IS THERE A MENINGOCOCCAL OUTBREAK?

Meningococcemia is a horrible disease. I was supposed to write about it when reports came out that there was an "outbreak" in Baguio City but decided to postpone it because I believed there was none.

In San Lazaro Hospital (SLH), the country's oldest hospital and the government's referral center for infectious diseases, 2-5 cases of meningococcemia weekly is 'normal.' They usually get 100++ cases yearly. In 1993, there were 203 cases of meningococcemia there, but I do not remember any news reports that came out at that time.

Morbidity and mortality reports say that there are now 12 cases of meningococcemia including 5 deaths recorded in Baguio City this month and 6 cases with 3 deaths at the San Lazaro Hospital (SLH).

I do not consider those figures an "outbreak" or an "epidemic."

The fourth edition (2001) of Prof. John Last's Dictionary of Epidemiology, which the CDC and WHO use for reference in epidemiology defines these terms:

Epidemic - occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time.

Outbreak - synonymous with epidemic. Sometimes the preferred word, as it may escape sensationalism associated with the word epidemic. Alternatively, a localized as opposed to generalized epidemic.

[Last JM, (2001) A dictionary of epidemiology. London: Oxford University Press.]

If there's anything that these meningococcal rumors are doing, it's the harm it does to Baguio City's tourism and business prospects.

Be calm. Don't panic. Here are some of the things you should know about meningococcemia:

• What is meningococcal meningitis?
Meningococcal meningitis is a bacterial infection that causes inflammation of the membranes surrounding the brain and spinal cord. It is caused by the bacterium Neisseria meningitides, also known as meningococcus.


• What are the symptoms?
Symptoms include fever, severe headache, stiff neck, rash, nausea, vomiting, and lethargy. The infection can lead to permanent disabilities, such as hearing loss and brain damage. Despite antibiotic treatment, 10% of people with meningococcal meningitis die each year from the disease.


• What is MENINGOCOCCEMIA?
Sometimes the meningococcal bacteria can infect the bloodstream. This infection is termed meningococcemia. It can lead to kidney and heart failure, and like meningococcal meningitis, can result in severe disability and death (20% of patients with meningococcemia die from the infection).


• How is the disease spread?
The infection is spread by direct contact with infected individuals (for example, sharing a glass or cigarette, or kissing) or through the air via droplets of respiratory secretions (for example, coughing or sneezing).


• How common is meningococcal disease?
Neisseria meningitides is the second most common cause of bacterial meningitis in the United States, responsible for 3,000-4,000 cases each year. While meningococcal disease overall remains relatively rare, the number of outbreaks has been on the rise in recent years. Whereas there were only 13 outbreaks during the 12-year period from 1980 to 1991, at least 33 outbreaks hit in just the 5 years between 1992 and 1996, according to the Centers for Disease Control and Prevention (CDC).


• Who is at risk for meningococcal meningitis?
In the past, the attack rate of endemic meningococcal disease was highest among children 6 to 36 months of age. Lately, however, the risk appears to be shifting toward older children and adolescents, with a rising number of outbreaks in schools, universities, and other organization-based settings, according to the American College Health Association (ACHA). In fact, over half of the outbreaks from 1992 to 1996 occurred in schools, colleges, universities, and similar settings. Also at increased risk for meningococcal disease are travelers to certain hyperendemic or epidemic countries (such as part of Sub-Saharan Africa), people with certain immune deficiencies, and household or institutional contacts of infected individuals.

[Medical News Today, Nov 22 2004]

If I were the news reporters, I will concentrate my efforts more on issues needing more attention like this.