Home Journals Articles Updates About
CN
image
收藏切换
Outbreak of Mycoplasma pneumoniae at a military academy
收藏切换
PDF
Xin Zhang1, †, Min-Na Han2, †, Jing-Hui Dong3, Xiao-Xi Li4, Xian-Yun Hu2, Zhi Wang2, En-Qiang Qin1, Jing Li5, Jun-Yuan Tan5, Fu-Sheng Wang1, *, Lei Huang1, *
Military Medical Research | 2021, 8(3) : 447 - 449
Less
收藏切换
Military Medical Research | 2021, 8(3): 447-449
• LETTER TO THE EDITOR •
Outbreak of Mycoplasma pneumoniae at a military academy
Full
Xin Zhang1, †, Min-Na Han2, †, Jing-Hui Dong3, Xiao-Xi Li4, Xian-Yun Hu2, Zhi Wang2, En-Qiang Qin1, Jing Li5, Jun-Yuan Tan5, Fu-Sheng Wang1, *, Lei Huang1, *
Affiliations
  • 1Center for Infectious Disease, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
  • 2Southern Distract Health Service of Chinese PLA General Hospital, Beijing 100039, China
  • 3Radiology Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
  • 4Clinical Lab Center, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
  • 5Medical Service Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Published: 2021-09-10 doi: 10.1186/s40779-020-00289-x
Outline
收藏切换

In 2019, an outbreak of Mycoplasma pneumoniae (M. pneumoniae) occurred at a military academy in China. The attack rate (10.08%, 60/595) was significantly different among the units. High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M. pneumoniae. In-time prevention and control measures effectively controlled the spread of the epidemic.

