The mycoplasmas are spread by aerosolized droplets of respiratory secretions. Transmission from person to person is aided by the long time period in which M. pneumoniae is present in

23.5 Bacterial Infections of the Lower Respiratory System 579

respiratory secretions, ranging from about 1 week before symptoms begin to many weeks afterward. Mycoplasmal pneumonia accounts for about one-fifth of bacterial pneumonias, and it has a peak incidence in young people. Immunity after recovery is not permanent, and repeat attacks have occurred within 5 years.

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