Published Date: 2012-01-17 12:42:06
Subject: PRO/EDR> Meningitis, meningococcal - Viet Nam: (Ho Chi Minh City)
Archive Number: 20120117.1012861
MENINGITIS, MENINGOCOCCAL - VIET NAM: (HO CHI MINH CITY)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Mon 9 Jan 2012
Source: Thanh Nien News [edited]
Doctors in Ho Chi Minh City [HCMC] have warned of the outbreak of a fatal type of encephalitis [sic] that has affected 5 co-workers. The disease was caused by _Neisseria_, a large genus of commensal bacteria that colonize in the mucosal surfaces of many animals, and quickly kill the infected body.
HCMC Tropical Diseases Hospital is treating a 29 year old patient with the disease. He was admitted with red spots from underskin bleeding and fever, news website VnExpress reported.
Nguyen Van Vinh Chau, director of the hospital, said a woman who is a co-worker of the man at a company in District 7 was also received at the hospital around 3 weeks ago with the disease.
Doctors at the hospital suspected the coincidence and contacted the district health authorities, who then confirmed that 3 other workers from the company had fallen sick with similar symptoms. Authorities are taking steps to quarantine the outbreak.
Doctors said the condition spreads through the respiratory tract and will lead to meningitis and blood infection.
ProMED-mail rapporteur Mary Marshall
[Meningococcal disease is caused by the bacterium _Neisseria meningitidis_. There are several different pathogenic serogroups of meningococcal bacteria including groups A, B, C, Y, and W135. These groups of bacteria can be further divided into specific strains.
_N. 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 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) facilitates the spread of the disease. The average incubation period for meningococcal meningitis is 4 days, ranging between 2 and 10 days (http://www.who.int/mediacentre/factsheets/fs141/en/). For a further discussion of meningococcal disease, see ProMED-mail post Meningitis, meningococcal - USA: (CO) fatal 20100625.2115.
An outbreak of meningococcal disease in either an organization or community is defined as the occurrence of 3 or more confirmed or probable cases during a period of up 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 (http://www.cdc.gov/mmwr/preview/mmwrhtml/00046237.htm).
Chemoprophylaxis is given to appropriate contacts whose risk for acquiring meningococcal disease is 500-800 times greater than among the total population (http://www.cdc.gov/mmwr/preview/mmwrhtml/00046237.htm). Close contacts of patients are household members, day-care center contacts, and persons directly exposed to the patient's oral secretions.
In an outbreak, the population at risk should be vaccinated with the meningococcal vaccine appropriate for the serogroup causing the outbreak as soon as possible after an outbreak has been declared.
Ho Chi Minh City, formerly named Saigon, is the largest city in Viet Nam, with a population of 7 396 446 in 2010 (http://en.wikipedia.org/wiki/Ho_Chi_Minh_City). A map of Viet Nam can be found at http://healthmap.org/r/1koL. - Mod.ML]