Two students at Ramapo High School were hospitalized on Friday with bacterial meningitis after sharing a water bottle during a hockey game earlier that day, health officials said yesterday. One of the students, a 15-year-old sophomore, was being treated last night at St. Joseph’s Regional Medical Center in Paterson and was described as “very seriously ill,” said Dorothy Voorman-Fish, president of the Wyckoff Board of Health. The other student, a senior, was at Hackensack University Medical Center in serious condition but was showing signs of improvement, Ms. Voorman-Fish said. Officials did not release the students’ names. Last night, the Ramapo-Indian Hills Regional High School District, which serves Wyckoff, Franklin Lakes and Oakland, had received no other reports of the disease, she said. As a precaution, the school district canceled sporting events on Saturday and gave antibiotics to members of the Ramapo hockey team. Also, the Ice House, the rink in Hackensack where the game was played, sanitized the locker room used by the team. Classes were to resume today, and parents “have no reason to worry,” Ms. Voorman-Fish said.

Meningitis outbreak at Ramapo High School

UNDIAGNOSED DEATHS - POLAND: SEPSIS SUSPECTED, REQUEST FOR INFORMATION
***************************************
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, 16 Jan 2007 10:06:39 -0800 (PST)
From: Staci Myers <smyersdvm@yahoo.com>


I received a report from a colleague in Poland regarding an 
unidentified "sepsis" being reported in the news in Warsaw and other 
cities. No other symptomology was available, but it reportedly 
originated among recruits at military bases 2-3 weeks ago and is now 
beginning to be seen in the civilian population. Deaths have 
evidently been reported, including a 3-year-old child.

Does anyone have any clarifying information on this?

--
Staci Myers, DVM, MPH
Supervisor, Data Management Division
Epidemiology Services
Oklahoma City-County Health Department
<smyersdvm@yahoo.com>

[We have not been able to obtain additional information on the 
above-reported event in Poland.  In the absence of more information 
on the symptoms it is very difficult to even attempt speculation on 
possible etiology (it is tempting to try to speculate something like 
meningococcal septicemia which has been observed in military 
recruits, and of course might be part of a larger outbreak ongoing in 
the community.... but hazardous in the absence of additional information).

ProMED-mail would greatly appreciate more information from 
knowledgeable sources on the above-mentioned outbreak of a 
"sepsis-like" illness in Poland. - Mod.MPP]
...........................mpp/pg/mpp

JUBA, Sudan, Jan 21 (Reuters) - At least 1,000 people have died in one week in south Sudan's Warap state from meningitis and another unknown disease, state governor Anthony Bol Madut said in a statement sent to Reuters on Sunday.

Emerging from Africa's longest civil war, south Sudan's infrastructure is almost non-existent and outbreaks of disease are frequent. A cholera outbreak last year killed 147 people.

"There is an outbreak of meningitis and (an) unknown disease spreading fast throughout the state and there is fear it may affect other neighbouring states," Madut's statement said.

He said the symptoms of the second disease were similar to yellow fever, but the patient died quickly. He appealed for medical experts to come to diagnose the disease and help stop the spread of the outbreak.

"Up to this time the death toll is over 1,000 this week alone," the statement said. "As I am writing this press release, I am expecting other death reports sooner or later."

Africa's "meningitis belt" stretches from Senegal to Ethiopia through some of the world's poorest and most war-scarred places, including Sudan. It accounts for more than half the cases of the disease worldwide each year.

Meningitis is an infection of the thin lining that surrounds the brain and spinal cord. It can cause complications including brain damage and deafness. About 5 percent to 10 percent of patients die from the illness, according to the World Health Organisation (WHO).

Hundreds of thousands of southern Sudanese returning home after a January 2005 peace deal with the government in Khartoum are especially at risk because they live in crowded camps where infectious diseases like meningitis thrive.

Warap is one of the poorest states in the south, on the border between north and south Sudan.

