Outbreak of Streptococcus pneumoniae serotype 1 pneumonia in a United Kingdom school

Pneumococcal pneumonia is not generally regarded as contagious.1 Although epidemics of pneumococcal disease have been reported (in sub-Saharan Africa2 3 and Canada4), outbreaks of pneumococcal infection are uncommon and are generally restricted to high risk individuals such as alcoholics,5 residents in shelters for the homeless,6 and people living in close groups7 including military camps,8 prisons,9 day care centres,10 and nursing homes.11 Recent reports have indicated that serotype 1 pneumococcus is largely responsible for the exponential increase in the incidence of empyema and complicated pneumonia seen in children in several countries over the past decade.12 13 14 There is also evidence of outbreaks of other forms of invasive serotype 1 disease in many countries.2 15 16 In contrast to most other invasive serotypes, carriage of serotype 1 is rarely detected in the nasopharynx of either adults or children, suggesting short duration of carriage or high virulence.17 18

There have been no reports of outbreaks of pneumococcal pneumonia among UK children, but they have been reported in other countries.7 19 We describe an outbreak of serotype 1 pneumococcal pneumonia among young children in a school in northeast England.