Re: Health officials investigate deaths in Solomons- Meningococcal bacteria suspected
Apparently, the 5 cases form a tight cluster:
Published Date: 2014-07-16 19:40:27
Subject: PRO/EDR> Undiagnosed disease - Solomon Islands (02): (MK) meningococcal sepsis, susp.
Archive Number: 20140716.2615500
UNDIAGNOSED DISEASE - SOLOMON ISLANDS (02): (MAKIRA ULAWA), MENINGOCOCCAL SEPSIS, SUSPECTED, COMMENT
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Date: Wed 16 Jul 2014
From: Jennie Musto <mustoj@wpro.who.int> [edited]
On behalf of the Ministry of Health and Medical Services (MHMS) of the Solomon Islands, please find below an updated situational report of the suspected meningococcal cases in Makira, one of the 9 provinces in Solomon Islands. The suspected meningococcal cases have been officially reported to the Ministry of Health and Medical Services.
Outbreak description
---------------------------
On 7 Jul 2014, different sources (official and non-official) were reporting deaths among children in Makira Province, Solomon Islands. Teams with national MHMS and WHO were sent to the field for further investigation on 8 Jul 2014. Meningococcal bacteria are suspected.
5 cases, 4 deaths, all males of 7, 11, 13 and 13 [years old?] (2 in a village and 2 in Kirakira hospital) and one hospitalised case, a male 4 years old. All cases are epidemiologically linked and were reported to have played with each other, and 2 cases were household contacts.
Date of onset is 3, 5 and 6 Jul 2014 (not sure for 2 others).
The village of origin is Goge (3 deaths and one case) and Manasughu (one death), 2 very remote neighbouring villages.
Symptoms were: fever, rash, abdominal pain, irritability, seizures. No CSF has been collected from cases.
Measures taken or considered: Close contacts were treated with antibiotics. Antibiotic supply is sufficient. Pastorex and Transisolate media are sent in country in order to proceed to test any new suspect case. An outbreak investigation is ongoing in the villages.
Surveillance is enhanced; a retrospective review of outpatients registered from 1 Jun 2014 did not identify [any] additional cases or any further rumours of cases or deaths, and active surveillance at Kirakira hospital has been implemented.
A follow up update of the outbreak will be further provided for PacNet members as the outbreak evolves in the Solomon Islands.
[Pastorex is a latex agglutination test that can detect soluble antigen in cerebrospinal fluid (CSF) or differentiate between _Neisseria meningitidis_ serogroups A, B/E. coli K1, C, Y/W135, _Hemophilus influenzae_ type b, _Streptococcus pneumoniae_, and _Streptococcus_ group B isolated from cultures,
http://did.it/contenuti/biorad/Pastorex_Meningitis.pdf.
Trans-Isolate medium is used to inoculate and transport CSF samples and supports the growth and survival of _N. meningitidis_, _S. pneumoniae_, and _H. influenzae_ in CSF if the CSF cannot be transported to a microbiology laboratory within one hour from the time of collection,
http://microbeonline.com/trans-isola...uction-uses/.]
--
Jennie Musto
Epidemiologist, WHO on behalf of:
Ms Alison Sio
Manager, National Surveillance Unit and
Dr Tenneth Dalipanda
Undersecretary for Health Improvement
Ministry of Health and Medical Services, Solomon Islands
<tdalipanda@moh.gov.sb>
<mustoj@wpro.who.int>
[ProMED-mail thanks Jennie Musto for a more detailed description of the outbreak on Mikira, one of the Solomon Islands, in early July 2014; 5 children 4-13 years of age were affected, and 4 died. All cases had played together. No additional cases were detected. Symptoms were: fever, rash, abdominal pain, irritability, and seizures. No cerebrospinal fluid, and presumably no other clinical specimens, had been collected from cases to aid in establishing a diagnosis, though "meningococcal septicemia" was initially suspected, and it seems that the current diagnosis is still meningococcal disease.
Solomon Islands is divided into 9 provinces. The capital and largest city of Makira Ulawa Province is Kirakira on Makira Island, which has a population of about 10 000 (
http://en.wikipedia.org/wiki/Makira). Solomon Islands is a constitutional monarchy with Queen Elizabeth II of the UK as its head of state; it consists of a large number of islands in Melanesia lying to the east of Papua New Guinea and northwest of Vanuatu and covering a land area of 28 400 sq km (11 000 sq miles) (
http://en.wikipedia.org/wiki/Solomon_Islands). The country's capital, Honiara, is located on the island of Guadalcanal. A map of Oceania, on which the Solomon Islands are found, can be accessed at
http://www.crwflags.com/fotw/flags/g(ocea.html. - Mod.ML
