Re: Shelby County, Indiana: Pneumonia outbreak under investigation - Mycoplasma suspected

                      http://www.schd.net/

                      Thursday, November 10, 2011 – Press Release
                      Most pneumonia NOT Mycoplasma


                      The Indiana State Department of Health made testing kits available for Mycoplasma pneumoniae available earlier this week. The first test results are now available. Nineteen patients aged 14 months to 56 years were tested. Only one patient tested positive for Mycoplasma pneumoniae. The samples that were negative for Mycoplasma were also tested for several common respiratory viruses. Seven of these patients tested positive for enteroviruses or human metapneumovirus. Like the common cold, bronchitis or pneumonia caused by viruses in healthy individuals should resolve with supportive treatment and does not depend on usual antibiotics. If you think you are ill, you should be seen by your primary care physician. Further information will be available from the ISDH next week.

                      The observed cluster of pneumonia cases does not constitute an outbreak of Mycoplasma pneumonia. However, these cases underscore the need for continued vigilance and adherance to good hand-washing or hand gel use and other prevention techniques such as coughing into your sleeve, as well as staying home when you are sick.

                      Comment


                      • #12
                        Re: Shelby County, Indiana: Pneumonia outbreak under investigation - cases test positive for Mycoplasma, enterovirus, and metapneumouvirus

                        http://www.in.gov/isdh/files/Week45-2011.pdf

                        The ISDH, the Shelby County Health Department and a local pediatrician’s office have continued a collaborated investigation of respiratory illness in Shelby County. The investigation was initiated November 4, 2011 when the ISDH was informed of several pneumonia cases in school-aged children. Representatives from all partners continue to conduct active surveillance to determine the scope of the illness. The ISDH Laboratories and respiratory epidemiologist issued collection kits to the facilities reporting illness and provided testing. The ISDH Laboratory has tested 17 specimens from Shelby County. All 17 specimens were tested for Mycoplasma pneumonaie and Chlamydia pneumonia. One of the specimens was positive for Mycoplasma pneumonaie. All specimens were also tested with the respiratory virus panel, which tests for Influenza, Adenovirus, Enterovirus/rhinovirus, Human metapneumovirus, Coronavirus and Parainfluenza virus. Of the 17 specimens that tested negative for Mycoplasma pneumonia and Chlamydia pneumoniae, eight were positive for three separate respiratory viruses. The viruses identified were; Adenovirus, Enterovirus/Rhinovirus, Human Metapneumovirus. One specimen was positive for both adenovirus and entero/rhinovirus. Specimens have been set-up in virus culture and are pending results. Final culture results may take several weeks. No specimens were positive for any strain of influenza. We have monitored our PHESS emergency chief complaint data and the influenza sentinel data for respiratory syndromes. Neither of the surveillance systems has indicated unusual influenza activity for this time of year. This investigation is still pending and updates will be provided as information is processed.

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