Pneumonia breaks out among Shelby County children

An outbreak of an usually mild form of pneumonia has been reported among school-age children in Shelby County, southeast of Indianapolis.

Several of the children, primarily in elementary and middle schools, have been hospitalized, the Shelby County Health Department reports.

"At least 20 students have shown a similar chest x-ray pattern, and several have required hospital admission and treatment with intravenous antibiotics," said a news release from Shelby County health officials. "The affected students are distributed throughout Shelby County, and thus the disease is not associated with any one school or other specific location or activity."

The exact cause is unknown, but it is believed to be a type of "walking pneumonia," which comes from specific bacteria that does not respond to drug treatments including penicillin and cephalexin. The bacteria can be fought with drugs including erythromycin (also known as Z-Pak), fluoroquinolones (also known as Cipro, Levaquin), and tetracyclines.

Typical symptoms include fever, cough, bronchitis, sore throat, headache and tiredness, according to the Indiana State Department of Health's epidemiology resource center, which said walking pneumonia usually is mild and rarely requires hospitalization. Infections of the middle ear

also can result.

Symptoms may persist for a few days to more than a month, according to the state center. Symptoms begin 15 to 25 days after exposure and generally develop slowly, over a period of two to four days.

The State Department of Health provided local physicians with testing kits for the bacteria mycoplasma to help determine if it is the cause of the ailment, Shelby County authorities said. The bacteria are transmitted via droplets from coughs or other contact with saliva.

There are no vaccines to prevent mycoplasma pneumonia, the state reports.

Children with the ailment should stay home from school, the health department said.

"If your children have a cough and any of the symptoms above, please keep them home from school and seek evaluation from your primary care physician," the release said. "As always, cough into your sleeve, wash your hands frequently or use antibiotic hand gel, and dispose of tissues properly."

http://www.indystar.com/article/20111108/LIVING01/111080396/Pneumonia-breaks-out-among-Shelby-County-children?odyssey=mod|newswell|text|IndyStar.com|s

Atypical Pneumonia in Indiana Children Raise trH3N2 Concerns
Recombinomics Commentary 19:45
November 8, 2011
"Every time it went away it would always come back, and it was 102," said parent Kim Dickmann.

Her son Luke, 6, has pneumonia.

"When you start seeing chest X-rays with infiltrates, fluid in the lungs, you know this is more than just your typical illness," said Dr. Paula Gustafson, a Shelby county pediatrician.

Gustafson said she saw 15 possible cases of pneumonia last week and upward of five possible cases on Monday.

"We've had some of them complain about intense cough, tightness in their chest, they've been on a couple rounds of antibiotics, and they aren't getting better," she said.

The above comments describe an atypical pneumonia in elementary and middle school students spreading throughout Shelby County, Indiana.  The Shelby County health department is treating the outbreak as Mycoplasma, but as seen above, cases have a high temperature and are not responding to antibiotics and there has been no lab confirmations reported.  Moreover, at least five of the more than 25 symptomatic students have been hospitalized.

The age demographic matches that of most confirmed trH3N2 cases this year (six of the seven were 9 years of age or younger), of which two were in Indiana.  Media reports do not suggest these patients have been tested for influenza.

More information on testing would be useful.