Mycoplasma pneumoniae causes not only pneumonia but also other respiratory syndromes such as bronchitis, bronchiolitis, pharyngitis, and croup. These infections mimic viral respiratory syndromes. Most cases are treated on an outpatient basis. Epidemics take place at intervals of 4-7 years. The incidence rate is highest among school children and second highest among children < 5 years of age. Among persons who have had M. pneumoniae pneumonia, rates of subsequent infection with this organism are low, and immunity appears to increase with age. The carrier state may last for several months. Patients with humoral immunodeficiency often develop severe infections due to M. pneumoniae, with involvement of the joints; in these individuals the carrier state may persist. M. pneumoniae has been isolated from bronchial washings from children with AIDS. These children have recovered from mycoplasmal infection with appropriate antibiotic treatment. Dermatologic, neurological, cardiac, renal, and pulmonary complications occur, although data on their frequency are lacking.
Pneumonia due to Mycoplasma pneumoniae was monitored in a large prepaid medical-care group in Seattle, Washington, between 1963 and 1975. The disease was diagnosed by isolation of M. pneumoniae and/or significant rises in titer of complement-fixing (antilipid) antibody in paired sera. Infection was endemic without significant seasonal fluctuations. Two epidemics occurred: the first peaked in January 1967, the second late in the summer of 1974. Total rates of pneumonia infection in children increased during M. pneumoniae epidemics, but epidemics of infection with respiratory syncytial virus had a greater effect. Age-specific attack rates for M. pneumoniae pneumonia among children aged five to nine years (about six per 1,000) were about twice the rates for younger children and four times those for adults. Serologic study of healthy schoolchildren showed annual rates of infection that paralleled but greatly exceeded rates of recognized M. pneumoniae pneumonia. Infection rates varied from 2% in endemic years to 35% in epidemic periods. A higher proportion of infections among children aged five to nine years than among adolescents aged 15-19 years resulted in pneumonia.
Dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) are reportable diseases, the third most common causes for hospitalization of children in Thailand. Data collected from the Ministry of Public Health were analysed for trends. Rates of DHF increased in Thailand until 1987 when the largest epidemic ever, 325/100000 population, was recorded. Whereas the disease used to be confined to large cities, the rate is now higher in rural (102.2 per 100000) than urban areas (95.4 per 100000 in 1997). The age of highest incidence has increased, and the age group most severely affected is now those 5-9 years old (679/100000 in 1997). The case fatality rate has decreased with improved treatment and is now only 0.28%.
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