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Outbreak of Chlamydia pneumoniae Infection in a Japanese Nursing Home, 1999-2000

Published online by Cambridge University Press:  21 June 2016

Kazutoshi Nakashima ,
Takeshi Tanaka ,
Michael H. Kramer ,
Hiroshi Takahashi ,
Takaaki Ohyama ,
Toshio Kishimoto ,
Hironori Toshima ,
Shigeyuki Miwa ,
Atsushi Nomura  and
Naoki Tsumura
...Show all authors
Kazutoshi Nakashima*
Affiliation:
Infectious Disease Surveillance Center, Yamaguchi, Japan
Takeshi Tanaka
Affiliation:
Infectious Disease Surveillance Center, Yamaguchi, Japan National Institute of Infectious Diseases, Tokyo, the Fukuoka Quarantine Station, Yamaguchi, Japan
Michael H. Kramer
Affiliation:
Infectious Disease Surveillance Center, Yamaguchi, Japan Bundesministerium für Gesundheit und Soziale Sicherung, Bonn, Germany
Hiroshi Takahashi
Affiliation:
Infectious Disease Surveillance Center, Yamaguchi, Japan
Takaaki Ohyama
Affiliation:
Infectious Disease Surveillance Center, Yamaguchi, Japan
Toshio Kishimoto
Affiliation:
Department of Virology I, Yamaguchi, Japan
Hironori Toshima
Affiliation:
Fukuoka, theToshima Clinic, Yamaguchi, Japan
Shigeyuki Miwa
Affiliation:
Nagato Environment and Health Center, Yamaguchi, Japan
Atsushi Nomura
Affiliation:
Nagato Environment and Health Center, Yamaguchi, Japan
Naoki Tsumura
Affiliation:
Department of Pediatrics, Kurume University School of Medicine, Yamaguchi, Japan
Kazunobu Ouchi
Affiliation:
Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
Nobuhiko Okabe
Affiliation:
Infectious Disease Surveillance Center, Yamaguchi, Japan
*
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjyuku, Tokyo 162-8640, Japan ([email protected])
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Abstract

Objective.

To identify risk factors for infection and severe illness due to Chlamydia pneumoniae.

Methods.

To identify risk factors for infection, we conducted a case-control study among nursing home residents who had onset of symptoms during December 1, 1999, to February 20, 2000. To identify risk factors for severe illness among nursing home residents, we conducted a retrospective cohort study.

Setting.

A nursing home providing long-term and day care services for elderly patients in Japan.

Participants.

Fifty-nine residents and 41 staff members of a nursing home.

Results.

The attack rates for respiratory illness were 53% (31 of 59) among residents and 22% (9 of 41) among staff. Infection was confirmed in 15 resident and 2 staff case patients by isolation of C. pneumoniae from nasal swab specimens. Fifteen resident case patients developed severe illness (ie, bronchitis, pneumonia, and hypoxia); one case patient died. The median age of resident case patients was 87 years. We could identify neither the source of the outbreak nor significant risk factors for infection and severe illness in residents. However, residents with a higher level of physical activity were more likely to become infected, whereas older residents (aged more than 85 years) and those with a lower level of physical activity were more likely to develop severe illness (P>.05). Contact with residents was a risk factor for infection in staff (relative risk, undefined; P = .04).

Conclusions.

C. pneumoniae can cause large outbreaks of infection and severe illness among elderly persons, and its transmission is likely to be enhanced by close contacts among people in nursing homes. Therefore, early detection of an outbreak by means of better surveillance, and subsequent isolation of patients, may be effective control measures.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 11 , November 2006 , pp. 1171 - 1177
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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