Outbreak of Meningococcimia in Delhi

beach

Meningitis: prevention



Delhi not alone, outbreaks across world this year ........


meningitis: the facts
WHAT IS MENINGOCOCCAL DISEASE: Meningitis is an infection of the meninges, the thin lining that surrounds the brain and the spinal cord. Neisseria meningitidis responsible for the current outbreak.

Transmission: Says Dr N.P.SINGH, Professor of Medicine, Maulana Azad Medical College: Transmitted from person to person through droplets of respiratory or throat secretions.

Close and prolonged contact- kissing, sneezing and coughing on someone. Average incubation period is 4 days.

TREATMENT: Meningococcal disease is potentially fatal and should always be viewed as a medical emergency. Admission to a hospital or health centre is necessary. Penicillin and Ciprofloxicin can manage the illness.

HIGH RISK GROUPS: Children and young adults are more vulnerable. Patients whose spleen has been removed can are more prone.

Bacteria occurs mostly during the change of seasons. ‘‘Due to the uncommon weather conditions (cool evening) the cases are being reported in the month of May which is otherwise very unusual,’’ Dr Banwalikar. ‘‘As the number of cases being treated increases the disease will die down,’’ he added.

VACCINES: Costing anything between Rs 500 to Rs 1000, the vaccines come in two forms-AC serotype and ACWY serogroup. Given in the fore arm, doctors say there is no routine reaction like fever or pain.

WHO NEEDS VACCINE: No mass vaccination needed. Only people in long term contact with patients-hospital staff and attendants. Vaccines will show effect after five days.

Indojingai

Thanks for the info beach.

meanwhile the cases are rising and so is the lives toll: 21 new meningitis cases in Delhi (warning pop-ups)

And the state Govt. says: Meningitis situation under control

I'm posting updates here, not to scare but to make aware/warn.
Travellers and residents alike.

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edwardseco

D..., now its broken out in Hyderabad..

camelgirl

I find checking www.who.int the World Health Organization website a useful, if technical, place to check out this stuff. They work with all the world governments and have up-to-date info. on outbreaks of everything. Navigate to the country and then go from there. Or such browse around the site. It's got loads of info. about travel, vaccines, etc.

mira4bai4

Chandigarh has had a few fatal cases now. It has been said that the out breaks are unusual as meningitis normally appears after a cool shift in the weather and this is very much out of season. I am unsure about this but whatever the situation is it is becoming concerning. Here is a link that may be of interest Docs caution against use of vaccines.

wandering_kat

My travel clinic talked me out of having the vaccine the other day - that's gotta be a first!
I think i'm in agreement on this particular vaccine, because there is a higher risk than with other shots of an anaphylactic reaction, and the infection responds very well to antibiotics.

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samkerr

Checked about this problem on the "who" site and there appears to be more cases in Delhi (obviously).It appears to be a particular strain that has been identified, does anyone know if adults who have been injected as students at University in England for meningitis would be protected. Is vaccination still not being recommended for travellers. i contacted m doctor and he said he would not give me antibiotics to take with me but just to seek medical help if needed, I think someone else mentioned that the symptoms are pretty nebulous so how would you know when to get treatment? I'm pretty OK about the whole thing but when the "who" advice is to avoid crowded places in India I wonder what planet they're on!

wandering_kat

They still don't seem to be recommending the vacc for travellers, but if you want it, it's for serotype A.
Apparently it's very responsive to ciprofloxacin, and a once-off dose of 500mg upon feeling the symptoms should sort it out.
but i'm not a doctor so don't quote me on it!

Gayamom

Hello all:

My other favorite place on the web is ProMed, which has this to say about the north India meningococcal outbreak:

ProMed on Delhi outbreak

As medical professionals on this forum will agree, meningococcal disease is something you wouldn't wish on your worst enemy -- it moves fast and is both mortal and morbid.

That being said, as travellers through Delhi, you're unlikely to contract the illness.

