Mass chemoprophylaxis in control of pneumococcal pneumonia outbreak in a military training centre.

BACKGROUND: Outbreaks of streptococcal pneumonia among young recruits in military training centers are well-documented. A significant outbreak of pneumonia occurred between November 19, 2011 and February 4, 2012 among the young recruits of a large training center located in Southern India.

OBJECTIVES: The objective of this investigation was to identify the cause of the outbreak, to control the outbreak at the earliest, and to provide future strategies for containing such an outbreak.

MATERIALS AND METHODS: The outbreak was investigated using standard epidemiological methods so as to describe its epidemiology, to identify the causative organism, to guide the outbreak control efforts, and to provide future strategies for containing such an outbreak.

RESULTS: Over 2 months, 58 cases of pneumonia occurred among the recruits of the center, giving an attack rate of 4.81 cases per 1,000 person-months. Radiological positivity was found in 72.4% of the cases. Streptococcus pneumoniae (S. pneumoniae) was grown in all the three bronchoalveolar lavage (BAL) samples. The outbreak rapidly ended following prophylaxis with oral azithromycin.

CONCLUSIONS: This outbreak of pneumococcal disease occurred in the setting of intense military training and a crowded environment. Oral azithromycin was found to be the suitable strategy for control of the outbreak.