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Wednesday, November 24, 2004
2 more hospitalized for possible meningococcemia
By Rimaliza Opiņa
BAGUIO CITY -- Two more persons, a 14-year-old girl and a four-year-old boy, were rushed to the hospital Tuesday morning on suspicion that they have contracted meningococcemia.
The girl is from Baguio while the boy is from the neighboring town of La Trinidad in Benguet Province.
Both were initially diagnosed to be suffering from acute tonsilopharyngitis but were immediately brought to the contagious disease ward of the hospital for further observation.
City Health Officer Florence Reyes said as standard operating procedure, all patients with rashes or flu-like symptoms brought to either the emergency room or outpatient department of every hospital were to be immediately classified as "suspect" meningococcemia patients, and automatically referred to either the Baguio General Hospital (BGH) or Benguet General Hospital (BEGH).
This is because meningococcemia, an acute infection of the bloodstream that later causes inflammation of the blood vessels, can mimic other diseases and could be mistaken as dengue or typhoid in most cases, said Health Secretary Manuel Dayrit.
Patients with meningococcemia, according to Dayrit, develop high fever, respiratory problem, rashes and vomiting.
"So once symptoms such as fever, cough or sore throat set in, one should see a doctor for evaluation," Dayrit said.
Meningococcemia, caused by the bacteria Neisseria meningitides, is also known as meningococcal septicemia, meningococcal blood poisoning, meningococcal bacteremia or bacteria in the blood.
Dayrit said the situation in Baguio, and in some Metro Manila areas where meningococcemia was also making an appearance, was under control.
"We can say it's pretty much contained now. The bacteria is endemic but not easily contagious," said Dayrit during a press conference at the Department of Health (DOH) Tuesday.
Nevertheless, hospital workers in Baguio are still taking extra precautions following the 12 cases, including five deaths, of meningococcemia recorded in the city since the start of November.
Two other suspected meningococcemia "index" cases, a 19-year-old and a 6-month-old, monitored by doctors at the Baguio hospital over the weekend were found to have dengue and typhoid fever.
Index cases are those classified by health authorities as highly probable cases or those who have acquired meningococcemia.
Dayrit said the disease is not as contagious as Severe Acute Respiratory Syndrome (Sars), but merits concern because of its high fatality rate of 20 to 50 percent adding that the bacteria damages the brain wall and can result to death in a matter of 24 hours.
"While it is a droplet infection and is transmitted through very close contact, it does not travel very far (airborne) so it is not possible for a person to be infected by the air we breathe," added the health chief.
Records showed that in 2000, there had been 61 cases of meningococcemia in the country, 39 in 2001, 30 in 2002, 39 in 2003 and 32 in 2004 but Dayrit said deaths could reach as high as 30 percent.
Dayrit said while it is given that bacteria could infect many people, only those who do not have a strong immunity system are likely to develop the disease and those aged one to nine years old are the most susceptible to infection and contract the disease.
In Baguio, Dr. Xenia Fabay, head of the BGH meningococcemia management team, told Mayor Braulio Yaranon the earlier four patients brought in together with four others who died of the disease were found to be suffering from typhoid fever and dengue.
Nevertheless, blood samples were taken from them and sent to the Regional Institute for Tropical Medicine to rule them out as possible carriers of the bacteria that cause meningococcemia.
The tourism industry said it continues to feel the effects of the meningococcemia scare in Baguio City.
Baguio Association of Hotels and Inns (Bahai) president Jeanine Chan, in a hastily called press conference, said Tuesday the continuous coverage of the outbreak might affect the staging of the 4th Tossed Salad festival on November 28.
Chan said some members of a group of culinary students from Laoag, Cagayan, and Pangasinan have cancelled their trip to Baguio for fear that they might be infected.
The group was supposed to participate in the making of the tossed salad.
Since Saturday, Chan said reservations in several hotel, inns and lodges have been cancelled, adding there were hardly any tourist arrivals.
The income from the tourist industry, according to the estimates of both the Bahai and the Hotel and Restaurants Association of Baguio (HRAB), went down to 80 percent.
Even bus companies are feeling the effect of the health scare.
Dagupan Bus-Baguio manager Moises Sanchez said they usually register the highest number of tourist arrivals beginning on weekends.
Buses from Manila were always full, he said, but when news broke out, buses coming up to Baguio were almost empty of passengers.
He said the departure time for most of their buses were scheduled every thirty minutes, last week however, they extended the waiting time to one hour to add more passengers.
"Walang umaakyat, wala ring bumaba (No one is going up and coming down)."
The Victory Liner management also disclosed that they recorded a 50 percent loss in just a few days.
The management also had to extend its waiting time from 20 minutes to thirty minutes.
City Epidemiology and Surveillance Unit (Cesu) chief Dr. Celia Flor Brillantes, who spoke before the City Council Monday, said the outbreak was limited only to one cluster, the group who attended the wake of the first recorded casualty.
"There was an outbreak in that group but not in the whole city as perceived by the general public," she explained
The bacteria that cause the disease live in the upper respiratory tract of an individual without causing harm to that person until something, such as a weakened immune system, triggers the bacteria's aggressive behavior resulting in sporadic cases of meningococcemia.
Symptoms of the disease include headache, nausea, vomiting, muscle and joint pains, stiff neck, vomiting, seizures, nerve palsies, rashes and gait disturbance.
The disease is treated with the administration of antibiotics such as Penicillin or Rifampicin, a semi-synthetic drug that inhibits the growth of bacterial cells.
Prevention and control is through the maintenance of sanitation, and by avoiding crowded places and close contact with those suspected to have acquired meningococcemia.
(November 24, 2004 issue)
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