Apr 27, 2009

South Florida links to 'Patient Zero' sought in meningitis outbreak

Health investigators try to find connections between patients who contracted a rare and deadly strain of meningitis.
BY FRED TASKER
ftasker@MiamiHerald.com

''Patient Zero,'' the first victim to come down with the rare strain of meningitis that has killed four and infected eight others in South Florida since December, was a South Florida resident who was sickened in December but has since recovered, health department officials said Friday.

Citing medical privacy laws, officials won't identify the person any more closely. But investigators now are trying to find links among the victims.

''We've looked at where they ate, where they shopped, where they socialized, their personal habits. We haven't uncovered the link yet,'' said Dr. Vincent Conte, senior physician for the Miami-Dade Health Department.

But since the W135 strain is so rare, health officials believe there is some connection by which it was passed on from Patient Zero to the other 11 victims.

''Based on epidemiological principles, to see this many W135s [the strain of meningitis] in such a short period of time, all identical biologically, it points to a common thread,'' Conte said.

The W135, which accounts for about 3 percent of all meningitis strains, can kill within hours of symptoms. Anyone experiencing severe headache, fever, nausea, vomiting and a stiff neck should see a doctor immediately, health officials warned.

Local and state epidemiologists now working the case don't know where Patient Zero caught it. He or she hadn't traveled outside the United States recently -- not even outside South Florida, Conte said.

Neither had any of the other victims except for one dead patient who was a British tourist identified by family and U.K. newspapers as Jade Thomas, 26.

Among the South Florida cases:

• Eight were female.

• Seven were white Hispanic, four were black non-Hispanic and one was white non-Hispanic.

• Of those who died, two were 20 to 30 and two were older than 50.

• Ages of the victims included one infant, four between the ages of 50 to 70 and three over 70.

That puzzles health officials, because they say meningitis cases usually are late teenagers or early adults. Miami-Dade health officials have sent official advisories to 7,000 physicians and 32 hospitals in South Florida, asking them to report immediately any new meningitis cases and to submit samples from such cases to the state laboratory near Jackson Memorial Hospital.

Staff from the U.S. Centers for Disease Control and Prevention are monitoring the situation but probably will not send help to South Florida unless the cases reach epidemic proportions. That would require 250 cases, Conte said, based on a proportion of the Miami-Dade population of 2.9 million.

``If we get more cases, they will become more active.''

Health officials in Broward are also working closely with the Miami-Dade office, said spokeswoman Candy Sims. ''We're in contact with them every day,'' she said.

NO PROGRAMS PLANNED

No special vaccination programs are planned now in public schools, Conte said.

``Schools have comprehensive health division monitors. If they get sick kids, the principals will notify us immediately. There is a heightened sense of surveillance all around. They're calling schools to make sure there are no kids who aren't reported.''

One problem is that South Florida schools have some of the state's lowest rates of compliance, even for vaccinations required to enter school -- including those against Hib meningitis, polio, measles, mumps, rubella, tetanus, diphtheria, pertussis and chicken pox. None of those shots, including the one for Hib meningitis, protects against the W135 meningitis bacteria.

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