Hospital Outbreak of Mixed Infection of Influenza Virus andMycoplasma pneumoniae

Ming-Ching Liu1, Chia-En Lien1,Ching-Fen Ko1, Ung-Chao Lei2,Jih-Hui Lin3, Shu-Ying Li3, Mei-Chu Lee1,Jiunn-Shyan Julian Wu1,Jenn-Huei Renn4, Nan-Yueh Lin5, Yeong-Sheng Lee1

2010 Vol.26 NO.18

Correspondence Author: Ming-Ching Liu


Some residents and health care workers (HCWs) of a long-term psychiatric care facility in Hualien presented with upper respiratory tract symptoms continuously since December 30, 2008. Investigation found that 62.2% of the residents (114/183) and 68.9% (11/16) of the HCWs were symptomatic. From the 104 samples obtained from symptomatic patients, 27 were H3 subtype of influenza A virus (Flu A H3) confirmed by reverse transcription-polymerase chain reaction (RT-PCR), 12 were serologically positive for Mycoplasma pneumoniae. Among the 27 specimens positive for influenza A virus, 11 of them were culture positive. Sequence analysis of the genome showed a 95% similarity in nucleotide identity. Based on these laboratory evidences, we attributed this respiratory outbreak to mixed infection of Flu A H3 and Mycoplasma pneumoniae. The outbreak was controlled after sick staffs were asked to stay home, sick residents were isolated, access and visitors were controlled, HCWs were asked to adhere to standard precautions. Although with higher coverage rate of seasonal influenza vaccines in long-term psychiatric facilities, influenza outbreaks still could occur because of the high population density and lack of self-care ability of residents. Therefore, infection control, cold chains of vaccines transportation, and vaccination rate among HCWs should be improved in facilities with high population density, especially in facing this episode of pandemic H1N1.