WHO officials were not immediately available to comment on the outbreak.

http://today.reuters.co.uk/news/CrisesArticle.aspx?storyId=L21654014&WTmodLoc=World-R5-Alertnet-6

MENINGOCOCCAL DISEASE UPDATE 2007 (05)
**************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail, a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Congo DR (Orientale)
[2] Sudan (Southern Sudan)
[3] Uganda (West Nile)
[4] Niger, serogroup X 2006

*****
[1] Congo DR (Orientale)
Date: Fri, 2 Feb 2007
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: WHO Outbreak Reports [edited]
<http://www.who.int/csr/don/2007_02_02/en/index.html>


 From 1 to 31 Jan 2007, the Ministry of Health has reported 53 suspected 
cases of meningococcal disease including 6 deaths (case-fatality rate, 11.3 
percent) in Adi health zone, Province Orientale, in the northeastern part 
of the country, bordering Uganda.

Two cerebrospinal fluid specimens have tested positive for _Neisseria 
meningitidis_ serogroup A by latex test.

A vaccination campaign targeting 99 400 people is being prepared and will 
be synchronized with Uganda, which is currently experiencing an outbreak of 
meningococcal disease in the neighboring area. The International 
Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis 
Control has agreed to provide 115 830 doses of bivalent meningococcal 
vaccine (A/C) along with injection materials and oily chloramphenicol.

WHO and Medecins sans Frontieres, Switzerland are working with the Ministry 
of Health to contain the outbreak. Case management, community education and 
strengthened surveillance are continuing.

--
ProMED-mail
<promed@promedmail.org>

[A map of Congo DR showing the Orientale Province in the northeast part of 
the country adjacent to Uganda can be found at: 
<http://www.un.org/Depts/Cartographic/map/profile/drcongo.pdf>. - Mod.LL]

******
[2] Sudan (Southern Sudan)
Date: Wed, 31 Jan 2006
From: ProMED-mail <promed@promedmail.org>
Source: Reliefweb [edited]
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/LSGZ-6XZDT2?OpenDocument>


 From 1 to 28 Jan 2007, the Ministry of Health of the Government of 
Southern Sudan has reported 666 suspected cases of meningococcal disease 
including 70 deaths (case-fatality rate: 10.5 percent) from 7 out of 10 
states in Southern Sudan. Some of these cases were also reported as early 
as October 2006.

The population in the affected states includes returnees as well as 
displaced people living in areas of difficult access and disperse 
population settlements. A number of cerebrospinal fluid specimens have 
tested positive for _Neisseria meningitidis_ serogroup A by culture as well 
as by latex test.

Several field investigations have been conducted through mobilization of 
rapid response teams, case management has been standardized in all the 
affected states, community mobilization and health education are ongoing 
and surveillance has been strengthened to ensure early case detection and 
monitoring of the epidemic. A mass vaccination campaign targeting the 
high-risk population in Warrab state, one of the most affected states 
during this outbreak, has already started targeting over 45 000 people. The 
WHO Country Office has provided the government with injection materials, 
oily chloramphenicol, transport media and rapid test kits to control this 
outbreak.

--
ProMED-mail
<promed@promedmail.org>

[A map of Southern Sudan showing the distribution of meningitis cases and 
deaths in southern Sudan from 15 Oct 2006 to 28 Jan 2007 can be found at: 
<http://www.reliefweb.int/rw/fullMaps_Af.nsf/luFullMap/E8BFCFB44E6096F6C12572750038FE70/$File/who_HLT_sdn070129.pdf?OpenElement>. 
- Mod.LL]

******
[3] Uganda (West Nile)
Date: Wed, 31 Jan 2007
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and New Vision (Kampala)[edited]
<http://allafrica.com/stories/200702010147.html>


Meningitis is spreading fast in West Nile, leading to the postponement of 
the beginning of the school term in the region. A total of 520 cases have 
been reported, up from 342 cases announced last week in the districts of 
Arua, Koboko and Yumbe, with 15 deaths registered.

As a result, the regional meningitis task force has directed that opening 
of schools in Arua and Maracha-Terego districts be postponed by 2 weeks, to 
allow mass vaccination. Schools countrywide were to open on Mon, 5 Feb 2007 
for the new academic year.

