This bulletin is to alert you to six cases of meningococcal disease reported in Kern County in the past 50 days and to request that you have a “high index of suspicion.” Since 1996, Kern County has reported an average of 6 cases of meningococcal disease per year with a range of 0 – 13 cases. Although 6 cases would not be considered an outbreak of disease at this time, advanced strain typing has identified three serogroup B isolates (one pending) with the exact strain type. The California Department of Health Services (CDHS) reported that this is the first time that they have identified three identical strain types from patients in the same city since testing began in November 2004.

Only time will tell if we are seeing a real increase in incidence this year and if the three isolates with the same strain is significant to the understanding of this feared disease. Since the early diagnosis and institution of treatment are critical in cases of meningococcal disease, please “think meningococcus” when seeing any patient, especially in a child with the sudden onset of a febrile disease.

Up to two-thirds of patients with meningococcal sepsis will have a petechial rash. Should you have a suspect case of meningococcal disease, please provide chemoprophylaxis immediately to all intimate contacts. Also, please counsel them to seek medical attention immediately should they develop any symptoms, especially fever, during the days following their last exposure to the index case.

Any suspect case must be reported immediately to the Public Health Department by phone (661) 868-0510 during the day or by calling Control 1 at 324-6551 after 5 p.m., on weekends or on holidays. In addition, please arrange to have all specimens sent directly to the Kern County Department of Public Health Laboratory. The CDHS will expedite advanced PCR stain typing for all suspected meningococcal disease cases. Quick reporting means a quick response by the Public Health Department to control further disease spread.

B.A. Jinadu, M.D., M.P.H.
Director of Public Health Services