Outbreak of Group A Streptococcal Pneumonia among Marine Corps Recruits - California, November 1-December 20, 2002
Journal article, 1 Nov-20 Dec 2002
NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA
Pagination or Media Count:
Between Nov 1 and Dec 20, 2002, 163 Marines, including 160 recruits, were admitted to the Naval Medical Center San Diego for possible pneumonia 128 cases were confirmed by chest radiograph. All pneumonia cases had the following investigations sputum, blood, and throat cultures Mycoplasma pneumoniae IgM and IgG Chlamydia pneumoniae IgM and IgG rhinoprobe DFA for respiratory syncytial virus, adenovirus, influenzae, and parainfluenzae urine Legionella antigen test urine Streptococcus pneumoniae antigen test and an antistreptolysin O ASO titer. A definite case of Group A streptococcus GAS pneumonia was defined as a blood or pleural fluid culture positive for GAS. A probable case of GAS pneumonia was defined as a positive throat or sputum culture for GAS or an ASO titer of 250 Todd units or greater in the absence of another identified etiologic agent. A definite case of M. pneumoniae was defined as IgG seroconversion and a probable case as a positive IgM. A confirmed case of C. pneumoniae was defined as a 4-fold rise in IgG or an IgM titer of 16 or greater and a possible case as an IgG titer 512. All cases were male with ages ranging from 18 to 33 years. One hundred thirty-two cases 81 were whitenon-Hispanic, 26 16 were whiteHispanic, three 2 were AsianPacific Islander, and two 1 were other. All cases were previously healthy and HIV-seronegative. Of the 128 cases of pneumonia, 66 52 had multilobar involvement, and 29 23 had a pleural effusion, including five 4 with an empyema. Thirty-one 22 of the pneumonia cases were caused by GASwith 6 cases of definite GAS and 25 cases of probable GAS. Forty-seven pneumonia cases were caused by other organisms, including 6 definite and 15 possible cases of C. pneumoniae, 3 definite and 16 probable cases of M. pneumoniae, 5 cases of adenovirus, and 2 cases of S. pneumoniae. Seventy-eight of 128 61 of pneumonia cases had a definite or probable diagnosis.
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