The Larimer County Department of Health and Environment is investigating several cases of meningococcal disease that have occurred over the past two weeks in Fort Collins, resulting in one death. Three cases have been confirmed as invasive meningococcal infections. Test results are still pending on one case with symptoms of bacterial meningitis.
The Health Department is looking into connections among any of the cases, and this investigation is ongoing.
Meningococcal disease is a severe infection caused by bacteria known as Neisseria menigitidis. These are common bacteria that are found in the throats of 5-15% of the population. It is uncommon for these bacteria to cause disease, but when they do, life-threatening illness can occur and can lead to rapid death in about 10% of cases.
Health Department staff have been notifying people who had close contact with the confirmed cases in the 7 days prior to the onset of illness to recommend preventive antibiotics to decrease the chance of additional cases. The bacteria are spread through secretions from the nose and throat. “Close contacts would include people in the same household, or anyone in direct and close contact with the infected person such as a family member, a boyfriend or girlfriend, or a roommate, ” said LeBailly. “These bacteria can be spread between people through large respiratory droplets or contact with the oral or nasal secretions of a person with the infection, though kissing, sharing eating utensils, beverage containers, a toothbrush, a cigarette or other items that would come in contact with the person’s saliva. A person who has had this type of exposure in the past 7-10 days is considered a close contact and should consider taking certain antibiotics to decrease the chance of getting the disease. ” Casual contacts do not need preventive medication, added LeBailly. Casual contacts include those who have been in the same room or space with the infected person, but have not shared items that come in contact with the nose, mouth or throat of the infected person. Humans are the only natural reservoir of meningococcal bacteria, which live in the nose, throat and mouth. They are transmitted person-to-person through large respiratory droplets or contact with the oral or nasal secretions of an infected person. The incubation period for this infection (time from exposure to infection and appearance of symptoms) is usually 3 – 4 days, but can vary from 1 – 10 days. Persons are considered infectious for up to 7 days before their illness begins.
Meningococcal infection usually appears in two typical forms: as meningitis (inflammation of the lining of the brain and spinal cord), or as septicemia [sepsis] (infection of the blood). Treatment with antibiotics needs to be started early since the infection spreads rapidly in the body and can lead to death or permanent disability. Preventive treatment is recommended for close contacts to prevent secondary cases. If more than 14 days has elapsed since exposure, treatment is not recommended.
A vaccine to prevent most types of meningococcal disease, (brand names: Menactra, Menomune, or Menveo) is also available, and should be considered for susceptible populations such as young adults entering college, especially those who will be living in dormitories.
Physicians throughout Larimer County have been alerted to the cluster of infections.
For more information on meningococcal disease, including symptoms, some helpful resources can be found at:
http://www.health.state.mn.us/divs/idepc/diseases/meningococcal/ [1]
http://www.cdc.gov/meningitis/index.html [2]
If you think a person has symptoms that suggest meningitis, contact your doctor immediately, call 911 for an ambulance or go to the nearest hospital emergency department. Early diagnosis and treatment are vital.
Signs and symptoms in older children and adults may include:
• Fever
• Headache
• Loss of appetite
• Neck stiffness
• Discomfort when looking at bright lights (photophobia)
• Nausea and/or vomiting
• Diarrhea
• Aching or sore muscles
• Difficulty walking
• General malaise
• Moaning, unintelligible speech
• Drowsiness
• Confusion
• Collapse
• Rash of red-purple pinprick spots or larger bruises.
• Painful or swollen joints
Signs and symptoms in infants and young children are similar to above, but may also include:
• Refusing to eat
• Irritability, fretfulness
• Grunting or moaning
• Extreme tiredness or floppiness
• Turning away from light (photophobia)
• Convulsions or twitching
• Dislike of being handled