Mycoplasma pneumoniae respiratory illness - two rural counties, West Virginia, 2011.

On October 28, 2011, the West Virginia Department of Health and Human Resources notified CDC of an increase in pneumonia cases among school-aged children in two rural counties. Mycoplasma pneumoniae was the suspected cause, based on epidemiology, clinical presentation, and testing of specimens sent to CDC. Three of six nasopharyngeal swabs were positive for M. pneumoniae in testing by quantitative real-time polymerase chain reaction (qPCR). The West Virginia Department of Health and Human Resources and CDC conducted an outbreak investigation to confirm the etiology of the outbreak, establish active case surveillance, and provide recommendations for treatment and containment. The investigation confirmed M. pneumoniae as the cause and identified 125 cases, including two caused by macrolide-resistant isolates. The outbreak was contained with public health interventions that included communicating to the public the importance of respiratory hygiene, providing hand sanitizer in schools, and informing health-care providers about macrolide resistance; antibiotic prophylaxis was not used. Despite the large number of cases and macrolide-resistant strains, no severe extrapulmonary manifestations (e.g., erythema multiforme) were reported.