Lessons learnt after school pneumonia

Jan 1 2009 by Sam Wood, The Journal

A MAJOR study into an outbreak of pneumonia at a North Tyneside school in 2006 has resulted in many lessons being learned, a health expert has said.

The North East Health Protection Agency (HPA) published the paper on the British Medical Journal website.

In October 2006, a serious outbreak of five cases of pneumonia was caused by pneumococcus bacteria in the reception classes of Priory Primary School in Percy Park Road, Tynemouth.

The outbreak began at the end of October – just before half-term – when four-year-old Jack Palmer began complaining of a high fever and shortness of breath, and was rushed to the heart and lung transplant unit at Newcastle’s Freeman Hospital.

His frantic parents Ross, 39, and Jennifer, 35, were told their son had pneumonia, but had suffered complications and was being treated for puss lying around his lungs.

The following day two other pupils were taken to hospital, including five-year-old Tom Robinson, whose parents Duncan and Liz came home from a meal to find him with a high temperature and back pain.

The Robinsons, who had heard about the outbreak, took their son straight to the doctor, who immediately sent him to hospital, where medics said they were lucky to have caught the illness so early. All three children made a swift recovery, and the reception year were given antibiotics. But at the end of November a fourth child was diagnosed with pneumonia.

Outbreaks caused by the pneumococcus strain of bacteria are extremely rare and this outbreak was the first of its kind involving children in a school to be reported in the UK.

The study, written in collaboration with colleagues from Northumbria Healthcare NHS Foundation Trust and Newcastle upon Tyne Hospitals NHS Foundation Trust, reviews the outbreak and outlines recommendations to protect public health in the event of any future outbreaks of serious pneumococcal disease.

Dr Meng Khaw of the Health Protection Agency in the North East and lead author of the study, said: “The outbreak in North Tyneside was particularly complex and many lessons have been learnt which we hope will be applied in the future.

“Early detection and notification of suspected outbreaks of serious pneumococcal disease is critical to enable infection control measures to be put in place quickly.

“Healthcare workers and other professional groups, such as teachers, can play a vital role in reporting suspected outbreaks.

“A crucial element of this outbreak was the use of a non-invasive urine test to identify the strain of the infection.

“This proved especially important as blood tests weren’t able to detect this particular infection on every occasion.

“At the time of the outbreak, there were no standard procedures to manage outbreaks of pneumococcal pneumonia.

“However, the HPA’s vaccine programme board has convened an expert group to develop guidelines and published interim guidelines for the management of clusters of serious pneumococcal disease in closed settings.”

Turn to pages two and three to see how we reported on the original outbreak.

Page 2: Four cases occur in a single school