Outbreak control of community acquired pneumonia in a large military training institution

BackgroundBetween 09 Jan 2011 to 25 Mar 2011 an outbreak of respiratory illness was reported from a Military Training institution. 52 cases of respiratory tract infection were admitted from this institution. All the cases were trainees between 18 and 21 years of age. Aggressive control measures were instituted along with the investigation of the outbreak to determine the nature of the disease and the causative organism.MethodsThe investigation of the outbreak was initiated on 08 Mar 2011 when a sudden rise in number of hospital admissions due to respiratory illness was noticed. Epidemiological information was collected from the cases. Routine blood investigations, sputum examination and chest radiograph of suspected cases were done.ResultsTotal of 52 cases of respiratory illness were reported during the period of outbreak giving an attack rate of 25.8 per 1000. Out of these 52 cases 23 (44.2%) were radiologically confirmed. Streptococcus pneumoniae was grown in 8 (25.85) out of 31 sputum samples. The outbreak was controlled by administration of 'supervised mass chemoprophylaxis' of all susceptible individuals in the institution with Tablet Azithromycin orally. Last suspected case was admitted to the military hospital on 25 Mar 2011.ConclusionThe study highlights the importance of Streptococcus pneumoniae as a causative organism for outbreaks of community acquired pneumonia (CAP) in large residential training institutions and reiterates the need for formulating a policy for continuous surveillance. It also highlights the importance of the novel method of using chemoprophylaxis for control of an ongoing outbreak of CAP.