Outbreak of Streptococcus pneumoniae serotype 1 pneumonia in a United Kingdom school

Atul Gupta, specialist registrar, paediatric respiratory medicine¹, F-M Khaw, consultant in health protection², E L Stokle, senior health protection nurse², R C George, consultant medical microbiologist³, R Pebody, consultant³, R E Stansfield, consultant microbiologist⁴, C L Sheppard, advanced healthcare scientist³, M Slack, consultant medical microbiologist³, R Gorton, consultant regional epidemiologist², D A Spencer, consultant paediatric respiratory medicine¹

¹ Paediatric Respiratory Unit, Freeman Hospital, Newcastle upon Tyne NE7 7DN, ² Health Protection Agency North East, Northern Office, Citygate, Newcastle upon Tyne NE1 4WH, ³ Health Protection Agency, Centre for Infections, London NW9 5EQ, ⁴ Microbiology Laboratory Service, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields NE29 8NH

Correspondence to: F-M Khaw Meng.khaw@hpa.org.uk

Healthcare workers and teachers should report suspected outbreaks of serotype 1 pneumococcal disease early, and childhood immunisation should be considered

The first 150 words of the full text of this article appear below.

Pneumococcal pneumonia is not generally regarded as contagious.¹ Although epidemics of pneumococcal disease have been reported (in sub-Saharan Africa^{2 3} and Canada⁴), outbreaks of pneumococcal infection are uncommon and are generally restricted to high risk individuals such as alcoholics,⁵ residents in shelters for the homeless,⁶ and people living in close groups⁷ including military camps,⁸ prisons,⁹ day care centres,¹⁰ and nursing homes.¹¹ Recent reports have indicated that serotype 1 pneumococcus is largely responsible for the exponential increase in the incidence of empyema and complicated pneumonia seen in children in several countries over the past decade.^{12 13 14} There is also evidence of outbreaks of other forms of invasive serotype 1 disease in many countries.^{2 15 16} In contrast to most other invasive serotypes, carriage of serotype 1 is rarely detected in the nasopharynx of either adults or children, suggesting short duration of carriage or high virulence.^{17 18}

There have been no reports of outbreaks of pneumococcal . . . [Full text of this article]

Published 31 December 2008, doi:10.1136/bmj.a2964
Cite this as: BMJ 2008;337:a2964