COMMUNICABLE DISEASE 
CONTROL BRANCH
- Attention all doctors - 
Date: 5/10/2017     Contact telephone number: 1300 232 272  (24 hours/7 days)

 

Meningococcal W outbreak in APY Lands

In the past two weeks three confirmed cases of invasive meningococcal W disease (MenW) have occurred in the Anangu Pitjantjatjara Yankunytjatjara (APY) lands. All cases were in Aboriginal children and appear to be related to a larger outbreak of MenW in the Northern Territory, again predominantly affecting Aboriginal children.

The Communicable Disease Control Branch (CDCB) routinely undertakes contact tracing for all invasive meningococcal cases (IMD) and, where indicated, arranges clearance antibiotics and vaccination. In response to the current outbreak, the CDCB is also co-ordinating a wider ACWY vaccination program in conjunction with local health clinics in the APY lands.

Be aware of the clinical features of meningococcal disease, particularly in people who may have resided in or have visited the APY lands:
· Symptoms of IMD may include fever, headache, vomiting, photophobia, joint pains, neck stiffness, drowsiness and irritability.
· Rash may be absent or atypical, but if present is classically petechial or purpuric.
· Children may have early signs of peripheral vascular shutdown (leg pain, abnormal skin colour and cold hands and feet), poor eye contact, altered mental state or pallor despite a high temperature.
· Meningococcal septicaemia is more common than meningitis, with a greater mortality.
· MenW disease may have atypical presentations such as epiglottitis, septic arthritis or pneumonia that present alone or in combination with the usual clinical findings.

Community based doctors with patients with suspected meningococcal disease are asked to:
· Urgently give parenteral benzylpenicillin 2.4g (child: 60mg/kg up to 2.4g) preferably intravenously, otherwise intramuscularly.
· Discuss with an infectious diseases physician alterative antibiotics if known penicillin anaphylaxis.
· Arrange urgent ambulance transfer to hospital.
· Notify the CDCB on suspicion of meningococcal disease on 1300 232 272 (24 hours / 7 days).
· Inform carers of patients with a non-specific febrile illness who do not require hospitalisation to watch and seek urgent hospitalisation if the patient deteriorates in any way, especially if a rash develops.

Hospital based doctors with patients with suspected meningococcal disease are asked to:
· Urgently give appropriate parenteral antibiotics, if not already administered.
· Commence droplet precautions.
· Wear a surgical mask if intubating or other airways management.
· Take blood for meningococcal PCR and culture, and if indicated also CSF, and request urgent testing.
· Notify the CDCB on suspicion of meningococcal disease on 1300 232 272 (24 hours / 7 days).

Further information:
Quadrivalent meningococcal vaccines that cover serogroup A, C, W and Y are currently available on the private market but not on the National Immunisation Program. Meningococcal C vaccine is available to all children aged 12 months through the National Immunisation Program. Serogroup B vaccine is also available for private purchase.

In South Australia there have been 31 cases of IMD for 2017, including 18 serogroup B, 10 serogroup W and 3 serogroup Y. In 2016 in total there were 27 cases of IMD (22 serogroup B and 5 serogroup W).

Further clinical information is available at www.sahealth.sa.gov.au/InfectiousDiseaseControl.

Dr Louise Flood - A/Director, Communicable Disease Control Branch
For updated information on notifiable diseases in South Australia, visit:
www.sahealth.sa.gov.au/NotifiableDiseaseReporting
Public – I4-A1

Download the official health alert here (PDF)
 

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