It was a great pleasure to read the nicely written article published in the journal on an Mycoplasma pneumoniae outbreak on a U.S. Navy vessel (7).
Indeed M. pneumoniae outbreaks have commonly been reported in military settings, being attributed mainly to the close proximity of army personnel and recruits (1, 3, 5, 6). Two types of epidemics have been noted: smoldering epidemics that occur over several months and are generally harder to detect and investigate (2, 7) and abrupt outbreaks that last for very short periods of time (3). The latter type is more common in recruit camps and during the 1960s provided the basis for several large-scale M. pneumoniae vaccine studies in U.S. Air Force and Marine recruit camps (4).
One important historical note is that the current report follows at least one previous description of a shipboard outbreak on a U.S. vessel. An earlier report published in 1966 (6) described a similar epidemic on a U.S. Navy nuclear submarine. The major difference between these studies was that diagnostic methods have changed with time: in the 1960s, the diagnosis was based mainly on complement fixation assay (6) or culture in some unique cases, whereas in this new study the diagnosis was based on DNA amplification carried out on throat swabs.
In a similar vein, serological responses were not evaluated in this report. Determination of the rate of seroconversion might have yielded a higher number of cases in this outbreak (3, 8) or at least some useful information about the sensitivity of molecular diagnosis.
REFERENCES
- 1.Feikin, D. R., J. F. Moroney, D. F. Talkington, W. L. Thacker, J. E. Code, L. A. Schwartz, D. D. Erdman, J. C. Butler, and M. S. Cetron. 1999. An outbreak of acute respiratory disease caused by Mycoplasma pneumoniae and adenovirus at a federal service training academy: new implications from an old scenario. Clin. Infect. Dis. 29:1545-1550. [DOI] [PubMed] [Google Scholar]
- 2.Foy, H. M., G. E. Kenny, R. McMahan, G. Kaiser, and J. T. Grayston. 1971. Mycoplasma pneumoniae in the community. Am. J. Epidemiol. 93:55-67. [DOI] [PubMed] [Google Scholar]
- 3.Klement, E., D. F. Talkington, O. Wasserzug, R. Kayouf, N. Davidovitch, R. Dumke, Y. Bar-Zeev, M. Ron, J. Boxman, W. Lanier Thacker, D. Wolf, T. Lazarovich, Y. Shemer-Avni, D. Glikman, E. Jacobs, I. Grotto, C. Block, and R. Nir-Paz. 2006. Identification of risk factors for infection in an outbreak of Mycoplasma pneumoniae respiratory tract disease. Clin. Infect. Dis. 43:1239-1245. [DOI] [PubMed] [Google Scholar]
- 4.Linchevski, I., E. Klement, and R. Nir-Paz. 2009. Mycoplasma pneumoniae vaccine protective efficacy and adverse reactions—systematic review and meta-analysis. Vaccine 27:2437-2446. [DOI] [PubMed] [Google Scholar]
- 5.Mogabgab, W. J. 1968. Mycoplasma pneumoniae and adenovirus respiratory illnesses in military and university personnel, 1959-1966. Am. Rev. Respir. Dis. 97:345-358. [DOI] [PubMed] [Google Scholar]
- 6.Sawyer, R., and R. G. Sommerville. 1966. An outbreak of Mycoplasma pneumoniae infection in a nuclear submarine. JAMA 195:958-959. [PubMed] [Google Scholar]
- 7.Sliman, J. A., D. Metzgar, D. C. Asseff, R. G. Coon, D. J. Faix, and S. Lizewski. 2009. Outbreak of acute respiratory disease caused by Mycoplasma pneumoniae on board a deployed U.S. navy ship. J. Clin. Microbiol. 47:4121-4123. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Thurman, K. A., N. D. Walter, S. B. Schwartz, S. L. Mitchell, M. T. Dillon, A. L. Baughman, M. Deutscher, J. P. Fulton, J. E. Tongren, L. A. Hicks, and J. M. Winchell. 2009. Comparison of laboratory diagnostic procedures for detection of Mycoplasma pneumoniae in community outbreaks. Clin. Infect. Dis. 48:1244-1249. [DOI] [PubMed] [Google Scholar]