Rhode Island Department of Health

Frequently Asked Questions Regarding Infection Control and Mycoplasma Pneumonia
January 9, 2007, 4 p.m.

What are the infection control measures for hospitalized patients with likely or possible Mycoplasma infection?

• In addition to standard precautions, droplet precautions are recommended. In patients with compatible clinical illness with Mycoplasma infection (such as severe pneumonia, meningitis or encephalitis) and with severity warranting hospitalization, an etiologic agent will likely not be confirmed at the time of hospital admission. Such patients should be placed in a private room with surgical masks for staff and visitors coming within 3-6 ft of the patient's bed. Healthcare providers should wear gloves if caring for the patient will entail contact with respiratory secretions.
• Removal of respiratory droplet isolation should be individualized, taking into account the results of diagnostic testing, antimicrobial treatment, patient's symptoms and clinical improvement.

Can pregnant healthcare workers care for patients with suspected Mycoplasma infection?

• Yes, with the same appropriate infection control precautions being observed.

What are the infection control measures in an office or clinic setting for patients who are ill and coughing?

• Consistent with previous recommendations (during SARS, high levels of influenza activity in the community, etc), such patients should be segregated as much as possible from other patients in the waiting area. Ill patients with cough should be triaged if feasible to a separate exam room or cubicle, and seen by a medical provider as rapidly as possible.
• Patients who are coughing should be instructed in respiratory etiquette ( www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm ) and provided with tissues and a receptacle for their disposal. Alcohol hand gel should be available. Placing a surgical mask on the patient should be considered, especially for persons unable to cover their cough.
• “Cover Your Cough” educational material available at: www.cdc.gov/flu/protect/covercough.htm

Have there been changes to the criteria for exclusion from school of children who are ill with respiratory symptoms such as cough, cold, runny nose, fever, sinusitis or otitis?

• There have not been changes to the criteria for exclusion from school of children who are ill with respiratory symptoms.
• Children with respiratory illnesses should be excluded from school when:

1. The illness severity prevents the child from participating in school activities. 
2.  Fever [Temperature greater than 101 degrees orally], excessive sleepiness, difficulty breathing, persistent cough or other signs suggesting severe illness is present.

(Adapted From: American Academy of Pediatrics, Managing Infectious Diseases in Day Care and Schools )

When may previously ill children return to school?

• Decisions on return to school are to be individualized in consultation with the treating healthcare provider, taking into account the resolution of symptoms and the child's overall well being.
• Children with “walking pneumonia” may return to school when exclusion criteria have resolved and the child feels well enough to resume normal activities.
• Children with fever should not return to school until they have been fever-free for 24 hrs and any other accompanying symptoms are resolved.

Should well children who are contacts of ill persons with possible Mycoplasma infection be excluded from school?

• No. Well children who are contacts of persons who may have Mycoplasma infection should not be excluded from school or daycare. They should be monitored for symptoms such as fever, cough, sore throat, ear pain, or headache, and if these develop, brought to their medical provider for further evaluation and treatment.