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Mycoplasma Pneumoniae Disease Outbreak Associated with an Extended Care Facility — Nebraska, 2014

Monday, June 15, 2015: 3:10 PM
Back Bay C, Sheraton Hotel
Deborah L Hastings , Nebraska Department of Health and Human Services, Lincoln, NE
Kari Harrington , East Central District Health Department, Columbus, NE
Preeta K. Kutty , Centers for Disease Control and Prevention, Atlanta, GA
Rebecca J Rayman , East Central District Health Department, Columbus, NE
Dana Spindola , East Central District Health Department, Columbus, NE
Maureen Diaz , Centers for Disease Control and Prevention, Atlanta, GA
Kathleen Thurman , Centers for Disease Control and Prevention, Atlanta, GA
Jonas Winchell , Centers for Disease Control and Prevention, Atlanta, GA
Thomas Safranek , Nebraska Department of Health and Human Services, Lincoln, NE
Audio File Recorded Presentation

BACKGROUND: Pneumonia is a major cause of morbidity and mortality among older persons. On June 20, 2014, an extended care facility notified public health authorities of a cluster of a respiratory illnesses cluster among residents and staff that resulted in 3 deaths. A variety of pathogens, with different prevention measures, cause nursing-home–acquired pneumonia outbreaks. We investigated to determine illnesses etiology and implement control measures.

METHODS: We assessed infection control practices, sent a health alert to local providers to identify additional patients, collected nasopharyngeal and oral pharyngeal swabs or autopsy specimens for multiplex real-time polymerase chain reaction (PCR) testing at CDC, and collected clinical and demographic information on patients.  Cases were defined as acute respiratory illness with cough and fever ≥ 100.4°F, or radiographic-confirmed pneumonia, during June 1-August 16 in persons linked to the facility.

RESULTS: A total of 50 persons met the case definition: 18 (13%) of 143 residents, 20 (15%) of 132 staff, and 12 community members. Median age was 45 (range 2-96) years; 37 (74%) were female. Eight (44%) residents were hospitalized and 6 (33%) died; 2 (17%) community members were hospitalized and 1 died. None of the staff were hospitalized or died. We sampled 30 persons; 14 (47%) were PCR-positive for Mycoplasma pneumoniae. Laboratory results guided antibiotic recommendations. We implemented droplet precautions; isolated ill residents; prevented ill staff from working; and stopped new admissions until September 14. 

CONCLUSIONS:  We demonstrated M. pneumoniae was the cause of this life-threatening outbreak of respiratory illnesses among older persons in a non-typical setting. M. pneumoniae should be considered as an etiologic agent during pneumonia outbreaks at extended-care facilities; prompt diagnosis could decrease morbidity and mortality.

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