April 6, 2001

Meningococcal Infection: Manitoba
The Winnipeg Regional Health Authority and Manitoba Health has launched a targeted immunization campaign for Winnipeg youth in grades 7 to 12. The vaccinations, which will be provided in a staged process through schools, began March 29, 2001. The city-wide campaign is anticipated to take 2 weeks. Approximately 60,000 Winnipeg youth will be offered vaccination. The immunization program is a precautionary step in light of nine cases of meningococcal infections diagnosed in the province since January 2001. Four cases have been in the targeted age group in Winnipeg. In total, six of the nine cases have been meningitis and three cases have been meningococcemia. With the exception of one case, all have been of the group C sub-type. An outbreak response team has been working since January to plan and anticipate any actions that may be required to protect the health of Manitobans. The Winnipeg Regional Health Authority will conduct the immunization campaign with the support of Manitoba Health. Public Health will continue to monitor the effect of any new cases and continue contacting close contacts of new cases to provide them with antibiotics.
Source: Communicable Disease Control Unit, Public Health Branch, Manitoba Health.

Neisseria meningitidis Serogroup W-135: France, the Netherlands, Germany
Enhanced surveillance for meningitis W135: 2a: P1.2,5 set up among several European countries following an epidemic of this strain among travellers to the hajj in 2000, has identified seven cases of infection with this or compatible strains between January 27-February 23, 2001. In France, meningococci of strain W135:2a:P1.2,5 were isolated from the blood of a 76 year-old woman with no known link to the hajj. The same strain was isolated from the blood of a 19 year-old man; multilocus DNA fingerprinting showed markers of electrophoretic type (ET)-37 complex in both cases. Neisseria meningitidis of strain W135:2a:NST was isolated from the blood and cerebrospinal fluid of a 6 month-old baby girl. Multilocus DNA fingerprinting showed that this strain does not belong to the ET-37 complex. In the Netherlands, meningococci of strain of W135:2a:P1.2,5 were isolated from a 29 year-old man. Further epidemiological data are unavailable. In Germany, N. meningitidis of strain W135:2a:P1.2,5 was isolated from a 1 year-old girl. Connections to the hajj have yet to be established. Strain W135:2a:P1.2,5 was isolated from a 2 year-old girl with septicaemia, who was Muslim but had no known direct connection to Mecca. The same strain was isolated from a 6 year-old girl with septicaemia, who was from a neighbouring town and became ill on the same date. This child was not Muslim and had no known connection to Mecca. Seven cases of infection with this or compatible strains were reported between December 30, 2000-January 26, 2001, from France, the United Kingdom, and Germany.
Source: Eurosurveillance Weekly, Issue 11, March 14, and Issue 7, February 15, 2001

Poliomyelitis: Dominican Republic and Haiti
During July 12, 2000-February 8, 2001, 12 laboratory-confirmed poliomyelitis cases attributed to vaccine-derived poliovirus type 1 were identified in the Dominican Republic. Of these, 11 (92%) case-patients were aged < 6 years (range: 9 months to 14 years), and the date of paralysis onset of the last case was January 2, 2001. All case-patients were inadequately vaccinated or unvaccinated. In Haiti, one confirmed polio case attributed to vaccine-derived type 1 poliovirus was reported in a 2 year old unvaccinated child with paralysis onset on August 30, 2000. As of February 21, 33 acute flaccid paralysis (AFP) cases from the Dominican Republic and three AFP cases from Haiti were pending final classification. Extensive control efforts are under way. The Dominican Republic held nationwide mass vaccination campaigns with oral poliovirus vaccine in December 2000 and February 2001, with a third round planned for April 2001.
Source: Morbidity and Mortality Weekly Report, Vol 50, Issue 08, March 02, 2001

The details given are for information only and may be very provisional. Where incidents are considered of national importance and are ongoing, the initial report will be updated as new information becomes available.

[Infectious Diseases News Brief]