Rhode Island Department of Health
Frequently Asked Questions on Mycoplasma Pneumoniae
January 9, 2007, 3 p.m.
What is the Department of Health trying to determine in the investigation?
HEALTH is looking to determine the cause of these pneumonia-like illnesses. We specifically want to know if the affected students were exposed to the mycoplasma pneumonia bacteria. Mycoplasma related respiratory illness is very common generally. Additionally, Health and CDC are looking to determine if there is more than the usual/expected amount of Mycoplasma in the community. HEALTH is always concerned with the prevention of the spread of disease.
What is mycoplasma infection?
Mycoplasma infection is a respiratory illness caused by a type of bacteria called by Mycoplasma pneumoniae. Usually mycoplasma infection is mild, causing symptoms, such as fever, cough, bronchitis, sore throat, and headache. A common result of mycoplasma infection is a mild form of pneumonia. It is very rare for this bacteria to cause serious illness such as encephalitis or meningitis.
Who gets mycoplasma infection?
Anyone can get the disease, but it most often affects older children and young adults.
When do mycoplasma infections occur?
Mycoplasma infections occur sporadically throughout the year. Widespread community outbreaks may occur at intervals of four to eight years. Mycoplasma infection is most common in late summer and fall.
How is mycoplasma spread?
Mycoplasma is spread through contact with droplets from the nose and throat of infected people especially when they cough and sneeze. Transmission is thought to require prolonged close contact with an infected person. The spread of bacteria in communities occurs slowly. The contagious period is probably less than 10 days.
What are the symptoms of mycoplasma infection?
Typical symptoms include fever, cough, bronchitis, sore throat, and headache. A common result of mycoplasma infection is pneumonia (sometimes called “walking pneumonia” because it is usually 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.
How soon after exposure do symptoms appear?
Symptoms generally begin 2-3 weeks after exposure. The symptoms generally develop slowly, over a period of 2 to 4 days.
How is mycoplasma infection diagnosed?
Mycoplasma infection is usually diagnosed on the basis of typical symptoms. Throat swabs and blood tests are not generally helpful except to evaluate other possible causes of illness (e.g. Strep throat). The use of more specific laboratory tests is often limited to special investigations.
How can I get my child and/or family tested?
The Health Department does not recommend routine testing for mycoplasma infection for either patients with mild respiratory illness or healthy individuals.
When will screening results for individuals tested as part of HEALTH's epidemiology investigation be done?
Results will be available in 2-4 weeks and will be sent to the individual's home.
Why does it take so long to get the results?
The normal time frame for any serologic testing is 10-14 days. The Health Department first consulted with CDC on December 21 and the first positive test results were received on December 29.
Will HEALTH or CDC be doing any more testing in the schools?
The Department of Health and the CDC will continue to monitor for any unusual increase in cases of pneumonia over the next month at Greenwood Elementary School, Blackrock and Oak Haven Elementary Schools and John F. Deering Middle School. As part of a follow-up to our investigation, special testing will be offered to children who are newly diagnosed as having pneumonia. In order to better understand the results of this study, we hope to also collect information from students at Deering Middle School who have not had pneumonia since October for the purpose of comparison.
Who pays for laboratory testing fees?
HEALTH is only paying for the costs of laboratory testing on blood samples as ordered by HEALTH as part of the CDC investigation. Parents/guardians of children participating in the CDC investigation should have lab orders signed by Dr. Gifford, Director of HEALTH. If a parent/guardian has misplaced their Department of Health laboratory orders, he/she should contact the Department of Health, Family Health Information Line, 1-800-942-7434. HEALTH has established an agreement with East Side Clinical Laboratories to perform CDC investigative blood tests.
Does past infection with Mycoplasma make a person immune?
Immunity after mycoplasma infection does occur, but is not lifelong. Second or repeat infections are known to occur, and are generally milder. The duration of immunity is unknown.
What is the treatment for mycoplasma infection?
Antibiotics such as azithromycin, erythromycin, clarithromycin or tetracyclines are effective treatment. However, because mycoplasma infection usually resolves on its own, antibiotic treatment of persons with mild symptoms is usually not necessary.
What do I do if my child experiences an adverse reaction to the antibiotics provided to Greenwood Elementary School families?
