An outbreak of childhood pneumonia with acute respiratory failure in Don Tum District, Nakhon Pathom Province, Thailand, May–September 2018
Keywords:
childhood pneumonia, acute respiratory failure, Don Tum DistrictAbstract
Background: In Don Tum District, Nakhon Pathom, physicians detected a cluster of childhood pneumonia with acute respiratory failure (ARF) during June–August 2018. An investigation was performed to confirm diagnosis and outbreak, determine a magnitude of children <10 years of age diagnosed pneumonia and pneumonia with ARF in Don Tum District and Nakhon Pathom, describe characteristics of children <10 years of age diagnosed pneumonia with ARF in Don Tum Hospital, and recommend preventive and control measures.
Method: A descriptive study was conducted by reviewing the number of children <10 years of age diagnosed pneumonia and pneumonia with ARF in Don Tum District and Nakhon Pathom, reviewing medical records of children <10 years of age diagnosed pneumonia with ARF in Don Tum Hospital during May–September 2018, interviewing case’ s parents and collecting tips of endotracheal suction catheters for identifying respiratory pathogens.
Result: During May–September 2018, 45 cases of pneumonia with ARF were found in Don Tum Hospital. All were recovery. During May–August 2018, 34 cases of pneumonia with ARF were found and proportion of ARF secondary to pneumonia was 23.5. Eleven cases of pneumonia with ARF were found in September 2018. Twenty–seven (60%) were male, median age was 1 year 7 months. Clinical manifestations were cough (96%), dyspnea (87%), and fever (84%). Top–three respiratory pathogens were Respiratory Syncytial Virus, Moraxella catarrhalis, and Rhinovirus. Seventy six percent had a history of air pollution exposure, 72.4% had a history of household smoking, and 66.7% exposed to who had fever, cough, and dyspnea. Three subdistricts with the highest morbidity proportion in Don Tum District were adjoining, but no epidemiological linkage among cases was identified.
Conclusion: An outbreak of pneumonia with ARF among children <10 years of age was detected in Don Tum District. Pathogens were mixed viruses and bacteria. Respiratory Syncytial Virus was the most likely pathogen. Monitoring a pneumonia situation among children <10 years of age regularly and strengthening preventive and control measures in schools and childcare when cases increase substantially, and air pollution assessments in a community are important.
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