Changes in the epidemiological pattern of Mycoplasma pneumoniae infections in Denmark. A 30 years survey.

A seroepidemiological survey has shown a remarkable shift in the previously reported regular cyclic pattern of Mycoplasma pneumoniae epidemics which culminated every 4.5 years during the period 1958-74. The last of four regular epidemics occurred in 1972. It was followed by 'premature' epidemics in 1975 and 1977/8 which inaugurated a change from an epidemic to an endemic pattern of the infection in Denmark. Over the following 9 years (1978-86) there has been an irregular but significant decrease in the annual number of seropositive samples with the usual high incidence during winter seasons. This endemic period terminated in the fourth trimester of 1987 with the development of a new epidemic. The hypothesis is advanced that a sixfold increase of children in day care may have influenced the change from an epidemic to an endemic situation which after 9 years led to a new epidemic of M. pneumoniae infection.