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Ebola: Information for U.S. Healthcare Workers and Settings

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Disease Name: Meningitis


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Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Immunization of close contacts is not an effective means of preventing illness from exposure to a primary case, but may be considered in an outbreak setting.


Overview / Case Definition

Neisseria meningitidis is a gram negative diplococcic bacteria.  Meningitis is the most common presentation of invasive meningococcal disease.  Detection or isolation of N. meningitidis in a specimen obtained from a normally sterile body site (blood, CSF, synovial fluid, pleural fluid or pericardial fluid) or from purpuric lesions are reportable and require a contact investigation.


Restrictions

Restrictions - Daycare Facility

A person who is diagnosed with a disease caused by Neisseria meningitidis must not provide personal care to children, or attend a daycare facility, as long as the disease is present in a communicable form.

Restrictions - Health Care Facility

A person with Neisseria meningitidis in a health care facility or residential care facility must be placed under respiratory isolation until twenty-four (24) hours after initiation of effective therapy.

Restrictions – School

A person who is diagnosed with a disease caused by Neisseria meningitidis must not work in any occupation that involves direct contact with students, or attend a private, parochial, charter, or public school as long as the disease is present in a communicable form


Reporting

1 day

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable: Yes

Reporting Timeframe: Within 1 working day



Diagnosis / Testing

The Centers for Disease Control and Prevention (CDC) recently released best practice guidance for clinical laboratories using Polymerase Chain Reaction (PCR) for the diagnosis of invasive Haemophilus influenzae (Hi) or Neisseria meningitidis (Nm).  This guidance was released after CDC became aware of recent instances in which it was not possible to determine whether cases of meningitis were part of a cluster due to the lack of serogroup data, hampering public health efforts to control possible outbreaks of the disease.

Many sites within the Idaho Sentinel Laboratory Network are adopting commercial molecular diagnostics such as the BioFire Film Array or ARUP PCR products.  These products enable the rapid detection of Hi and Nm genes but do not provide information about the serotype of the agent, which is critical for public health investigation and response. 

Idaho Bureau of Laboratories is requesting laboratories using PCR for the diagnosis of Hi and Nm to:

  1. select assays capable of detecting and differentiating all Hi serotypes (serotypes a-f) and all Nm serogroups common in the United States,  or
  2. send either reactive primary specimens or isolates to our reference bacteriology laboratory so that we may culture, confirm, and serotype them. 


Treatment

Persons who should be strongly considered for immediate prophylaxis include:

  1. All intimate contacts (household, school/daycare, close friends)
  2. Anyone directly exposed to the patient’s nasopharyngeal secretions.  (Health care workers who have not had direct contact with the case’s nasopharyngeal secretions are not at increased risk, and prophylaxis is not indicated for them).
  3. Travelers with direct contact with respiratory secretions.


Additional Information

Immunization of close contacts is not an effective means of preventing illness from exposure to a primary case, but may be considered in an outbreak setting.


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