Global Meningococcal Activity
Update: March 23, 2005
The Public Health Agency of Canada (PHAC) is monitoring reports of meningococcal
activity.
China
Between November 2004 and January 30, 2005, China reported 546 confirmed
cases and 16 deaths of Meningococcal disease – primarily serotype
C and serotype A, in 28 provinces. Nearly half (258) of the reported
cases occurred between January 1 and January 30. In Anhui Province,
49 cases were reported, 30 cases in Henan Province, 19 cases in Hebei
Province, 16 cases in both Jiangsu and Sichuan Provinces. The remaining
reported 128 cases have been reported throughout the remaining 23 provinces
with each reported less that 10 cases
While the total number of cases reported in January this year was higher
than that of the same period in 2004, it was lower compared with the
same period in 2003 and 2002. The Ministry of Health in China has augmented
meningitis prevention and control activities.
Based on the latest available information from the Chinese Ministry
of Health, a total of 424 cases of Meningitis including 43 deaths, were
reported in February. No additional information has been released with
regard to the geographic distribution of cases or prevalent serotype
in February. Map provided is based on information released for January.
Source: People's Republic of China, Ministry of Health
Sporadic meningococcal meningitis occurs throughout the world with seasonal
variations. The largest and most frequently recurring outbreaks have
been in the semi-arid area of sub-Saharan Africa, designated as the "African
Meningitis Belt"; this area extends from Guinea, Senegal and southern
Mauritania in the west to Ethiopia, northern Kenya and western Eritrea
in the east. Worldwide, most endemic meningococcal disease is caused
by serogroups A, B or C. Serogroups Y and W-135 are relatively uncommon
causes of meningococcal infection in most parts of the world.
Meningococcal disease is endemic in Canada with periods of increased
activity occurring roughly every 10 to 15 years, with no consistent pattern.
The incidence rate of meningococcal disease has varied considerably with
different serogroups, age groups, geographic locations and time. There
have been sporadic localized outbreaks and periods of elevated incidence
of serogroup C disease during 1989-1993 and 1999-2001. From 1985 to 2001
there was an average of 305 cases of meningococcal disease reported annually.
Meningococcal meningitis, a form of meningococcal disease, is a contagious
disease that causes inflammation of the lining of the brain and spinal
cord and can lead to rapid death or permanent brain damage, particularly
in young children.
Transmission of meningitis occurs by direct contact with respiratory
droplets from the nose and throat of infected persons. Fifty per cent
of cases occur in infants, children and adolescents < 19 years of
age, with the highest risk in children < 5 years of age.
Symptoms include the sudden onset of intense headache, fever, nausea,
vomiting, photophobia (aversion to light) and stiff neck. Neurological
signs include lethargy, delirium, coma and/or convulsions. Infants may
have illness without sudden onset and stiff neck. Many infected people
do not develop symptoms but can become carriers.
Meningococcal disease is a medical emergency, requiring early diagnosis,
hospitalization, and effective treatment. When the infection is diagnosed
and treated early, antibiotics can be effective in arresting the illness
and reducing fatalities. Vaccination against serotype A, C, Y and W135
is available.
Recommendations
The Public Health Agency of Canada strongly recommends that
Canadians travelling to geographic areas experiencing increased
meningitis activity at this time, seek an individual risk assessment
consultation with their personal physician or a travel medicine
clinic before departure to determine their risk for meningitis
infection and their need for vaccination. Canadians working in
countries with increased meningitis activity should ensure that
their meningitis vaccination status is current.
The Public Health Agency of Canada recommends as well, that travellers
who become sick or feel unwell on their return to Canada should
seek a medical assessment with their personal physician. Travellers
should inform their physician, without being asked, that they have
been travelling or living outside of Canada, and where they have
been. |
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