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Meningo-like Illness Now Meningitis in the Philippines

Recombinomics Commentary
January 17, 2005

>> Health Secretary Manuel Dayrit has deferred the lifting of the alert level in the country's summer capital after the bacterium causing meningococcemia manifested "differently," causing the emergence of meningitis cases.
A nine-year-old girl admitted at the Baguio General Hospital on January 13 after developing fever was diagnosed to have meningitis. The 21-year-old man who was earlier announced by the DOH as a case of meningococcemia turned out to have meningitis, too.
Dayrit could not say if the bacterium Neisseria meningitidis, which causes meningococcemia, has mutated but simply said they have the "same bacteria manifesting differently."
He said only microbiologists could determine if the bacteria have mutated, adding that both diseases have the same symptoms except for rashes which can only be found in the case of meningococcemia.
Knowing the significance of this matter, Jean Marc Olivé, country representative of the World Health Organization (WHO), said a group of microbiologists from France, Canada and the US Centers for Disease Control (CDC) will arrive soon to study the patterns of meningococcemia in the country.
"However, the clinical presentation and the high case fatality ratio observed are unusual in epidemic meningococcal disease. Therefore, further epidemiological and laboratory investigations are needed to better characterize the cause and extent of the outbreak," the WHO reported in its website.<<

The need to better characterize the cause and extent of the meningo-like outbreak are clear.  There is still no mention of testing the patients for bird flu.  There were only 7 cases of meningo in Baguio City, yet there are over 100 cases of meningo-like illness throughout the country. 

The meningo-like cases have a fatality rate of 68%, the same as for bird flu in Vietnam and Thailand last season.  This season, none of the confirmed H5N1 avian influenza cases in Vietnam have recovered.

In mice, more virulent versions of H5N1 produce neurological disease, including hind leg paralysis.  In the 1918-19 flu pandemic, there were also cases with neurological aspects and WSN/33 was isolated to study such cases.

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