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July 1, 2004
Viral meningitis activity in Fairfax County is occurring within an
expected range this year, according to results of an investigation
that began June 18 in response to two reported deaths of children
who lived in the same neighborhood, one of which was associated
with suspected viral meningitis and the other of unknown cause.
Once the cases were brought to the Health Department's attention,
the Fairfax County Health Department implemented
emergency-room-based surveillance to evaluate the extent of the
problem.
"This effort was challenged by the fact that health care
providers in Virginia are not required to report cases of viral
meningitis to the Health Department. Therefore, the Health
Department did not have data on past viral meningitis
activity," said Gloria Addo-Ayensu, health director for Fairfax
County. The Health Department conducted an analysis of Fairfax
County hospitals' discharge data from 2001-2004 to establish
baseline rates for the county. Approximately 150 viral meningitis
hospitalizations per year were recorded. Since June 18, the Health
Department conducted 31 investigations and identified 12 cases
which met clinical and laboratory criteria for viral
meningitis.
The Health Department conducted the investigations in
collaboration with the Virginia Department of Health and the
Centers for Disease Control and Prevention (CDC). "As we wrap
up this investigation, there is no indication of an outbreak at
this time and ongoing active surveillance of viral meningitis is no
longer warranted. The current level of viral meningitis activity
for the population the size of Fairfax County is common for this
time of the year. It is likely there will be additional viral
meningitis cases throughout the season which typically lasts until
October," said Gloria Addo-Ayensu, M.D., health director for
Fairfax County.
Results of laboratory testing indicate that some of the current
cases are associated with enterovirus infection. Enteroviruses
cause most cases of viral meningitis. According to the CDC,
enteroviruses are the most common human viruses and account for
approximately 10 to 15 million symptomatic infections in the United
States each year. Most enterovirus infections result in mild
illness, such as a cold or rash with fever. Fewer than 1 in every
1,000 infected persons develop viral meningitis and death is
uncommon. Enterovirus infections are more common during summer and
fall months. Symptoms of viral meningitis include fever, severe
headache, stiff neck, neck pain, nausea and vomiting, sensitivity
to bright light, and possibly a rash.
Meningitis also can be caused by bacteria. Bacterial meningitis
often has the same symptoms as viral meningitis, but is a more
serious condition that can be treated with antibiotics and, in some
cases, prevented with a vaccine. Unlike bacterial meningitis, no
specific treatment or vaccine is available for viral meningitis.
Therefore, contact tracing and case investigation are not routinely
conducted for viral meningitis.
The most efficient ways to prevent the spread of enteroviruses as
well as many other germs is to wash hands frequently, especially
before eating and after using the bathroom and avoid sharing eating
utensils, lip balm, lipstick, water bottles and other personal
items. Persons who have symptoms of meningitis should seek medical
attention. The Health Department's hotline established at the
beginning of the investigation to address public concerns will
continue to be available. For more information, call the Health
Department hotline at 703-246-2411, TTY 703-591-6435.
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