Probable epidemic Mycoplasma pneumoniae disease activity in metropolitan Sydney, 2015: combining surveillance data to cross-validate signal detection

Authors

  • Philip N Britton Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney; Marie Bashir Institute of Infectious Diseases and Biosecurity Institute (MBI), University of Sydney; Department of Infectious Diseases and Microbiology, Children’s Hospital at Westmead
  • Shopna K Bag Western Sydney Public Health Unit, Western Sydney Local Health District
  • Robert Booy Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney; Marie Bashir Institute of Infectious Diseases and Biosecurity Institute (MBI), University of Sydney; National Centre for Immunisation Research and Surveillance
  • Caroline HW Sharpe Rapid Surveillance, Centre for Epidemiology and Evidence, Population and Public Health Division, NSW Ministry of Health
  • Katherine B Owen Rapid Surveillance, Centre for Epidemiology and Evidence, Population and Public Health Division, NSW Ministry of Health
  • Jiaying Zhao Rapid Surveillance, Centre for Epidemiology and Evidence, Population and Public Health Division, NSW Ministry of Health
  • Melissa J Irwin Rapid Surveillance, Centre for Epidemiology and Evidence, Population and Public Health Division, NSW Ministry of Health
  • Cheryl A Jones Marie Bashir Institute of Infectious Diseases and Biosecurity Institute (MBI), University of Sydney; Department of Paediatrics, University of Melbourne

DOI:

https://doi.org/10.33321/cdi.2017.41.40

Keywords:

Mycoplasma pneumoniae, surveillance, encephalitis, pneumonia, children, Australia

Abstract

Introduction
Mycoplasma pneumoniae is a leading cause of community acquired pneumonia and well-recognised cause of encephalitis in children. Sentinel hospital surveillance identified a temporal cluster of children with suspected encephalitis associated with M.pneumoniae in NSW. We aimed to determine whether this cluster was associated with epidemic M.pneumoniae activity.
Methods
A multi-faceted investigation was undertaken using existing data sources including:
Active clinical surveillance of suspected encephalitis (ACE study) associated with M.pneumoniae at the Children’s Hospital at Westmead (CHW).
Syndromic surveillance of Emergency Department presentations for pneumonia in children 0-16 years to 86 NSW hospitals.
Laboratory sentinel surveillance of M.pneumoniae testing performed at CHW and the Institute for Clinical Pathology and Medical Research (ICPMR), Westmead.
Results
We detected an increased number of cases of hospitalised suspected encephalitis associated with M. pneumoniae in 2015 at the Sydney Childrens Hospital Network (SCHN), with a peak in July, that were predominantly in Western Sydney. Concurrently, monthly pneumonia presentations to 86 NSW emergency departments in children aged 0-16 years increased in 2015. This increase was greater in children aged 5-16 years compared to those aged 0-4 years and in metropolitan sites compared with rural hospitals. Laboratory data from sentinel laboratories showed increased frequency of testing, and of tests returned positive for M.pneumoniae in 2015 compared to preceding years. In aggregate, this information was considered suggestive of epidemic activity of M.pneumoniae in metropolitan Sydney in 2015.
Conclusions
Active surveillance for childhood encephalitis has the potential to provide sentinel surveillance data to identify epidemic infectious disease activity. Combining multiple sources of surveillance data affords opportunities to cross-validate epidemic signals. M.pneumoniae disease activity is challenging to measure, and may be a cause of significant disease burden in Australian children during epidemic years.

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Published

01/12/17

How to Cite

Britton, Philip N, Shopna K Bag, Robert Booy, Caroline HW Sharpe, Katherine B Owen, Jiaying Zhao, Melissa J Irwin, and Cheryl A Jones. 2017. “Probable Epidemic Mycoplasma Pneumoniae Disease Activity in Metropolitan Sydney, 2015: Combining Surveillance Data to Cross-Validate Signal Detection”. Communicable Diseases Intelligence 41 (December):295-307. https://doi.org/10.33321/cdi.2017.41.40.

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Vol. 41 (2017)

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Original article

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