schoolboy
There are fears that a new virulent strain of the disease is circulating in South Africa
Mail & Guardian reporter
James Hale (16), a scholar at Pretoria Boys High, was packing to return to boarding school on Sunday when he developed a severe headache.
His parents took him to Sunward Park Clinic in Boksburg where flu was diagnosed. They returned home but the boy was so ill he couldn’t even bathe himself properly. His parents took him back to hospital. A blood test was done and he was admitted for observation. At 4am he was rushed to intensive care and before dawn died of meningitis.
Dr Victor Diab, manager of Sunward Park Clinic, said Hale had died of meningococcal meningitis. “It is a very dangerous kind of meningitis and can kill in six to eight hours.”
Most forms of meningitis are easily treatable, according to the South African Institute for Medical Research (SAIMR).
Dr John Rodda, paediatric neurologist at Chris Hani Baragwanath hospital and an expert on meningitis, said such rapid death after the onset of symptoms “is more likely to be meningococcal, which is most often found in institutions like boarding schools, creches, hostels. It spreads quite quickly by touching and children playing together.”
On Tuesday Department of Health authorities visited Pretoria Boys High and gave about 20 children a prophylaxis, Rifampricin a drug that can prevent meningococcal meningitis. Some were sent home and one child was isolated.
SAIMR deputy director of the pneumococcal research unit Dr Shavir Madhi said they were disturbed at a recent increase in meningococcal meningitis nationally and especially in Gauteng. “In the first two weeks of July we have already seen seven cases at Chris Hani Baragwanath hospital, compared to two in June and one in May. Nationally we have seen 21 cases in Bloemfontein and Johannesburg in June, and 22 up to mid-July.
“We are not certain if a new strain of a lethal meningitis is circulating, but are running tests and will know by Friday. The outcome for patients with this form of meningitis is good provided treatment is started early.” The SAIMR is only aware of cases from government laboratories.
A girl admitted to the Sandton Medi-Clinic with meningococcal meningitis last week was “doing well”, doctors said. A child admitted to Sunninghill Clinic in the past month was discharged after treatment. A patient is being treated at Milpark hospital and another at Pretoria’s Union hospital.
However, there seems to be no coordination of information between state and private hospitals, even though meningitis is a notifiable disease.
Gauteng Department of Health technical adviser on outbreaks Johan van Heerden asked if the Mail & Guardian “had a hidden agenda” in asking about mengingococcal meningitis, “because it will cause panic, you merely want to sensationalise. This is not in the public interest.”
JoAnne Collinge, spokesperson for Minister of Health Dr Manto Tshabalala-Msimang, said Hale’s case was not formally notified to the health authorities because the tests conducted at the hospital where he was treated were not “conclusive as to the cause of death”.
“Normally, health authorities would only offer prophylactic medication once meningococcal meningitis has been confirmed by laboratory tests. In this case, although there had been no confirmation, an exception was made and prophylactic medication was administered to his associates,” Collinge said.
Collinge said meningococcal meningitis is endemic in South Africa and a fair number of cases are reported each year. Last year there were 60 notified cases and four deaths and in 1999 there were 194 cases and 29 deaths.
There is a worldwide alert on meningococcal meningitis that is increasing with a new virulent strain possibly emerging.
Professor Hendrik Koornhof, an expert on meningitis and consultant to the SAIMR, said there was concern about “W135, a new isolate which is now disseminating throughout the world. There are concerns that it will cause outbreaks. It kills rapidly. We are doing DNA fingerprinting of 12 isolates belonging to that organism and will have results by next week.”
Koornhof said there was no need for panic. “World Health Organisation and Centres for Disease Control recommendations say those who should get prophylaxis are people with very close contact; those who share a bed or table, but not the people who live next door. It is not necessary to immunise a whole school but those in the same dormitory or close contacts.”