Health Department discloses information about fatal meningitis

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The V.I. Health Department on Friday released additional information about a case of bacterial meningitis that caused a recent death in the territory, prompting the department to issue a warning on Thursday.

V.I. Health Commissioner Darice Plaskett said Friday that the person who succumbed to the disease, meningococcal meningitis, was a 21-year-old man on St. Thomas.

Meningococcal meningitis - an inflammation of the protective membranes covering the brain and spinal cord - is caused by the bacteria Neisseria meningitidis.

V.I. Health officials said that they had done an investigation and treated those who - because of their close personal contact with the man - had potentially been exposed to the bacteria with antibiotics in an attempt to prevent them from getting sick.

"We were promptly notified and completed an investigation within the incubation period and ensured that everyone who had close contact with him received the appropriate treatment," Plaskett said Friday.

The incubation period for a disease is the period between exposure to the infection and the appearance of the first symptoms.

Plaskett and Dr. Marc Jerome, Health Department medical director, said Friday afternoon that at that point, there had been no further reports of suspected meningitis in the territory.

"We are past the incubation period, so if anyone had been exposed and infected, they would have been symptomatic by now," Plaskett said.

However, she and Jerome still cautioned local health care workers to be vigilant for symptoms of meningitis and report suspected or confirmed cases to Health using the V.I. Notifiable Disease Form.

The young man who died on St. Thomas had not been in school or at university, Plaskett said.

Late last year, meningitis outbreaks at two stateside university campuses grabbed headlines.

Symptoms of meningitis infection include a sudden onset of fever, headache and stiff neck. There can be other symptoms as well, including nausea, vomiting and increased sensitivity to light, according to the CDC.

Neisseria meningitidis is spread through the exchange of respiratory and throat secretions through actions such as kissing, coughing and sneezing. The bacteria are not spread by casual contact or by simply breathing the air where a person with the disease has been, according to the Centers for Disease Control and Prevention.

However, the Neisseria meningitidis bacteria can spread to people who have had close or lengthy contact with a patient with meningococcal meningitis.

Symptoms can appear two to 10 days after infection, most often within three to four days. The most serious cases result in death.

In the United States, about 4,100 cases of bacterial meningitis, including 500 deaths, occurred each year between 2003 and 2007, according to the CDC.

In its initial announcement on Thursday, the V.I. Health Department released few details about the death, not even specifying on which island it occurred.

Dr. Georges Benjamin, the executive director of the American Public Health Association, said that any decision by public health officials about what to announce and when to announce it depends on the specific situation and can be affected by many factors, including whether all who were potentially exposed to the illness are known.

"Every situation is different," he said. He did not speak specifically to the local situation.

Generally speaking, though, the first goal is to take care of the person who is exposed or sick, and then to mitigate the risk to the public as much as possible, according to Benjamin.

"It's all about trying to protect the public health," he said.

Public health officials have to weigh the necessity of maintaining patient privacy with the need to inform and educate the public, he said.

"The more information you release, while protecting patient confidentiality, the better trust you're going to have with the community," he said.

"The more you can share, without violating the patient's confidentiality and without panicking people, the better."

The goal, he said, is to arm members of the public with information so they know how to protect themselves.

"It's a matter of giving the public enough information so that they're not worried and they are informed," he said.

Effective communication is a key tool for public health, according to Benjamin.

"I like to give people as much information as I possibly can," he said.

Benjamin said the goal is to keep people comfortable that they've gotten as much information as they need.

"From a public health perspective, it's not about getting on the news, it's about using public communication as a tool to protect the public," he said.

- Contact Joy Blackburn at 714-9145 or email

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