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Human to Human Transmission of Meningo-like Illness

Recombinomics Commentary
January 12, 2005

>>However, Olive said there was a "very low risk of infection" for the public because the disease is spread only through very close contact or exposure for a long period of time.<<

Although exposure over a long period of time may be a requirement for meningococcemia (meningo), the meningococcemia-like (meningo-like) illness appears to be transmissible human to human after brief contact.  Although there may be some symptoms in common, the confirmed meningo disease has a case fatality rate of 25% while the meningo-like disease has a case fatality rate of 68%, which is very similar to the bird flu case fatality rate for H5N1 in Vietnam and Thailand.

However, the meningo-like agent is more easily transmitted from human to human.  One cluster of five fatal cases involved the index case and four who attended his wake.  Only one of the four was a relative and all lived in separate communities.  The index case died November 6 and the four attendees at his wake died between November 17 and19.  It would seem that their contact with each other would be relatively brief.  In another wake linked cluster, a 12 year old neighbor of the index case developed meningo-like symptoms after attending the wake.  He recovered, but his 10 year old brother died.

Media reports describe other brief encounters.  One index case developed symptoms after getting a haircut near a market that had been linked to several other cases.  The index case died as did the person who drove him to the hospital.  Similarly, two siblings developed symptoms at the same time as a third case.  All three had attended the same fair but the third case had no contact with the siblings.

Thus, it would appear that the etiological agent of meningo-like illness requires only a brief encounter for human to human transmission.

Testing of current cases for avian influenza would be useful;.  Isolation of the infectious agent and appropriate warnings that reflect the transmissibility of the agent causing meningo-like illness would also be appropriate.

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