Date: Fri 23 Sep 2016
Source: Radionz.co.nz [edited]
There have been unconfirmed reports of an outbreak of meningitis in the Malaita Province of Solomon Islands. A doctor working in the Atoifi Hospital told the Solomon Star on Monday [19 Sep 2016] that 5 people had been diagnosed with the disease. [Dr] Chellion Evan said the patients who arrived at the hospital were in a serious condition but could not be immediately treated. However, they were being closely monitored in isolation.
Dr Evan said he believed these were cases of bacterial meningitis, which can be fatal if left untreated.
He said villagers in the area had been warned to look out for early symptoms of meningitis; these include fever, vomiting, headaches and nausea, as well as joint pain, pale skin, and cold hands and feet. Dr Evan said this could be followed by a rash, neck stiffness, disorientation, and a dislike of bright lights.
The last suspected outbreak of meningitis in the Solomon Islands was in July 2014 when 4 children were reported to have died in Makira Province.
[The news report above says that 5 people have been diagnosed as having suspected bacterial meningitis but are not being immediately treated, although the news article goes on to say without further explanation that the disease is fatal if left untreated.
Acute bacterial meningitis is a rapidly progressive disease. In a patient with suspected acute bacterial meningitis, blood cultures and a lumbar puncture (LP) and cerebrospinal fluid (CSF) examination and culture are indicated to determine the causative organism and its antibiotic susceptibilities. An empiric intravenous antibiotic regimen is started as quickly as possible that has a spectrum broad enough to cover the most likely bacterial pathogens until the specific bacterial aetiology is known. It is vital to begin treatment as early as possible in the course of the disease, as delay may contribute significantly to morbidity and mortality. Adjunctive dexamethasone is also given before or with the 1st antibiotic dose. Once a pathogen is known, the antibiotic regimen can be tailored to the antibiotic susceptibilities of the pathogen.
Common causes of bacterial meningitis vary by age group: in newborns - Group B _Streptococcus_, _Streptococcus pneumoniae_, _Escherichia coli_, _Listeria monocytogenes_; in infants and children - _S. pneumoniae_, _Neisseria meningitidis_, _Haemophilus influenzae_ type b, Group B _Streptococcus_; in adolescents and young adults - _N. meningitidis_, _S. pneumoniae_; and in older adults - _S. pneumoniae_, _N. meningitidis_, _H. influenzae_ type b, Group B _Streptococcus_, _L. monocytogenes_. Outbreaks of meningitis in the community are often due to _N. meningitidis_.
More information on this outbreak would be appreciated from knowledgeable sources.
The patients were admitted to Atoifi Hospital, which is located on Malaita Island
[A HealthMap/ProMED-mail map can be accessed at: