Infectious Dis. Medical News about Mycoplasma pneumoniae

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An Outbreak of Acute Respiratory Disease Caused by Mycoplasma pneumoniae Onboard a Deployed US Navy Ship
Journal of Clinical Microbiology, 10/23/09

Sliman JA et al. – The authors identified 179 cases of acute respiratory illness including 50 cases of radiographically–confirmed pneumonia over the course of four months on a deployed US Navy vessel. Laboratory tests showed Mycoplasma pneumoniae to be the etiological agent. This report represents the first published description of a shipboard outbreak of this pathogen.

Exclusive Author Commentary
David Metzgar, 10/26/09

This paper describes the first recognized outbreak of M. pneumoniae in a shipboard environment, and offers a detailed description of the time course of this outbreak – one that is very distinct from the more commonly reported influenza outbreaks that are often recognized on ships. Historically, large transport vessels have been recognized as a primary route for transmission of infectious diseases. The plague, smallpox, typhus, syphilis and many others appear to have been spread from continent to continent by seafaring vessels, often with disastrous consequences for previously unexposed populations. The consequences for the populations aboard the ships can be equally threatening. Since the advent of effective diagnostic testing, many shipboard outbreaks of respiratory disease have been investigated using laboratory support to identify the responsible pathogens. However, these have almost always been limited to cross-sectional analyses performed after the outbreak was recognized (and usually after the ship has subsequently travelled to a port). Such investigations have usually been targeted at rapid, high attack rate epidemics, and, in cases where a confident diagnosis could be made, have almost always identified influenza as the culprit. Recently, the US Navy instituted onboard sample collection programs on many of our larger vessels. This type of ongoing collection allows investigators to diagnose specimens collected from patients prior to recognition of an outbreak event, which in turn allows the identification and post-hoc description of outbreaks that occur slowly and may not be noticed for months after they have begun. This is exactly the sort of outbreak that is known to be generated in shorebound populations by the slowly spreading atypical pneumonia pathogen Mycoplasma pneumoniae. The data presented in this paper describe a Mycoplasma pneumoniae outbreak onboard the USS Boxer while at sea. The outbreak lasted for several months, and ultimately involved 179 acute respiratory disease cases and 50 radiologically confirmed pneumonia cases. While the outbreak was not identified or investigated until it was essentially over, continuous collection of respiratory specimens from symptomatic patients prior to the investigation allowed for a detailed description of its course and impact.

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