Meningitis mini-epidemic hits: Thousands could be infected and not know it

State health officials say frequent and thorough hand washing is the first line of defense against a documented viral meningitis outbreak in the Houma-Thibodaux area that is known to have affected 23 people, mostly children, including seven who attend a YMCA day camp.

Authorities are stressing that the cases involve a form of meningitis that is rarely, if ever, fatal or related to problems beyond headache, fever and related maladies.



The best defense against viral meningitis and many other communicable diseases, Louisiana’s chief epidemiologist said in an interview, is frequent hand-washing and use of disinfectants.

Dr. Raoult Ratard of the Louisiana Department of Health and Hospitals said those precautions are especially important because when such outbreaks occur the number of known cases represents only about ten percent of people actually infected.

The other 90 percent of people exposed may have few if any symptoms but can still spread the virus.



Viral meningitis is described by state health officials as “a relatively common and rarely serious disease caused by one of several types of viruses.”

A U.S. Centers for Disease Control definition says meningitis is an inflammation of the tissue that covers the brain and spinal cord. Viral meningitis is the most common type of meningitis and less severe than bacterial meningitis.

Most people, according to the CDC, get better without medical treatment. But infants younger than a year and people with weakened immune are more likely to have severe symptoms.



The term “outbreak,” Ratard said, would be synonymous with a small epidemic.

“When you look at this type of outbreak some of it is spread through droplets from the mouth, from sneezing and most of it from the stools,” Ratard said. “People use a bathroom and do not wash their hands really well. They put the virus on door knobs and everywhere.”

Insects such as mosquitoes are not vectors for the disease, which Ratard said is spread by human-to-human contact.


Last week state health officials confirmed an outbreak but would only say it was in the Department of Health and Hospitals Region III. Region III is a seven-parish area made up of Assumption, Lafourche, St. Charles, St. James, St. John, St. Mary and Terrebonne parishes.

Aseptic meningitis, state fact sheets say, results in an estimated 11 cases per 100,000 people per year.

An outbreak occurred in Terrebonne Parish in 1988. In 1991 outbreaks were reported in Ascension, East Baton Rouge and Iberia parishes, St. John in 1993 and St. Tammany in 1995.



No reporting was done from 1999-2001.

Angi Falgout, CEO of the Bayouland YMCA, first learned that a child attending the day camp was diagnosed after an employee told her early Monday morning of a Facebook post that mentioned the child’s illness. The aunt of the child came to the Y later that morning and informed Falgout.

“I immediately began making calls to confirm the case and to assess the risk,” said Falgout, who received word later that day of another child being ill. She wrote a letter to parents Monday informing them that were at least two cases of meningitis involving children in the program. The letter was given to parents as they picked up their children Monday afternoon, with an attached fact sheet Falgout received from DHH providing meningitis information.



In the letter Falgout told parents that health officials said the occurrence of two cases at the same camp was likely “a mere coincidence.”

It was not until Wednesday, as DHH continued its investigation, that Falgout learned a total of seven children from the program were treated for symptoms.

Falgout’s letter was shared by parents on Facebook, intensifying panic among some.



She said Friday that of the children attending the camp, two sets of two children were from the same households.

Ratard said that would not be unusual.

Plans for a visit to the Splash camp by a local business, Bricks 4 Kids, which brings huge quantities of Lego block pieces to parties and events, were canceled, a manager at the company confirmed, after word of infected children at the camp was received.


“We have concerns for the potential of spreading the meningitis virus and the supplies that we use,” said manager Kathy Williams.

Falgout said she was disappointed that several parents whose children were sick did not inform her.

“It would make it a lot easier to be more proactive if they had,” said Falgout. “But I am a parent, and I am sure the only thing they were worried about at that time was their children.”



Ratard said outbreaks such as the one currently being experienced will result in around 30 cases or so and then disappear, in his experience.

He described the current situation as a “community outbreak.”

“From what we have seen there is not a single case where there is a focus of infection,” Ratard said. “It is usually limited to one or two towns, then you may have a few other cases here and there.”



Children attending day camp at the Bayouland YMCA had the first known cases of viral meningitis locally diagnosed this year. There are as many as 23 known cases of people with symptoms and as many as 2,500 carriers.

 

JP ARGUELLO | THE TIMES