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Tijuana, Mexico: Meningitis outbreak

alert

Senior Moderator
http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,83670

Archive Number 20100715.2366
Published Date 15-JUL-2010
Subject PRO/EDR> Meningitis, meningococcal - Mexico: (BN)


MENINGITIS, MENINGOCOCCAL - MEXICO: (BAJA CALIFORNIA)
*****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 13 Jul 2010
Source: Frontera [in Spanish, machine trans., edited]
<http://www.frontera.info/EdicionEnLinea/Notas/Noticias/13072010/458185.aspx>


Enrique Chacon Cruz, infectious disease
specialist from the Department of Pediatrics at
Tijuana General Hospital, said that more than 20
cases of meningococcal meningitis, most of whom
are minors, have been reported in the state.

The pediatrician explained that meningococcal
meningitis is a sudden illness, which can lead to
death within 24-48 hours of the 1st symptoms. It
affects all ages, with greater risk in infants
and persons between 2 and 18. Fever, headache,
loss of appetite, malaise, drowsiness, and rash
are some of the symptoms of this disease. He
urged patients with these symptoms to go
immediately to the General Hospital where the
staff is trained in the diagnosis and treatment of this disease.

[Byline: Celia Garc?a]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[_Neisseria meningitidis_ causes bacterial
meningitis and sepsis. 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 percent 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.) facilitates the spread of the disease. The
average incubation period for meningococcal
meningitis is 4 days, ranging between 2 and 10 days
(see <http://www.who.int/mediacentre/factsheets/fs141/en/>).

The decision to implement mass vaccination to
prevent meningococcal disease depends on whether
the occurrence of more than one case of the
disease represents an outbreak. Serogrouping,
such as, A, B, C, Y, or W135, and additional
subtyping of the meningococcal isolates allow
identification of an "outbreak strain" and aid in
better defining the extent of an outbreak. An
outbreak of meningococcal disease in either an
organization or community has been defined as the
occurrence of 3 or more confirmed or probable
cases during a period of less than or equal to 3
months, resulting in a primary disease attack
rate in the population at risk of at least 10
cases per 100 000 persons, which is about 10
times greater than the normal occurrence
(see <http://www.cdc.gov/mmwr/preview/mmwrhtml/00046237.htm>).

In organization-based outbreaks, the population
at risk is the group of persons who are linked by
a common affiliation, such as, attending the same
school or university. In community-based
outbreaks, the population at risk is the smallest
geographically contiguous population that
includes all (or almost all) case-patients, such
as, the population of a neighborhood, town, city, or county.

However, it is not possible to calculate a
primary attack rate in Tijuana from the data
presented in the news release above: we don't
know if a common serogroup is involved, the
period of time in which the cases occurred, how
many of the 20 cases are primary, and the size of
the population at risk (that is, whether the
cases were restricted to an organization or
neighborhood, or were dispersed throughout the city.

Tijuana is the largest city in the Mexican state
of Baja California, with a population of 1 483
992 (2005), and is situated on the US-Mexico
border adjacent to the US city of San Diego,
California
(<http://en.wikipedia.org/wiki/Tijuana>). It is
estimated that the 2 border crossing stations in
Tijuana account for 300 000 daily border crossings.

Maps of Mexico are available at
<http://www.lib.utexas.edu/maps/americas/mexico_pol97.jpg> and
<http://healthmap.org/r/01Jd>. - Mod.ML]
 
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