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Chlamydophila pneumoniae Infection

 College studentsClinical Features
Pneumonia or bronchitis, gradual onset of cough with low-grade fever. Less common presentations are pharyngitis, laryngitis, and sinusitis. The spectrum of illness can range from asymptomatic infection to severe disease.
Etiologic Agent
The bacterium Chlamydophila (or Chlamydia) pneumoniae (C. pneumoniae) is distinct from other Chlamydia species.
Incidence
The overall incidence is unknown. Each year, an estimated 2-5 million cases of pneumonia and 500,000 pneumonia-related hospitalizations occur in the United States.
Sequelae
C. pneumoniae infection may be associated, by some investigators, with atherosclerotic vascular disease. Associations with Alzheimer's disease, asthma, and reactive arthritis have been proposed.
Transmission
Person-to-person transmission by respiratory secretions. Outbreaks can occur periodically, primarily in close-contact settings such as military barracks, college dormitories, long-term care facilities, or prisons.
Risk Groups
All ages at risk, but most common in school-age children. In the United States, about 50% of adults have evidence of past infection by age 20. Reinfection throughout life appears to be common.
Treatment
Macrolides are often the first-line treatment; tetracyclines and fluoroquinolones are also effective.
Surveillance
No national or state surveillance exists.
Trends
Unknown. Improved diagnostic testing may lead to improved recognition of infection.
Challenges
There is a lack of standardized diagnostic methods. Isolation of the etiologic agent is difficult, so antibody tests using paired acute- and convalescent-phase sera have been used for diagnosis. There are no known methods to prevent possible sequelae. The role of C. pneumoniae in atherosclerotic vascular disease needs further definition. Postinfection carriage of C.pneumoniae can occur for up to 8 weeks.
Opportunities
To apply new laboratory methods, such as real-time polymerase chain reaction, and to evaluate association between C. pneumoniae infection and atherosclerosis, as well as other chronic diseases.
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