In a circular copied to district leaders, Arua vice-chairman Kamilo Sabo, 
said the postponement affected all government and private schools. The task 
force, in collaboration with the WHO and Doctors without Borders, starts 
mass vaccination on 2 Feb 2007 in Koboko, Omugo and Ayivu sub-counties, 
which have the highest number of cases.

It will then roll to all affected sub-counties in Arua. The next 10 days 
will cover Maracha/Terego, Koboko and Yumbe districts, medical sources 
revealed.

[Byline: Patrick Alioni and Carol Natukunda]

--
ProMED-mail
<promed@promedmail.org>

[A map of Uganda showing the affected areas in the West Nile Region in 
northwestern Uganda can be found at: 
<http://www.un.org/Depts/Cartographic/map/profile/uganda.pdf>. - Mod.LL]

******
[4] Niger, serogroup X 2006
Date: Fri, 2 Feb 2007
Source: ProMED-mail <promed@promedmail.org>
Source: Clinical Infectious Diseases [edited]
<http://www.journals.uchicago.edu.newproxy.downstate.edu/cgi-bin/resolve?id=doi:10.1086/511646>


In several recent meningococcal updates on ProMED, serogroup X was 
discussed.  The following is the abstract from Boisier P, Nicolas P, Djibo 
S, et al: Meningococcal Meningitis: Unprecedented Incidence of Serogroup X 
Related Cases in 2006 in Niger. Clin Infect Dis 2007;44: 657-63:

In Niger, epidemic meningococcal meningitis is primarily caused by 
_Neisseria meningitidis_ (Nm) serogroup A. However, since 2002, Nm 
serogroup W135 has been considered to be a major threat that has not yet 
been realized, and an unprecedented incidence of Nm serogroup X (NmX) 
meningitis was observed in 2006.

Methods. Meningitis surveillance in Niger is performed on the basis of 
reporting of clinically suspected cases. Cerebrospinal fluid specimens are 
sent to the reference laboratory in Niamey, Niger. Culture, latex 
agglutination, and polymerase chain reaction are used whenever appropriate. 
Since 2004, after the addition of a polymerase chain reaction-based 
nonculture assay that was developed to genogroup isolates of NmX, 
polymerase chain reaction testing allows for the identification of Nm 
serogroup A, Nm serogroup B, Nm serogroup C, NmX, Nm serogroup Y, and Nm 
serogroup W135.

Results. From Jan to Jun 2006, a total of 4185 cases of meningitis were 
reported, and 2905 cerebrospinal fluid specimens were laboratory tested. 
NmX meningitis represented 51 percent of 1139 confirmed cases of 
meningococcal meningitis, but in southwestern Niger, it represented 90 
percent. In the agglomeration of Niamey, the reported cumulative incidence 
of meningitis was 73 cases per 100 000 population and the cumulative 
incidence of confirmed NmX meningitis was 27.5 cases per 100 000 population 
(74.6 cases per 100 000 population in children aged 59 years). NmX isolates 
had the same phenotype (X : NT : P1.5), and all belonged to the same 
sequence type (ST-181) as the NmX isolates that were circulating in Niamey 
in the 1990s. Nm serogroup W135 represented only 2.1 percent of identified 
meningococci.

Conclusions. This is, to our knowledge, the 1st report of such a high 
incidence of NmX meningitis, although an unusually high incidence of NmX 
meningitis was also observed in the 1990s in Niamey. The increasing 
incidence of NmX meningitis is worrisome, because no vaccine has been 
developed against this serogroup. Countries in the African meningitis belt 
must prepare to face this potential new challenge.

--
ProMED-mail
<promed@promedmail.org>

[A map of Niger can be found at: 
<http://www.un.org/Depts/Cartographic/map/profile/niger.pdf>. - Mod.LL]

According to WHO, laboratory investigations have identified the bacteria Neisseria Meningitides sero group A as the strain causing the current epidemic. People aged between five and 29 have been most affected.

