City Health Dept. Taking Action To Thwart Cluster of Meningitis Cases

Sat. October 18, 2003 12:00 AM

Offering Prevention Advice to Those at Risk

Chicago, IL - During the past week, the Chicago Department of Public Health (CDPH) has become aware of 6 cases (4 confirmed, 2 probable) of invasive meningococcal disease.

Meningococcal disease is a serious bacterial infection caused by the bacteria Neisseria meningitidis that can be rapidly fatal if not treated with antibiotics. It happens in two forms: meningitis and bloodstream infection.

Three of the 6 infected individuals have died. A fourth remains in critical condition.

Investigation is ongoing and information could change, but some common characteristics of the infected individuals have been identified. It appears that this cluster is centered among gay or bisexual men who have had close, direct contact with others in social settings on Chicago’s North Side during the first two weeks of October.

The bacteria that cause this disease are spread by close, direct contact such as the following:
-Kissing the lips of another person
-Other direct contact with saliva (Sneezing or coughing directly in another person’s face)
-Sharing items that have been in another person’s mouth or nose such as beverage glasses, cigarettes, pipes, drinking straws, drug paraphernalia, and eating utensils (such as cups, spoons)
-Sexual Contact

The bacteria that cause meningococcal disease first infect the inside of a person’s throat and nose, but most often cause no symptoms at all. In fact, 5 to 10 percent of all people may carry Neisseria meningitidis in their noses at any given time without becoming ill. In a small percentage of people carrying the bacteria, the bacteria pass into the bloodstream, causing illness. These illnesses almost always occur within 4 days of having been exposed to the bacteria, but sometimes it can take as long as 10 days for symptoms to develop.

Meningococcal disease usually starts with a sudden onset of fever and severe headache. A stiff neck may also develop, and rash often occurs. Nausea and vomiting sometimes occur as well, but may not be a sign of meningococcal disease unless the other described symptoms are also present. Immediate medical treatment is needed for meningococcal disease—the condition can be treated successfully with antibiotics.

What CDPH has been doing
While meningococcal disease does occur sporadically (approximately 15-40 cases per year are reported in Chicago), there is a potential for clusters and even outbreaks of the disease because it is spread from person to person. CDPH works quickly to identify close contacts of patients and ensure that they receive antibiotic treatment to reduce their chances of becoming ill.

This week, CDPH has investigated cases, identified their close contacts as much as possible, and facilitated treatment for contacts. We have also put out an alert to hospitals, raising their awareness of meningococcal disease and the need to quickly identify, treat, and report cases to the Department of Public Health. Last night, physicians from CDPH visited several businesses on the North Side where gay and bisexual men socialize and distributed fact sheets about the illness.

A vaccine is available for certain strains of the bacteria. The vaccine is considered safe but is not widely used except for people traveling to areas of the world where there are frequent outbreaks of the disease and for people with certain medical conditions.

When an outbreak occurs with a vaccine-preventable strain in a defined population, CDPH experts, in consultation with the Centers for Disease Control and Prevention (CDC) and the Illinois Department of Public Health, may recommend vaccination of certain individuals or groups to reduce the risk of disease. Currently CDPH is awaiting lab results that will determine if that type of intervention is plausible. Any vaccination strategy, if recommended, would need to be implemented quickly, and CDPH will keep the press and public updated as the situation develops.

Recommendations and current plans
People with symptoms of meningococcal disease should get medical attention right away.

We continue to facilitate medication for close contacts of cases. Medication is recommended for people who had close contact (as defined above) with a case within the 10 days before onset of illness in the case.

Otherwise, people who wish to reduce their risk of meningococcal disease should reduce activities and behaviors (listed above) that can spread the bacteria.

The City will be providing information to the public at two vans stationed in northside neighborhoods tonight.

In an outbreak setting with certain types of the bacteria, vaccination may be recommended for people at risk.

Currently information about this cluster with regard to vaccination is pending, and CDPH is consulting with the CDC about this possibility.

Chicago Department of Public Health -