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An outbreak of type 1 pneumococcal pneumonia in a men's shelter
Abstract:
A striking increase in blood culture isolates of Streptococcus pneumonia capsular type 1 was noted at Boston City Hospital in early 1978. The increased incidence of type 1 pneumococcal bacteremia was due, at least in part, to an outbreak of disease among alcoholic, male clients of Boston's largest shelter. Residents of the shelter also were found to have a high rate of nose and throat carriage of type 1 pneumococci. This outbreak of bacteremic pneumococcal pneumonia is compared with endemic disease caused by other serotypes observed at Boston City Hospital during the same period and with previous studies of epidemic pneumococcal disease. Routine serotyping of pneumococcal isolates is important, especially in light of the emergence of pneumococci resistant to multiple antibiotics and of the renewed use of polysaccharide vaccines.
Insights
An outbreak of Streptococcus pneumoniae type 1 caused increased bacteremic pneumonia in alcoholic men at a Boston shelter. High carriage rates in residents contributed to the epidemic, highlighting the need for serotyping.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- A notable rise in Streptococcus pneumoniae (pneumococcus) type 1 blood isolates occurred in early 1978.
- This increase was linked to an outbreak of pneumococcal bacteremia, particularly affecting alcoholic men at a large Boston shelter.
Purpose of the Study:
- To investigate the cause of increased type 1 pneumococcal bacteremia.
- To compare this outbreak with other pneumococcal serotypes and historical epidemic data.
Main Methods:
- Analysis of blood culture isolates from Boston City Hospital.
- Serotyping of Streptococcus pneumoniae to identify specific capsular types.
- Comparison of outbreak data with endemic disease and previous studies.
Main Results:
- The outbreak of type 1 pneumococcal bacteremia was significantly associated with an epidemic among residents of a homeless shelter.
- Shelter residents exhibited high rates of nose and throat carriage of type 1 pneumococci.
- Bacteremic pneumococcal pneumonia caused by type 1 was compared to endemic disease from other serotypes.
Conclusions:
- Routine serotyping of pneumococcal isolates is crucial for public health surveillance.
- Emerging antibiotic resistance and vaccine use underscore the importance of ongoing serotype monitoring.
- Understanding outbreaks, like this type 1 pneumococcal pneumonia epidemic, informs prevention and control strategies.