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We report a surge of patients, especially children and adolescents, with respiratory disease caused by in Denmark since October 2023. While the surge has reached an epidemic level, no impact on hospital capacity has been observed; only 14% (446/3,195) of cases, primarily adults, required hospitalisation. Macrolide resistance was detected in less than 2% of samples tested. Timely monitoring of hospitalisations linked to infections has been established to inform the healthcare system, decisionmakers and the public.


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  1. Waites KB, Xiao L, Liu Y, Balish MF, Atkinson TP. Mycoplasma pneumoniae from the respiratory tract and beyond. Clin Microbiol Rev. 2017;30(3):747-809.  https://doi.org/10.1128/CMR.00114-16  PMID: 28539503 
  2. Lind K, Benzon MW, Jensen JS, Clyde WA Jr. A seroepidemiological study of Mycoplasma pneumoniae infections in Denmark over the 50-year period 1946-1995. Eur J Epidemiol. 1997;13(5):581-6.  https://doi.org/10.1023/A:1007353121693  PMID: 9258572 
  3. Meyer Sauteur PM, Beeton ML, Uldum SA, Bossuyt N, Vermeulen M, Loens K, et al. Mycoplasma pneumoniae detections before and during the COVID-19 pandemic: results of a global survey, 2017 to 2021. Euro Surveill. 2022;27(19):1.  https://doi.org/10.2807/1560-7917.ES.2022.27.19.2100746  PMID: 35551702 
  4. Meyer Sauteur PM, Chalker VJ, Berger C, Nir-Paz R, Beeton ML, ESGMAC and the ESGMAC–MyCOVID study group. Mycoplasma pneumoniae beyond the COVID-19 pandemic: where is it? Lancet Microbe. 2022;3(12):e897.  https://doi.org/10.1016/S2666-5247(22)00190-2  PMID: 35964636 
  5. Emborg HD, Carnahan A, Bragstad K, Trebbien R, Brytting M, Hungnes O, et al. Abrupt termination of the 2019/20 influenza season following preventive measures against COVID-19 in Denmark, Norway and Sweden. Euro Surveill. 2021;26(22):1.  https://doi.org/10.2807/1560-7917.ES.2021.26.22.2001160  PMID: 34085632 
  6. Munkstrup C, Lomholt FK, Emborg HD, Møller KL, Krog JS, Trebbien R, et al. Early and intense epidemic of respiratory syncytial virus (RSV) in Denmark, August to December 2022. Euro Surveill. 2023;28(1):2200937.  https://doi.org/10.2807/1560-7917.ES.2023.28.1.2200937  PMID: 36695451 
  7. Johannesen TB, Munkstrup C, Edslev SM, Baig S, Nielsen S, Funk T, et al. Increase in invasive group A streptococcal infections and emergence of novel, rapidly expanding sub-lineage of the virulent Streptococcus pyogenes M1 clone, Denmark, 2023. Euro Surveill. 2023;28(26):2300291.  https://doi.org/10.2807/1560-7917.ES.2023.28.26.2300291  PMID: 37382884 
  8. Indenrigs- og Sundhedsministeriet. Sundhedsstyrelsens bekendtgørelse om anmeldelse af smitsomme sygdomme: BEK nr. 1260 af 27/10 2023. [Executive Order on notification of communicable diseases. The Danish Health Authority's executive order no. 1260 of 27/10 2023]. Copenhagen: Indenrigs- og Sundhedsministeriet. [Accessed: 8 Jan 2024]. Danish. Available from: http://www.socialjura.dk/content-storage/regler/2023/bek-1260-af-2710-2023/menu/all//new
  9. Beeton ML, Zhang XS, Uldum SA, Bébéar C, Dumke R, Gullsby K, et al. Mycoplasma pneumoniae infections, 11 countries in Europe and Israel, 2011 to 2016. Euro Surveill. 2020;25(2):1.  https://doi.org/10.2807/1560-7917.ES.2020.25.2.1900112  PMID: 31964459 
