Outbreak of Pneumococcal Pneumonia among Military Recruits

Control of Streptococcus pneumoniae serotype 5 epidemic of severe pneumonia among young army recruits by mass antibiotic treatment and vaccination

“…Outbreaks of pneumococcal pneumonia became relatively rare in the post-antibiotic era [12][13][14], although reports appear to be more frequent in recent years, mainly among the very young, the disabled and the elderly [13], as well as among young adults living in confined settings [12]. Pneumococcal outbreaks in non-elderly adults involve either a single [1,3,4,12,[15][16][17][18][19] or multiple [2,[20][21][22] pneumococcal serotypes. One large outbreak of invasive pneumococcal disease caused by Sp5 was recently reported from Canada, in a non-elderly urban population living in crowded and poor conditions [23].…”

“…Early detection and treatment of new ILI cases may have prevented their progression to pneumonia, while mass antibiotic prophylaxis combined with universal pneumococcal immunization resulted in interruption of the outbreak. Previous outbreaks were halted either using mass antibiotic prophylaxis [1], mass pneumococcal vaccination [3,4,15,38], a combination of these two measures [2,12,20,39] or without any intervention [16]. As is evident from the epidemiological curve ( Fig.…”

“…Outbreaks of severe respiratory illness among healthy young adults are uncommon, and have a wide range of differential diagnoses. Such outbreaks caused by Streptococcus pneumoniae have rarely been described in non-elderly healthy adults [1][2][3][4], and detailed description of such outbreaks and the interventions that took place are scarce. In the available reports, unique environmental settings such as weakened immune competence and extreme crowding were prevalent.…”

“…An epidemiological investigation was consequently initiated, which included culture to detect pneumococcal carriage, followed by antibiotic prophylaxis administration and vaccination. The objectives of the present report are: (1) to describe the epidemiologic characteristics of the outbreak, including carriage among contacts; and (2) to document the effect of the preventive measures on disease rate and carriage of the epidemic strain.…”

Proportion of adult community-acquired pneumonia cases attributable to Streptococcus pneumoniae among Hajj pilgrims in 2016

“…Many pilgrims are elderly with pre-existing underlying health conditions and worship under crowded conditions that promote respiratory disease transmission and infection . Crowding in particular has been associated with pneumococcal disease outbreaks (Banerjee et al, 2005;Mercat et al, 1991). The acquisition and transmission of S. pneumoniae is well documented during Hajj, independent of clinical status (Memish et al, , 2015a, and the organism is a leading cause of pneumonia-related hospitalizations and intensive care unit (ICU) admissions during the event (Al-Tawfiq and Memish et al, 2014).…”