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Commentary

Additional Meningococcemia-like Illness in the Philippines

Recombinomics Commentary
January 15, 2005

>>However, in Misamis Oriental a five-year-old child and a woman suspected to have been infected with the meningococcemia bacteria were already isolated in the Northern Medical Center (NMMC).
Aside from the two, another two children from El Salvador town in Misamis Oriwntal (sic) were likewise believed to have suffered meningococcemia and then admitted to the medical center.<<

Additional meningo-like cases are being reported outside of Bagiou City.  Media reports would put the number of meningo and meningo-like cases in the Philippines at close to 100, although the WHO announcement this week only mentions 33 in Baguio City.

Again there is no mention of laboratory results for confirmation of meningococcemia as a secondary (Neisseria meningitides isolation) and no mention of a primary.  It is not clear if either of the above sets of cases are linked. 

However, earlier reports show strong linkage, but again there are no reports of lab confirmation of the secondary infection or any mention of a primary.  One of the largest reported clusters centered on a 41M who died of meningo-like illness.  A relative who attended his wake died between 11 and 13 days after his death as did 3 other attendees at the wake.  All lived in separate communities and all died within a few days of each other. It seems likely that the index case infected a relative before he died, and then the relative infected three others at the wake.

Meningococcemia usually affects children under the age of 4.  It sounds like the five fatalities above were all adults and all died.  However, the high case fatality rate and older age of the victims did not seem to raise questions about the primary disease.

Focusing on the primary disease, such as a fatal bird flu, may provide quicker answers than tracking the secondaries.

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