Outbreak of pneumococcal disease in a nursing home in Spain

Abstract

On 6 February 2002, a cluster of pneumonia cases was reported to the Sección de Vigilancia Epidemiológica del Servicio Aragonés de Salud (epidemiological surveillance unit, health services of Aragon) in Zaragoza, Spain; all patients were residents of a nursing home for elderly people. The residents in the home were aged 56-102 years, the median age was 86.

Outbreaks of serious pneumococcal disease in closed settings in the post-antibiotic era: A systematic review

“…Of the 42 outbreaks reported, 24 occurred in the USA, 10,11,13,14,25,26,38,39,42,44 10 in the UK, 9,12,15,17,20,21,24,33,36 three in Canada, 30 two in France 28,35 and one each in Israel, 34 the Netherlands 32 and Spain. 27 The majority of outbreaks 14 occurred in hospital settings 12,13,15,20e22,31e34,36,43,45 followed by long term care facilities (LTCF) in which 12 were reported. 10,14,25e 27,38,39,42,44,46 Five outbreaks of serious pneumococcal disease in household settings were reported in three papers, 17,24,30 three papers reported pneumococcal outbreaks of S. pneumoniae in child care settings 16,18,40 and three further papers reported four outbreaks involving military personnel.…”

“…27,38 In eight of the 12 outbreaks pneumococcal polysaccharide vaccine (PPV) coverage was reported among the population living in the facility 14,25,38,39,42,44,48 ; coverage was less than 10% in six. 11,25,38,39,42 In the other two outbreaks 14,44 PPV coverage was 58% and 49%, respectively.…”

“…Nasopharyngeal swabbing of residents and staff was undertaken in five of the 12 reported outbreaks 14,27,38,39,42 leading to the identification of carriers of the same strain among patients in three of these outbreaks 14,38,39 and among staff in two of them. 27,38 In eight of the 12 outbreaks pneumococcal polysaccharide vaccine (PPV) coverage was reported among the population living in the facility 14,25,38,39,42,44,48 ; coverage was less than 10% in six.…”

Contact with young children is a major risk factor for pneumococcal colonization in older adults

“…In other contexts, such as nursing homes, more adult-adult transmission likely occurs as this would explain nursing home based pneumococcal disease outbreaks. 45 To adequately investigate this however, the establishment and appropriate application of more sensitive methods for pneumococcal carriage surveillance are imperative. Despite some limitations, the results of our study contribute to our understanding of pneumococcal carriage and can inform future policy decisions and preventive strategies aimed at reducing pneumococcal disease burden in children and adults.…”