  10. Dumke R, Benitez AJ, Chalker V, Gullsby K, Henrich B, Hidalgo-Grass C, et al. Multi-center evaluation of one commercial and 12 in-house real-time PCR assays for detection of Mycoplasma pneumoniae. Diagn Microbiol Infect Dis. 2017;88(2):111-4.  https://doi.org/10.1016/j.diagmicrobio.2017.03.004  PMID: 28318608 
  11. Uldum SA, Bangsborg JM, Gahrn-Hansen B, Ljung R, Mølvadgaard M, Føns Petersen R, et al. Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011. Euro Surveill. 2012;17(5):20073.  https://doi.org/10.2807/ese.17.05.20073-en  PMID: 22321137 
  12. Voldstedlund M, Haarh M, Mølbak K, MiBa Board of Representatives. The Danish Microbiology Database (MiBa) 2010 to 2013. Euro Surveill. 2014;19(1):20667.  https://doi.org/10.2807/1560-7917.ES2014.19.1.20667  PMID: 24434175 
  13. European Centre for Disease Prevention and Control (ECDC). Communicable disease threats report, 26 November - 2 December 2023, week 48. Stockholm: ECDC; 2023. Available from: https://www.ecdc.europa.eu/en/publications-data/communicable-disease-threats-report-26-november-2-december-2023-week-48
  14. Meyer Sauteur PM, Beeton ML; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma and Chlamydia Infections (ESGMAC), and the ESGMAC Mycoplasma pneumoniae Surveillance (MAPS) study group. Mycoplasma pneumoniae: delayed re-emergence after COVID-19 pandemic restrictions. Lancet Microbe. 2023 Nov 23:S2666-5247(23)00344-0. doi:  https://doi.org/10.1016/S2666-5247(23)00344-0 . Epub ahead of print. PMID: 38008103.
  15. World Health Organization (WHO). Disease Outbreak News. Upsurge of respiratory illnesses among children-Northern China. Geneva: WHO; 2023. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON494
  16. Abu-Raya B, Viñeta Paramo M, Reicherz F, Lavoie PM. Why has the epidemiology of RSV changed during the COVID-19 pandemic? EClinicalMedicine. 2023;61:102089.  https://doi.org/10.1016/j.eclinm.2023.102089  PMID: 37483545 
  17. Hatter L, Eathorne A, Hills T, Bruce P, Beasley R. Respiratory syncytial virus: paying the immunity debt with interest. Lancet Child Adolesc Health. 2021;5(12):e44-5.  https://doi.org/10.1016/S2352-4642(21)00333-3  PMID: 34695374 
  18. Statens Serum Institut (SSI). Overvågning af Influenza, covid-19, RS-virus og andre luftvejssygdomme. [Surveillance of Influenza, COVID-19, RS-virus, and other respiratory diseases]. Copenhagen: SSI; 2023. Danish. Available from: https://www.ssi.dk/sygdomme-beredskab-og-forskning/overvaagning-af-luftvejssygdomme
  19. Loconsole D, De Robertis AL, Sallustio A, Centrone F, Morcavallo C, Campanella S, et al. Update on the epidemiology of macrolide-resistant Mycoplasma pneumoniae in Europe: a systematic review. Infect Dis Rep. 2021;13(3):811-20.  https://doi.org/10.3390/idr13030073  PMID: 34562998 
  20. Wang G, Wu P, Tang R, Zhang W. Global prevalence of resistance to macrolides in Mycoplasma pneumoniae: a systematic review and meta-analysis. J Antimicrob Chemother. 2022;77(9):2353-63.  https://doi.org/10.1093/jac/dkac170  PMID: 35678262 
  21. Zhao F, Liu J, Shi W, Huang F, Liu L, Zhao S, et al. Antimicrobial susceptibility and genotyping of Mycoplasma pneumoniae isolates in Beijing, China, from 2014 to 2016. Antimicrob Resist Infect Control. 2019;8(1):18.  https://doi.org/10.1186/s13756-019-0469-7  PMID: 30697421 
  22. Yu HX, Zhao MM, Pu ZH, Ju YR, Liu Y. A study of community-acquired Mycoplasma pneumoniae in Yantai, China. Colomb Med (Cali). 2018;49(2):160-3.  https://doi.org/10.25100/cm.v49i2.3813  PMID: 30104808 

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