Mycoplasma pneumoniae  /  Epidemiological survey  /  Disease control and prevention
Xin Zhang, Min-Na Han, Jing-Hui Dong, Xiao-Xi Li, Xian-Yun Hu, Zhi Wang, En-Qiang Qin, Jing Li, Jun-Yuan Tan, Fu-Sheng Wang, Lei Huang. Outbreak of Mycoplasma pneumoniae at a military academy[J]. Military Medical Research, 2021 , 8 (3) : 447 -449 . DOI: 10.1186/s40779-020-00289-x
Full Text
Less
Dear editor,
Mycoplasma pneumoniae (M. pneumoniac) may be the causative agent of 70% in crowded populations such as military personnel and students[1]. In the winter of 2019, a M. pneumoniae outbreak occurred at a military academy in China. Here we report the result of epidemiological investigation and disease prevention/control measures.
The outbreak occurred among training freshmen, the barracks were devoid of heating equipment, with residence area of 2.8–3.2 m2 per capita. All cadets ate at one cafeteria. Since late November 2019, total 15 cadets developed cold-like symptoms, all of them tested positive for M. pneumoniae IgM antibody, and several had CT scan-confirmed pneumonia. As the outbreak continued to spread, the patients were isolated in a temporary ward in early December. As strict prevention and control measures were timely implemented, new cases quickly declined, and the last case was reported on January 1st 2020.
The attack rate was 10.08% (60/595), with a total of 36 confirmed cases and 24 suspected cases (case definition see Additional file: Appendix I). The outbreak lasted 102 days, with four peaks. The interval between each peak was nearly the incubation period (Fig. 1).
The 60 cases were distributed among five companies: 12 in company G, 10 in company H, 17 in company I, four in company J, and 17 in company K. The highest attack rate was in company K (17/110, 15.45%) and the lowest in company J (4/118, 3.39%). There were significant differences in attack rate between companies H and K (χ2=3.515, P=0.048), G and J (χ2=3.871, P=0.042), I and J (χ2=9.351, P=0.002), and J and K (χ2=9.910, P=0.001; Additional file: Appendix Table S1 and Appendix Fig. S1).
We obtained complete medical records for 33 cases, including 19 confirmed and 14 suspected cases. The most common symptoms were cough (30/33) and fever (27/33). Other symptoms included runny nose (27, 81.82%), rhinobyon (23, 69.70%), sore throat (22, 66.67%), sneezing (21, 63.64%), fatigue (21, 63.64%) and headache (18, 54.55%). Sixteen cases had a history of burnout (e.g., stay up late or night shifts).
Within the 36 cases that tested positive for IgM antibody. Thirty-three of the patients had a chest computed tomography (CT) scan and 21 of the patients had radiologically confirmed pneumonia. The main damages were consolidation in 8 cases, ground glass opacity in 8 cases and fibrosis formation in 2 cases. Details see Additional file: Appendix Fig. S2.
All confirmed and suspected cases were treated with moxifloxacin or levofloxacin for 10 to 14 days. Two severe cases were hospitalized for 7 to 10 days. All patients were successfully treated without any complications or sequela.
Following the incidence of febrile patients, an emergency response team was immediately organized. The prevention and control measures were the following. (1) Isolation: all patients were isolated in a temporary ward, and all group activities were canceled. (2) Quarantine: all close contacts were quarantined. (3) Daily morning health check for any symptoms of disease. (4) Daily “zero” reporting system. (5) Sterilization and disinfection, especially in dormitories, bathrooms, and cafeteria. (6) Health education: wear face masks, improve hand hygiene and cough manners (cover mouth and nose with elbow or tissue instead of hands). Following a maximum incubation period with no registered new cases, the outbreak was declared terminated.
Clinical manifestations of M. pneumoniae infections are variable. The most common manifestation is tracheobronchitis. Most of patients report non-specific symptoms similar to those of the common cold or other upper respiratory infections (URI). It is a challenge to effectively distinguish M. pneumoniae pneumonia from pneumonia caused by other pathogens based on clinical manifestations or imaging results[2]. Currently, the most common clinical tests are based on serology and nucleic acid detection. The titer of IgM antibody reaches a detectable level within 1 week after disease onset, and the sensitivity is low, limiting the clinical value of these tests in early diagnosis[3].
Currently, macrolides are the preferred first-line antibiotics for M. pneumoniae infections. However, surveillance of antibiotic resistance by Chinese CDC showed that the prevalence of macrolide-resistant M. pneumoniae (MRMP) was 98.1% in children under 14 years of age and 83% in adolescents and adults[4]. Respiratory fluoroquinolones can achieve high concentrations in lung tissue and have greater activity than macrolides.
This outbreak in Northern China lasted more than 3 months. The time interval between each peak, which was approximately an incubation period, showed the typical features of generation to generation transmission. The possible reasons for this outbreak may be explained as follows, 1) high-intensity training and psychological stress decreases immunity and 2) cold and dry climates, high-density residences, and non-ventilated rooms promote the epidemic spread.
In summary, accurate etiological diagnosis, early isolation, standardized treatment of patients, medical observation, quarantine of close contacts, and regular environmental disinfection are crucial measures to reduce secondary transmission and mitigate outbreak consequences.
Supplementary information
Less
The online version contains supplementary material available at https://doi.org/10.1186/s40779-020-00289-x.
Additional file. Appendix I. Case definition. Appendix Table S1. Distribution of cases within the military campus. Appendix Fig. S1. Location of the cadets’ dormitory and other facilities. Appendix Fig. S2. Lung CT images of four cases infected with Mycoplasma pneumoniae.
Abbreviations
Less
CAP: Community-acquired pneumonia; CT: Computed tomography; URI: Upper respiratory infections; MRMP: Macrolide-resistant M. pneumoniae.
Acknowledgements
Less
We are grateful to Bo-An Li and Bo Li from the 5th medical center for their contribution in immunological tests.
Authors’ contributions
Less
XZ, MNH, LH, and FSW designed the study and wrote the manuscript, had full access to the data, and take responsibility for the accuracy of the data analysis; XZ, MNH, JHD, EQQ, JYT, and XXL analyzed data; MNH, XYH, ZW, EQQ collected samples, clinical data, and contributed to the manuscript preparation; JHD analyzed the CT images and drafted the manuscript; JL and EQQ made critical revisions to the manuscript; LH obtained funding sources for this study; XYH, ZW, JL, and JYT provided administrative, technical, and/or logistic support for the study. All authors have contributed to, read, and approved the final, submitted version of the manuscript.
Availability of data and materials
Less
All data generated or analyzed during this study are included in this published manuscript.
Ethics approval and consent to participate
Less
Written informed consent was obtained from each participant.
Consent for publication
Less
Not applicable.
Competing interests
Less
None of the authors have any competing interests in the manuscript.
Author details
Less
1Center for Infectious Disease, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China. 2Southern Distract Health Service of Chinese PLA General Hospital, Beijing 100039, China. 3Radiology Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China. 4Clinical Lab Center, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China. 5Medical Service Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
Funding
Less
  • military medical innovation research project of PLAGH(CX19015)
  • program for military medical innovation(18CXZ038)
References
Less
1.
Jacobs E, Ehrhardt I, Dumke R. New insights in the outbreak pattern of mycoplasma pneumoniae. Int J Med Microbiol. 2015;305(7):705-8. https://doi.org/10.1016/j.ijmm.2015.08.021.
2.
Miyashita N, Akaike H, Teranishi H, Nakano T, Ouchi K, Okimoto. NChest computed tomography for the diagnosis of Mycoplasma pneumoniae infection [J]. Respirology. 2014;19(1):144-5. https://doi.org/10.1111/resp.12218.
3.
Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen[J]. Clin Microbiol Rev. 2004;17(4):697-728. https://doi.org/10.1128/CMR.17.4.697-728.2004.
4.
Zhao F, Liu G, Wu J, Cao B, Tao XX, He LH, et al. Surveillance of macrolide-resistant Mycoplasma pneumoniae in Beijing, China, from 2008 to 2012[J]. Antimicrob Agents Chemother. 2013; 57(3):1521-3. https://doi.org/10.1128/AAC.02060-12.
Appendix
Less
Year 2021 volume 8 Issue 3
PDF
46
25
Cite this Article
BibTeX
Article Info
doi: 10.1186/s40779-020-00289-x
  • Online Date：2025-12-04
  • Published：2021-09-10
Article Data
Affiliations
History
Funding
military medical innovation research project of PLAGH(CX19015)
program for military medical innovation(18CXZ038)
Affiliations
    1Center for Infectious Disease, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
    2Southern Distract Health Service of Chinese PLA General Hospital, Beijing 100039, China
    3Radiology Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
    4Clinical Lab Center, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
    5Medical Service Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China

Corresponding:

References
Share
https://castjournals.cast.org.cn/joweb/mmr/EN/10.1186/s40779-020-00289-x
Share to
QR

Scan QR to access full text

Cite this article
BibTeX
Citations
表12种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
  • BibTeX
  • EndNote
  • RefWorks
  • TxT
Links
Articles
Latest Articles
Most Read
Collections
Updates
Events
News
Multimedia
About
About Us
Contact
No. 86 Xueyuan South Road, Haidian District, Beijing
100081
010-62199257
qkjq@cast.org.cn

Copyright © 2025 China Association for Science and Technology. All rights reserved. For all open access content, the relevant licensing terms apply.
Sponsored by the Office of the Leading Group for Cybersecurity and Informatization of CAST, and supported by Science and Technology Review Publishing House