Meningococcal case notification No 13 for Northland

Northland DHB Media Statement
20 October 2011

Meningococcal case notification No 13 for Northland

A twelve year old girl, diagnosed with probable meningococcal infection, was transferred to Starship Hospital yesterday. Dr Jonathan Jarman, Northland DHB medical officer of health said this is the thirteenth case of meningococcal disease in Northland since July.

“This is the fourth meningococcal case diagnosed this month. To date we have had two cases of meningococcal B, eight cases of meningococcal C, and are waiting serotyping on the most recent three cases. Of the eight meningococcal C cases, three people have lost their lives.’

“Last month we launched a meningococcal C vaccination campaign in Northland targeting those most at risk of this disease: being children, teenagers and young adults.”

The vaccine being used (Meningitec ®) has a very good safety record and has been widely used in Europe, UK and Australia since 1999. The vaccine does not contain live bacteria and it is not possible to get the disease from the vaccine. Only one dose is required to give protection in children over 12 months of age.

The vaccine provides protection after about 10 days. It is 90-95 per cent effective.

“We are aiming to vaccinate at least 85 per cent of everyone in Northland aged 12 months to under 20 years.”

“However one of our concerns is that people who have been vaccinated for meningococcal B believe they have protection from meningococcal C – they don’t. Even though they may sound the same - they are not,” said Dr Jarman. Thousands of Northland children received the meningococcal serogroup B vaccine during the epidemic of serogroup B disease.

Contract Tracing
Dr Jarman said that meningococcocal disease is not highly infectious and the people most at risk are those who live in the same house as a case.

“This is not a disease you catch by sitting beside someone in a picture theatre.”

Contacts of cases are followed up by nurses from the public health unit and offered advice and sometimes a public health antibiotic if they were considered to be at high risk.

“If members of the public are concerned about meningococcal or believe they have been in close contact with a meningococcal case, they can talk to one of our public health nurses on our 0800 meningococcal information phone line - 0800 430 123,” said Dr Jarman.

Meningococcal disease is a bacterial infection. Symptoms of meningococcal disease in babies and young children may include fever, irritability, sleepiness, floppiness, hard to wake, refusing drink or food, vomiting and a rash. Adults can have similar symptoms and may also have a stiff neck, headache and sensitivity to lights. Prompt treatment with antibiotics (usually by injection) can prevent death or permanent disability such as damage to the brain or deafness.

Meningococcal can be difficult to diagnose. Anyone with some of these symptoms should seek medical attention without delay, as early treatment is very important. If despite earlier treatment your condition deteriorates, don’t hesitate to seek medical attention again.

“Northland currently has an outbreak of Group C Meningococcal disease but there is a safe, effective vaccine available which can protect against this disease and it only takes one shot.”

“The free vaccine is available for children and youth 12 months to under twenty years of age via the school based vaccination programme, at the family doctors or in community clinics across Northland,” said Dr Jarman.

Following the latest case in Whangarei, parents and caregivers in the district may wish to ensure their children access the vaccine via their school based programme:

Whangarei School Schedule
Tikipunga High School.............27 October
Kamo Intermediate..............16 November
Otangarei Primary................28 November
Tikipunga Primary................1 December
Totara Grove Primary............1 December

School and community vaccination schedules can also be downloaded from the NDHB internet website www.northlanddhb.org.nz.

“A special meningococcal vaccination clinic is also being held within Tikipunga High School’s auditorium on Saturday, 29 October. Alternatively children and youth could visit their family doctor who is also able to vaccinate them against meningococcal C disease,” said Dr Jarman.

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NORTHLAND DHB MENINGOCOCCAL SPECIFIC CASE INFORMATION

July Notification - Confirmed
10 Jul 2011 - 18 year old female - Meningococcal C
22 Jul 2011 - 18 year old male - Meningococcal C

August Notification- Confirmed
9 Aug 2011 - 1 year old male - Meningococcal C Death
11 Aug 2011 - 1 year old male - Meningococcal C
24 Aug 2011 - 45 year old female - Meningococcal B
25 Aug 2011 - 18 year old male - Meningococcal C Death

September Notification- Confirmed
04 Sept 2011 - 14 month old male - Meningococcal B
22 Sept 2011 – 15 year old male - Meningococcal C
22 Sept 2011 - 82 year old female - Meningococcal C Death

October Notification- Confirmed
07 Oct 2011 - 5 year old child - Meningococcal C
09 Oct 2011 - 2 year old girl - await lab results re Type

October Notification – Probable
12 Oct 2011 - 16 month old male - await lab results re Type
19 Oct 2011 - 12 year old girl - await lab results re Type


MENINGOCOCCAL DISEASE BACKGROUND INFORMATION
(Ref IMAC http://www.immune.org.nz/?T=665)
What is meningococcal disease?
Meningococcal disease is a bacterial infection. It causes severe illnesses most commonly presenting as meningitis (an infection of membranes that cover the brain) and bacteraemia (blood infection), and less commonly pericarditis (inflammation of the lining of the sac that contains the heart) and arthritis (swelling of the joints).
The most common strains of bacteria which cause meningococcal disease in New Zealand are Type B and C.

What are the symptoms of Meningococcal disease?
In the early stages meningococcal disease may look like influenza. It can progress quickly and can be difficult to diagnose. It is important to remember that not everyone will develop all the symptoms listed and they may appear in a different order. If an individual develops some of the symptoms listed, especially red or purple spots, get medical help urgently. If you can’t get in touch with the doctor, or are still worried after getting advice, trust your instincts and go to the emergency department of your nearest hospital.
In babies, the main symptoms of meningitis may include:
a high-pitched, moaning cry
irritable when picked up
a bulging fontanelle
drowsy and less responsive – difficult to wake
floppy and listless, or stiff with jerky movements
refusing feeds, vomiting
skin that is pale, blotchy or turning blue
fever

In babies, the main symptoms of bacteraemia may include:
rapid or unusual patterns of breathing
skin that is pale, blotchy or turning blue
fever with cold hands and feet
shivering
vomiting, refusing feeds
red or purple spots
pain or irritability from muscle aches or severe limb/joint pain
floppiness
severe sleepiness.

In older children, adolescents and adults, the main symptoms of meningitis may include:
a stiff neck (check that they can kiss their knees or touch their forehead with their knees)
a very bad headache
dislike of bright lights
vomiting
fever
feeling drowsy, less responsive and confused
a rash

In older children, adolescents and adults, the main symptoms of bacteraemia may include:
sleepiness, less responsive, vacant or confused
severe aches and pains in the arms, legs and joints
very cold hands and feet
shivering
rapid breathing
red or purple spots
vomiting
fever
diarrhoea and stomach cramps.

For further information about meningococcal disease visit the Ministry of Health website http://www.moh.govt.nz/meningococcal.

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