MENINGITIS, MENINGOCOCCAL - USA (03): (OHIO) SUSPECTED, REQUEST FOR
INFORMATION
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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed 27 May 2009
Source: The Columbus Dispatch [edited]
Officials at Mary Rutan Hospital in Bellefontaine [Ohio] say they don't
know how 2 women in separate rooms of the maternity ward -- one of whom
later died -- contracted bacterial meningitis late last week. But they say
there is no threat of an outbreak and that expectant mothers ready to
deliver their babies at the Logan County [Ohio] hospital have no cause for
concern. The hospital has pulled batches of any medications the women may
have been given and what remains of any supplies that were used and they
will be tested as a possible source, said hospital spokeswoman Tammy
Allison. She did not know whether hospital employees would be tested for
the bacteria.
The 2 women delivered babies on Thursday [?21 May 2009] and showed signs of
bacterial meningitis on Friday [?22 May, 2009], Allison said. They both
were transferred to Riverside Methodist Hospital in Columbus [Ohio] on
Friday afternoon, and one died, Allison said. She said the other woman
remains in critical condition. Both infants were transferred to Nationwide
Children's Hospital in Columbus as a precaution, Allison said. She said
federal privacy regulations prevent her from releasing the women's names or
the condition of the babies.
Riverside spokesman Mark Hopkins said [one of the women], 30, of Huntsville
[Ohio], was transferred from Mary Rutan and died on Friday. Her daughter,
was in good condition yesterday [26 May 2009] at Children's, a spokeswoman
said.
Allison said the Centers for Disease Control and Prevention, as well as the
local and state health departments, have been contacted and an internal
investigation is under way. The maternity unit is licensed for 12 beds,
according to the Ohio Department of Health. It remains open, though Allison
would not say how many mothers and babies were there yesterday [26 May 2009].
Bacterial meningitis is spread from person to person through respiratory
droplets. It infects the fluid surrounding the brain and spinal cord and
can be fatal without early treatment. If detected early, it can be
successfully treated with strong antibiotics. Serious after-effects can
include brain damage, hearing loss, limb amputation, and learning
disabilities. However, Allison said that Logan County health commissioner
Dr Boyd Hoddinott advised the hospital that the illness is not contagious
and represents no danger to patients. Hoddinott was out of the office late
yesterday [26 May 2009] and could not be reached for comment. Symptoms
include fever, vomiting, an intense headache, and stiffness of the neck.
About 2600 people in the United States contract bacterial meningitis each
year, according to CDC. In 2006, 634 people died of meningitis, according
to the latest data from CDC. There were about 58 cases in Ohio last year
[2008], according to preliminary numbers from the state, said spokesman
Kristopher Weiss. This year [2009], the department has logged 21 cases, not
including the 2 in Logan County. At any given time, an estimated 5 per cent
to 25 per cent of people are carrying the bacteria but have no symptoms.
Those people play a major role in transmitting the disease.
Two vaccines are available for protection against meningitis, and federal
health officials recommend vaccination for young people, especially college
students. The disease is most common in infants, but no vaccine is approved
for use in people younger than 2 years old.
[byline: H Zachariah, M Crane]
--
communicated by:
HealthMap Alerts via ProMED-mail
[Although not specified in the news report, the cause of meningitis in the
2 cases in Bellefontaine, Ohio, from the limited information presented, is
presumably _Neisseria meningitidis_. The bacteria are transmitted from
person to person via droplets of respiratory secretions mostly from
asymptomatic nasopharyngeal carriers of the microorganism. It is estimated
that between 10 to 25 per cent of the population carry _N. meningitidis_ at
any given time, and the carriage rate may be much higher in epidemic
situations. Close and prolonged contact (such as kissing, sneezing and
coughing on someone, living in close quarters or dormitories (military
recruits, students), sharing eating or drinking utensils, etc.) facilitate
the spread of the disease. The average incubation period for meningococcal
meningitis is 4 days, ranging between 2 and 10 days
(
transmission within the hospital setting to these 2 obstetrics patients,
who showed signs of bacterial meningitis within 24 hours of delivery, is
unlikely. Although details about lengths of hospital stay prior to delivery
are not given in the news report for the 2 meningitis cases, it would seem
more likely that the microorganism was transmitted from asymptomatic
nasopharyngeal carriers in the community.
A quadrivalent A, C, Y, and W135 meningococcal conjugate vaccine (Menactra)
was licensed in the United States in January 2005. The conjugate vaccine
induces a T-cell-dependent response, resulting in an improved immune
response, providing long-lasting immunity and preventing nasopharyngeal
carriage of _N. meningitidis_ and thus reducing bacterial transmission of
this microorganism
(
2007, the FDA approved expanding the age range for Menactra, a bacterial
meningitis vaccine, to include children ages 2 to 10 years. Previously, the
vaccine was approved by the FDA for people ages 11 to 55 years. See also
Confirmation of the identity of the pathogen involved would be appreciated.
DNA fingerprinting of the isolates would help in epidemiologic linkage.
The town of Bellefontaine, Ohio lies north of the city of Columbus, Ohio.
The Mary Rutan Hospital in Bellefontaine, Ohio can be located on
and the HealthMap/ProMED-mail interactive map at
[see also:
Meningitis, meningococcal - USA (02): (FL) 20090424.1547
Meningitis, meningococcal - USA: (PA) 20090218.0674
2006
---
Meningococcal disease cluster - USA (NY) (02) 20060630.1808
Meningococcal disease cluster - USA (NY): RFI 20060607.1584]
.................ml/mj/sh
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