Please call the Department of Health, Family Health Information Line, 1-800-942-7434 to report any adverse reactions to the antibiotics. Be prepared to share your name, your child's name and the symptoms. For specific medical advice you will be referred to your primary physician.
What can be done to prevent the spread of mycoplasma?
At this time, there are no vaccines for the prevention of mycoplasma infection. As with any respiratory disease, all people should cover their mouth and nose when coughing or sneezing, and stay home from work or school when they are sick. For specific medical advice, you will be referred to your primary physician.
Do you have any printed instructions for proper handwashing or cough etiquette?
To download electronic versions of educational materials, visit http://www.cdc.gov/germstopper/materials.htm.
What is going on in Coventry and West Warwick?
On Tuesday, January 2, 2007, the CDC classified mycoplasma as the “probable” cause of a case of encephalitis at the John F. Deering Middle School in West Warwick. That child is currently recovering at home. Usually mycoplasma infection is mild, causing symptoms, such as fever, cough, bronchitis, sore throat, and headache. A common result of mycoplasma infection is a mild form of pneumonia. It is very rare for this bacteria to cause serious illness such as encephalitis or meningitis.
HEALTH is also investigating reports of higher than normal absenteeism over the past two months related to pneumonia in two Coventry schools: Blackrock Elementary and Oak Haven Elementary. We do not yet know if these illnesses are related to mycoplasma. We have not confirmed an outbreak at the John F. Deering Middle School or elsewhere.
On Thursday, January 4, 2007 HEALTH recommended the temporary closure of schools in Warwick, West Warwick and Coventry after an additional possible case of encephalitis was reported, and to allow time for HEALTH and the CDC to more fully investigate.
Are there any other clusters in Rhode Island?
HEALTH in collaboration with the CDC is actively monitoring all schools for evidence of increased absenteeism and possible respiratory illness.
Why were previous school meetings in Warwick and West Warwick only open to parents/guardians at those schools?
Parent/guardian meetings were closed to media and people not affiliated with the school because the information shared may be considered confidential. Parents/guardians were offered the opportunity to ask specific questions about their children's health which means the communications were treated like patient-provider interactions and therefore confidential.
Are there any more parent/guardian informational meetings planned?
There is an informational meeting for parents/guardians of John F. Deering Middle School students scheduled for Wednesday, January 10 at 6:30 p.m. at West Warwick High School.
Why is CDC here?
It is unusual to have a mycoplasma cluster. The Centers for Disease Control and Prevention (CDC) were initially invited to rule out rabies and Eastern Equine Encephalitis (EEE) as causes of the neurological conditions. The CDC remains here to provide specialized laboratory support and technical assistance in the investigation.
What do daycare facilities need to know?
Daycare providers should reinforce three key principles:
1. Daycare providers should implement and reinforce hand hygiene and cough etiquette principles. Hand hygiene means frequently washing hands with soap and water or using alcohol gels. Cough etiquette means coughing or sneezing into the inside of your elbow to prevent contaminating hands. Preventive measures are extremely effective in preventing the spread of illness.
2. Daycare providers should apply routine policies for exclusion at daycares. Sick children should be sent home and remain home for 24 hours after symptoms subside.
3. Daycare providers should know that HEALTH does not recommend testing for mycoplasma as a means to determine whether a previously ill child can return to day care, nor should it be used to screen well children for admission to day care.
How will alcohol gels be distributed?
The state will be distributing alcohol gels and dispensers to all Rhode Island schools beginning Sunday, January 7, 2007. All schools will also be receiving 2 refill packs of alcohol gels for each dispenser. (Details of this distribution are being finalized at this time.)
Should community programs (YMCAs, libraries) or special events (sporting events) be closed/cancelled?
Community programs/special events should continue as normal. The Department of Health, however, is reminding everyone to practice routine prevention practices such as handwashing and proper cough etiquette.
What is defined as close contact?
Close contact is defined as someone who lives in your home.
People in senior centers and nursing homes spend prolonged periods of time together. Why are they not closed?
People in all settings should practice good handwashing and proper cough etiquette measures. People who are sick should refrain from visiting people in a nursing home or senior center.
Is Mycoplasma related to bird flu?
There is no relationship between Mycoplasma and the bird flu.
How do I get more information?
Please consult the Department of Health Website at www.health.ri.gov . or call the Department of Health, Family Health Information Line 1-800-942-7434.
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