SFDPH Health Advisory: Serogroup B Meningococcal Disease December 3, 2013 SF Dept of Public Health San Francisco Department of Public Health, Serogroup B Meningococcal Disease, SFDPH 0 Because of recent outbreaks of Serogroup B Meningococcal Disease at Princeton Unversity and University of California, Santa Barbara, students from these universities may return to San Francisco for the holidays and present themselves to local medical providers for care. Actions Requested of All Clinicians: Be alert for cases compatible with meningococcal disease. Immediately (within 1 hour) report all suspect cases of meningococcal disease to the 24/7 Communicable Disease Control Unit (CDCU) at (415) 554-2830. Do not wait for laboratory confirmation to report a clinically suspected case. Any delay in reporting compromises the ability to identify close contacts and ensure they receive antibiotic prophylaxis. After hours press “1” and “1” again to page the on-call physician. Let CDCU know if the cases may be connected with the outbreaks at Princeton University and UC Santa Barbara Implement appropriate infection control precautions if meningitis is suspected. Obtain blood and CSF cultures prior to administration of antibiotics if possible to enhance detection of N. meningitidis. SFDPH can assist with coordinating Polymerase Chain Reaction (PCR) testing if needed. Assist CDCU as requested to identify close contacts of cases of meningococcal disease—if patient is severely ill or to be intubated attempt to identify contacts prior to intubation if possible. General Information Concerning Meningococcal Disease Prompt recognition and antibiotic treatment of meningococcal disease is critical. Symptoms of meningitis may include sudden onset of fever, headache, and stiff neck, accompanied by nausea, vomiting, photophobia (sensitivity to light), and altered mental status. Symptoms of bacteremia or septicemia may include fatigue, nausea, vomiting, cold hands and feet, chills, severe muscle aches or abdominal pain, rapid breathing, diarrhea, and appearance of a petechial or purpuric rash (dark purple spots that do not blanch with pressure). The following may be helpful in making the diagnosis: A thorough examination of the skin, conjunctiva and pharynx for petechiae, with particular attention to pressure zones beneath clothes, the palms and the soles Severe muscle or abdominal pain, particularly when there is no apparent alternative etiology Blood pressure values that are in the normal range but are actually low considering the heart rate, temperature, and severity of illness (e.g., BP 100/60 with a heart rate of 140). Platelet counts between 100,000-150,000/mm3. While any individual finding does not necessarily indicate IMD, the constellation of findings warrants closer scrutiny and consideration of antibiotic therapy. Antibiotic treatment should not be delayed to obtain diagnostic specimens. Click here to view the SFDPH Health Advisory issued on November 27, 2013. Comments are closed.
