February 12, 1997

Outbreaks of Pneumococcal Pneumonia Among Unvaccinated Residents in Chronic-Care Facilities—Massachusetts, October 1995, Oklahoma, February 1996, and Maryland, May-June 1996

JAMA. 1997;277(6):452-453. doi:10.1001/jama.1997.03540300020009

DURING October 1995-June 1996, CDC and state and local public health agencies investigated outbreaks of pneumococcal pneumonia with bacteremia at chronic-care facilities (CCFs) serving predominantly elderly populations in Massachusetts, Oklahoma, and Maryland. This report summarizes these investigations and identifies measures that may prevent such outbreaks.

In the investigation of these outbreaks, pneumonia was defined as a chest radiograph consistent with pneumonia and compatible clinical features. Control measures implemented in these outbreaks included restricting group activities and new admissions to the CCFs, cohorting of staff-resident assignments, and vaccination of all residents lacking documentation of pneumococcal polysaccharide vaccine (PV). In two of the outbreaks, antimicrobial prophylaxis was administered in conjunction with PV, after which no additional cases of invasive pneumococcal infection were identified.

Massachusetts.  During October 5-14, 1995, a total of 10 cases of pneumonia occurred among 67 residents of a CCF (attack rate [AR]=14.9%); two cases were fatal. The