Pneumonia cluster in a boarding school--implications for influenza control

Streptococcus pneumoniae is a common cause of community acquired pneumonia (CAP). Influenza infection increases susceptibility to S. pneumoniae infection in adults but this link is less well described in children. We report on an outbreak of CAP affecting 25 previously well adolescents in a New South Wales boarding school. S. pneumoniae 1 was confirmed in two cases. During this period, the school also experienced an influenza outbreak with an influenza-like illness attack rate peaking at 27% in Year 8 students. A planned school closure may have contributed to controlling the outbreak. Boarding schools are vulnerable to outbreaks of respiratory illness and strategies for limiting this risk are required.