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Meningococcemia as a Secondary Infection of Bird Flu
January 15, 2005
Dr. Eric Bertherat, a meningococcemia expert of the World Health Organization (WHO), said Baguio's semi-temperate weather is a big factor in the upsurge of cases of the dreaded bacterial disease since last October.
Bertherat, whom the WHO sent to the country to help authorities address the health problem, said cold weather is often associated with "outbreaks" of meningococcemia.
"Meningococcemia starts in early winter even in developed countries," he said. "Cold weather brings influenza and other infections of the respiratory tract."
The outbreaks of meningococcemia are associated with influenza infections, which is why the meningo-like illness must be tested for bird flu. Bird flu has a case fatality rate of about 70%, which is the case fatality rate for the meningo-like cases. In these cases there is no isolation of Neisseria Meningitidis A, but 70% of the patients die. Thus, it is possible that in some instances where Neisseria Meningitidis A is detected, the cases have meningococcal secondary infections.
The predominant clinical feature of the meningo-like illness is fever and petechial hemorrhages in the skin (bleeding under the skin). Pandemic influenza like H5N1 in poultry in Vietnam, is associated with internal hemorrhaging. This feature was also common in people in the 1918-19 pandemic.
Media reports do not mention tests for avian influenza in the meningo-like patients, even in clusters of five linked fatalities.
A broad screening of meningo-link patients should have been done months ago. The sooner these patients are tested for avian influenza (or influenza in general), the better.