Meningitis Outbreak in the city of Estrela D’Oeste/SP, September, 2006: from investigation to control

Abstract

 Meningococcic disease (DM) is a severe infectious disease of expressive relevance in public health, due to the  epidemical potential, the high morbid-mortality and the significant percentage of sequels this hazard presents. In  September, 2006, the city of Estrela D’Oeste/São Paulo confirmed the occurrence of three cases of DM, with a  lethality of 66,7%. All cases were serogrouped and all were identified as being caused by serogroup C  meningococcus. The objective of this investigation was to characterize and to confirm the occurrence of:  outbreak of the disease in the region. Case investigation was performed with the analysis of databanks, of  epidemiological reporting/investigation charts, of hospital consults sheets and of processed exams and  interviews with the physicians, suspicious cases and their families. In order to be included in this outbreak, the  following case definitions were adopted: suspicious case: all patients with signs or symptoms of acute meningitis,  e.g. high fever, vomiting, intense headache, rigidity of the nape or raising of the fontanelle, with or without  toxemia (somnolence and/or torpor and/or irritation) and skin lesions (petechiae or purpura), living or coming to  the city of Estrela D’Oeste during the month of September of 2006. Confirmed case: a suspicious case with  confirmation by laboratorial criteria and/or necropsy. In the occasion an outbreak of the disease was confirmed in  the city of Estrela D’Oeste, with three cases and one death, evolving in rapid and progressive course, with the  identification of meningococcus of the C serogroup in the State of São Paulo. Measures of control,  chemoprophylaxis and vaccination were performed judiciously and timely. Investigation allowed the timely start of  preventive and controlling actions.