Sudan: Meningitis spreads in south
[NAIROBI, 22 February 2007 (IRIN) - A total of 1,477 cases of meningitis, including 117 deaths, have been reported in south Sudan since the beginning of 2007, according to the United Nations World Health Organization (WHO).

Areas most affected by the outbreak include Warrap, Yambio, Maridi and Mundri, although the disease has spread to eight of south Sudan's 10 states.

"Meningitis is a dry season disease that will continue to affect people here until around May/June," said Philippe Verstraeten, head of the emergency preparedness and response unit of the UN Office for the Coordination of Humanitarian Affairs (OCHA).

According to WHO, delayed and irregular weekly reporting, inadequate surveillance systems, as well as incomplete population data, were causing difficulties in determining whether some of the districts had reached the epidemic threshold.

"Although we see many sick people here we are struggling to secure vaccines for them because we cannot get reliable population data. Meningitis, unlike other diseases such as cholera, for example, depends heavily on the availability of good and reliable data to determine the standard alert and epidemic threshold," said Verstraeten.

According to WHO, laboratory investigations have identified the bacteria Neisseria Meningitides sero group A as the strain causing the current epidemic. People aged between five and 29 have been most affected.

Meningitis is a potentially fatal infection that affects the thin lining surrounding the brain and spinal cord. Several different bacteria can cause meningitis and Neisseria meningitidis is one of the most important because of its potential to cause epidemics. The most common symptoms are stiff neck, high fever, confusion, headaches and vomiting. It can cause complications, including brain damage and deafness. Vaccines are available for routine prevention and to control epidemics.

According to WHO, the highest burden of the disease occurs in the 'African Meningitis Belt', which stretches from Senegal in the west to Ethiopia in the east, a region with an estimated population of 300 million people.

Enhanced epidemiological surveillance and prompt case-management are used to control the epidemic in the African meningitis belt.

In an effort to contain the spread of the disease, 50,000 people have already been vaccinated in Warrap's greater Tonj area while another 53,000 have received vaccines in Kajo-Keji State.

ro/jn/mw
http://www.reliefweb.int/rw/RWB.NSF/db900SID/EVOD-6YNJ96?OpenDocument

Jasmine Iglesias

Jasmine Iglesias is 23 years old and has a four-year-old son, Jordan. Jasmine contracted meningococcal meningitis and septicaemia at Christmas 2000.

"I was staying with my mum and I was feeling very unwell. I was being sick all the time and the headache was excruciating. My mum became very worried and called for an ambulance. By the time I reached the hospital, I had the septicaemic rash.

"At hospital, I was taken to intensive care, where I spent ten days. I was on a life support machine all through Christmas and although I kept trying to wake up, I was just put back to sleep. Whilst unconscious I contracted pneumonia and I had a mild stroke.

"When I did wake up, I couldn't move my right side, and just kept thinking that this couldn't be happening to me.

"When I was transferred from intensive care to a ward, I was determined to get over the diseases. Seeing my son everyday provided great motivation. By the start of February, I was out of hospital and starting to walk again.

"It has taken years of hard work to get where I am now and I couldn't have done it without my family around me. I still have vertigo, but think that I am SO lucky that I am alive having had meningococcal septicaemia, pneumonia and a stroke. I know that other people haven't been so lucky and have not survived the diseases.

"Meningitis Research Foundation's helpline has been brilliant. I was often on the phone crying and they were very supportive telling me that after such a big trauma it was ok to feel like this and it would pass.

"Telling my story is just one of the ways that I am working with Meningitis Research Foundation to fight back against meningitis and septicaemia."

Jasmine Iglesias, Canterbury, England

MENINGOCOCCAL DISEASE UPDATE 2007 (09)
**************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Poland (Warsaw)
[2] Sudan (Southern Sudan)
[3] Uganda (West Nile)

thanks Candles...sorry for reposting but couldn't read it.  Putting some of your info over on happenings in state of Washington (young woman's death).  They are big on Bird Flu Prepping in that state due to their sensitive location.

.................................................

Amanda - I had viral meningitis twice!!