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We report the third outbreak of pneumococcal pneumonia within one year among workers in European shipyards. During January and February 2020, 37 cases of pneumonia were identified in a shipyard in Marseille, south-eastern France. Outbreak control measures were implemented, including a mass vaccination campaign with 23-valent pneumococcal polysaccharide vaccine targeting all shipyard workers. Given the high mobility of shipyard workers, coordinated responses between European public health institutes are necessary to avoid further outbreaks.


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  1. Levet P, Raoult D, Parola P. Treating influenza with antibiotics. Int J Antimicrob Agents. 2017;50(4):505-6.  https://doi.org/10.1016/j.ijantimicag.2017.04.012  PMID: 28669834 
  2. Santé publique France. Méningites, septicémies et pneumonies à pneumocoque. [Pneumococcal meningitis, bacteraemia and pneumonia]. Paris: Santé publique France. [Accessed: 12 Feb 2020]. French. Available from: https://professionnels.vaccination-info-service.fr/Maladies-et-leurs-vaccins/Meningites-septicemies-et-pneumonies-a-pneumocoque
  3. Santé publique France. Bilan annuel 2018: Impact de la vaccination par le vaccin pneumococcique conjugué 13-valent (VPC13) sur l’incidence des infections invasives à pneumocoques. Données du réseau Epibac et du CNR des pneumocoques (réseau CNRP-ORP). [Annual report 2018; Impact of the 13-valent pneumococcal conjugate vaccine (VPC13) vaccination on the incidence of invasive pneumococcal infections. Data from the Epibac network and pneumococcal LNR]. Paris: Santé publique France; Nov 2019. French. Available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-et-infections-respiratoires/infections-a-pneumocoque/donnees/#tabs
  4. Weiser JN, Ferreira DM, Paton JC. Streptococcus pneumoniae: transmission, colonization and invasion. Nat Rev Microbiol. 2018;16(6):355-67.  https://doi.org/10.1038/s41579-018-0001-8  PMID: 29599457 
  5. Amin-Chowdhury Z, Iyanger N, Ramsay ME, Ladhani SN. Outbreaks of severe pneumococcal disease in closed settings in the conjugate vaccines era, 2010-2018: A systematic review to inform national guidance in the UK. J Infect. 2019;79(6):495-502.  https://doi.org/10.1016/j.jinf.2019.10.009  PMID: 31629865 
  6. Almirall J, Serra-Prat M, Bolíbar I, Balasso V. Risk factors for community-acquired pneumonia in adults: a systematic review of observational studies. Respiration. 2017;94(3):299-311.  https://doi.org/10.1159/000479089  PMID: 28738364 
  7. Martin-Loeches I, van Someren Gréve F, Schultz MJ. Bacterial pneumonia as an influenza complication. Curr Opin Infect Dis. 2017;30(2):201-7.  https://doi.org/10.1097/QCO.0000000000000347  PMID: 27984245 
  8. Ewing J, Patterson L, Irvine N, Doherty L, Loughrey A, Kidney J, et al. Serious pneumococcal disease outbreak in men exposed to metal fume - detection, response and future prevention through pneumococcal vaccination. Vaccine. 2017;35(32):3945-50.  https://doi.org/10.1016/j.vaccine.2017.06.010  PMID: 28633889 
  9. Kiang L. A series of 3 cases of Streptococcus pneumoniae pneumonia in 3 foreign shipyard workers. Ann Case Rep. 2018;6.
  10. Berild JD, Steens A, Winje BA, Danielsen TE, Fjeldheim JH, Holmemo HD, et al. Management and control of an outbreak of vaccine-preventable severe pneumococcal disease at a shipyard in Norway. J Infect. 2019;S0163-4453(19)30387-1.  https://doi.org/10.1016/j.jinf.2019.12.015  PMID: 31891730 
  11. Linkevicius M, Cristea V, Siira L, Mäkelä H, Toropainen M, Pitkäpaasi M, et al. Outbreak of invasive pneumococcal disease among shipyard workers, Turku, Finland, May to November 2019. Euro Surveill. 2019;24(49):1900681.  https://doi.org/10.2807/1560-7917.ES.2019.24.49.1900681  PMID: 31822326 
  12. Wong A, Marrie TJ, Garg S, Kellner JD, Tyrrell GJSPAT Group. Welders are at increased risk for invasive pneumococcal disease. Int J Infect Dis. 2010;14(9):e796-9.  https://doi.org/10.1016/j.ijid.2010.02.2268  PMID: 20637673 
  13. Palmer KT, Cosgrove MP. Vaccinating welders against pneumonia. Occup Med (Lond). 2012;62(5):325-30.  https://doi.org/10.1093/occmed/kqs055  PMID: 22764269 
  14. Health and Safety Executive (HSE). Pneumonia vaccination for employees exposed to welding and metal fumes. Norwich: HSE; Jan 2014. Available from: https://www.hse.gov.uk/pubns/eis44.pdf
  15. Lepoutre A, Varon E, Georges S, Dorléans F, Janoir C, Gutmann L, et al. Impact of the pneumococcal conjugate vaccines on invasive pneumococcal disease in France, 2001-2012. Vaccine. 2015;33(2):359-66.  https://doi.org/10.1016/j.vaccine.2014.11.011  PMID: 25448105 

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