Reasonable Rascal
06-05-02, 23:54
MENINGITIS, VIRAL - USA (TEXAS)
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Date: Mon 3 Jun 2002
From: ProMED-mail
Source: Austin American Statesman, AP report, Mon 3 Jun 2002
[edited]
<http://www.austin360.com/statesman/editions/today/metro_state_13.ht
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So far 5 patients at Valley Regional Medical Center have been diagnosed with viral meningitis after they were admitted to the hospital last week complaining of severe headaches and fever. Viral meningitis is a less severe form of meningitis than bacterial, which has a higher mortality rate and more severe symptoms. The viral form is rarely fatal for people with normal immune systems, according to the Centers for Disease Control and Prevention.
"It's an unusual amount that we're seeing at the hospital right now," said Dr. Robert Lozano, a Brownsville neurologist. "We're a little concerned about it. I've been practicing here 10 years, and I have never seen a peak like this." One of the unusual features of the cases is that they involve 2 sets of family members, Lozano said. "Usually, whole families don't get it," Lozano said. Lozano said the patients are expected to recover fully.
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ProMED-mail
[The diagnosis does not identify a specific virus as the etiologic agent. Various enteroviruses have been associated with meningitis in the past, but other viruses are not excluded. The early timing of this outbreak (enteroviruses tend to peak in their activity in the late summer and early fall in the USA) and the concern raised by the neurologist starts one to think of some other alternative diagnoses. For example: Why does
West Nile virus spring into my mind (a left-field diagnosis)? (In the WNV outbreaks in Romania in recent years have presented as viral meningitis -- see refs below. - Mod.JW) While WNV has not been reported in Texas as yet, it doesn't mean it hasn't managed to "sneak in the back door". And there are other encephalitis viruses that have been active in neighboring states (Eastern equine encephalitis and WNV have been active in Louisiana). It's curious that there have been "sets of family members" involved as well, because the "usual suspects" do not tend to cluster in families. More information on this outbreak would be very much appreciated. - Mod.MPP]
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If indeed, as the ProMed moderator pointed out, it may be WNV, that in and of itself represents a very unusal pattern for US cases, as to date we have not seen any cases of multiple infections within family or close neighborhood groups. I cannot state with any authority whether or not such groupings are seen in countries where WNV is more prevalent.
RR
***************************
Date: Mon 3 Jun 2002
From: ProMED-mail
Source: Austin American Statesman, AP report, Mon 3 Jun 2002
[edited]
<http://www.austin360.com/statesman/editions/today/metro_state_13.ht
ml>
So far 5 patients at Valley Regional Medical Center have been diagnosed with viral meningitis after they were admitted to the hospital last week complaining of severe headaches and fever. Viral meningitis is a less severe form of meningitis than bacterial, which has a higher mortality rate and more severe symptoms. The viral form is rarely fatal for people with normal immune systems, according to the Centers for Disease Control and Prevention.
"It's an unusual amount that we're seeing at the hospital right now," said Dr. Robert Lozano, a Brownsville neurologist. "We're a little concerned about it. I've been practicing here 10 years, and I have never seen a peak like this." One of the unusual features of the cases is that they involve 2 sets of family members, Lozano said. "Usually, whole families don't get it," Lozano said. Lozano said the patients are expected to recover fully.
--
ProMED-mail
[The diagnosis does not identify a specific virus as the etiologic agent. Various enteroviruses have been associated with meningitis in the past, but other viruses are not excluded. The early timing of this outbreak (enteroviruses tend to peak in their activity in the late summer and early fall in the USA) and the concern raised by the neurologist starts one to think of some other alternative diagnoses. For example: Why does
West Nile virus spring into my mind (a left-field diagnosis)? (In the WNV outbreaks in Romania in recent years have presented as viral meningitis -- see refs below. - Mod.JW) While WNV has not been reported in Texas as yet, it doesn't mean it hasn't managed to "sneak in the back door". And there are other encephalitis viruses that have been active in neighboring states (Eastern equine encephalitis and WNV have been active in Louisiana). It's curious that there have been "sets of family members" involved as well, because the "usual suspects" do not tend to cluster in families. More information on this outbreak would be very much appreciated. - Mod.MPP]
--------------------------------------------------
If indeed, as the ProMed moderator pointed out, it may be WNV, that in and of itself represents a very unusal pattern for US cases, as to date we have not seen any cases of multiple infections within family or close neighborhood groups. I cannot state with any authority whether or not such groupings are seen in countries where WNV is more prevalent.
RR