Mycoplasma pneumoniae Epidemiology in England and Wales: A National Perspective

Abstract

Investigations of patients with suspected Mycoplasma pneumoniae infection have been undertaken in England since the early 1970s. M. pneumoniae is a respiratory pathogen that is a common cause of pneumonia and may cause serious sequelae such as encephalitis and has been documented in children with persistent cough. The pathogen is found in all age groups, with higher prevalence in children aged 5-14 years. In England, recurrent epidemic periods have occurred at ~4-yearly intervals. In addition, low-level sporadic infection occurs with seasonal peaks from December to February. Voluntarily reports from regional laboratories and hospitals in England from 1975 to 2015 were collated by Public Health England for epidemiological analysis. Further data pertaining cases of note and specimens submitted to Public Health England from 2005 to 2015 for confirmation, molecular typing is included.

Keywords: England; Mycoplasma pneumoniae; epidemiology; microbiology; wales.

Figure 1

Laboratory reports of Mycoplasma pneumoniae infection detection by genomic and serological methods in England and Wales from January 1989 to June 2015. The line at 20 cases per 3 weekly average rolling period defines seven epidemic periods of declining magnitude and clarity, lasting up to 2 years (1991–1992, 1994–1995, 1998–1999, 2001–2003, 2005–2006, 2011, 2015). National reporting categories include antibody detection and antibody-detection rising titre. A rising titre is defined as a four-fold increase in detectable anti-Mycoplasma pneumoniae antibody level.

Figure 2

Number of laboratory reports per year from January 1995 to June 2015 separated by detection methodology. National reporting categories included are: antibody detection and antibody-detection rising titre. A rising titre is defined as a four-fold increase in detectable anti-Mycoplasma pneumoniae antibody level (methods not specified). Other indicates specimens for which M. pneumoniae infection was determined using antigen detection (method not specified), microscopy and unknown categories. Culture indicates cases from which specimens yielded isolates of M. pneumoniae and genomic detection those for which DNA of M. pneumoniae was detected by PCR.

Figure 3

Distribution of MLST sequence types for 57 M. pneumoniae clinical isolates in the 4-yearly epidemic cycles observed in the UK. Year groups indicative of epidemic periods are listed on the x-axis. Sequence types (ST) 1–12 are listed in the key and indicated with differing colors. Allelic profiles are available on http://pubmlst.org/mpneumoniae.

Figure 4

Distribution of MLVA types in positive M. pneumoniae clinical specimens/isolates collated into the 4-yearly epidemic cycles observed in the UK. Year groups indicative of epidemic periods are listed on the x-axis. MLVA profiles are listed in the key and indicated with differing colors.

Figure 5

Distribution of P1 type in 4-yearly epidemic cycles observed in the UK for positive M. pneumoniae clinical specimens/isolates. Year groups indicative of epidemic periods are listed on the x-axis. P1 types are listed in the key and indicated with differing colors.