Meningococcus is transmitted via respiratory droplets from the mouth and nose of infected people. Once acquired, the majority of people remain asymptomatic, but in a sub-group of colonized individuals, it goes on to cause invasive disease -- meningitis and/ or bloodstream infection. If symptoms are to occur, they develop in 2-10 days (commonly 3-4 days) after exposure.

The organism comes in several "flavors." A, B, C, and Y are the most common causes of human disease.

Endemic disease occurs annually in sub-Saharan Africa. Outbreaks on all continents occur and have been associated with institutional settings (dorms, barracks) and religious festivals (the Hajj) where large numbers of people are in close contact.

To answer an earlier question, in the U.K., I believe type C is most common and that university students there are routinely inoculated with a type C vaccine. Some of the cases in Delhi have been typed as A -- I would not assume cross-protection if you have been vaccinated against type C.

In the U.S., vaccination with a A, B, C, Y meningococcal vaccine was recently added to the immunization schedule for 11 - 12 year olds (i.e. most of you haven't received it). It's also now (recently) recommended for students entering college and living in residence halls (some of you may have received it).

Once a case of meningococcal disease has been identified, close contacts of the patient are given prophylactic antibiotics -- these should not be taken casually by others, including travellers. Under the supervision of public health authorities, meningococcal outbreaks in small, closed communities have been controlled using mass chemoprophylaxis (antibiotics).

More commonly, control of an outbreak depends on close surveillance, elimination of crowding and poor ventilation, and yes, vaccination, in this case against type A or with a quadrivalent vaccine.

Specific advise re: vaccination has not been issued by the Centers for Disease Control (U.S.) for travellers to India. The CDC Yellow Pages simply state "confer with your health provider."

Personally, if I were headed to Delhi as a traveller, I would not take this matter lightly. I would seriously consider vaccination (if still at home) and talk to a travel health specialist (not Joe/ Jane doc) about this.

Regardless of whether I received the vaccine or not, I would very much avoid areas where cases are known to have occurred. I would avoid large crowds (where that's possible) and crowded conditions. If I had fever and rash or fever and headache +/- stiff neck, I would react quickly and immediately seek medical care. I would keep in mind that I am unlikely to contract this illness.

After doing the above, I would relax and enjoy my trip. Meningococcal outbreaks occur all the time in everyone's home countries, and we survive them, probably even switch off the TV when they're droning on about them. It's not an exotic killer, but as old as humanity. If you use common sense and take simple precautions, you'll be fine.

Hope this is helpful -- GM

P.S. Please confirm anything you read regarding health matters with your own health provider. The above is the best information I have, but I cannot guarantee its accuracy. This is not meant as specific health advice but as general information. [Sorry, that whole medicolegal risk thing . . . .]

camelgirl

Thank you for an excellent link. I've saved it to my favorites.

samkerr

That was a very detailed and comprehensive reply , now I need to organise our vaccinations before we go in a couple of weeks. It's going to be difficult to avoid crowded places (the ticket office at Delhi Station!) but we'll do our best without getting too neurotic about it. Hopefully it won't get any worse Thanks again

tornado989

i got news thru word of mouth that the meningitis virus (bacteria) cannot sustain the increasing temperature and will die in the intense heat...... as a result causing a decrease in the number of people getting the disease....

i just hope its true!!!!!!

do u folks know anything abt this???

phobal

If you can prevent harm to yourself, why would you not want to? Just because there's fear over it? Sure, people tend to focus on minor problems that just seem bad due to the media (cough, SARS), but people in NYC working in the WTC on s11 went back to their offices in spite of a plane flying into the first tower, as well.

Nick-H

Well, there are risks and risks... I wouldn't want to come in contact with meningitis if I could help it, but the disease has occured in London without people feeling the need for a mass evacuation.

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katcalls

Just an update on this one.

I went to update my jabs yesterday here in Sydney. The travel doctor I saw did recommend I get the ACYW shot specifically for this outbreak. I did get it - cost A$50 which I think is okay. Lasts 3 years.

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