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EMERGENCYNET NEWS SVC.-04/13/92-2100CDT

RAPIDLY EXPANDING DISEASES - APRIL 1992

By: Clark Staten, EMT-P

Chicago, IL - A survey of reported outbreaks of diseases in the United States indicates a resurgence of several diseases that many health experts had predicted would have been completely iradicated by the 1990's.


MEASLES

The Center for Disease Control in Atlanta has reported a series of recent out breaks of measles, particularly among pre-school hispanics that have not been vaccinated for the previously common disease. Caused by a virus, measles are characterized by a skin rash, fever, body aches, and malaise. Although not normally serious, some victims progress into pneumonia or other life-threatening disease processes.

CDC says that the incidence of outbreaks is most likely in poor "inner city" areas and in those where there is a language barrier that prevents knowledge of vaccination techniques. Hispanics, Asians, and other groups who have recently migrated to the United States seem involved in the initial infections of larger spread outbreaks of the disease.

Areas with the greatest numbers of reported cases of measles are San Diego, Los Angeles, Orange, Santa Cruz, San Mateo and Alameda counties in California. The next greatest numbers were found in Dade County Florida, Honolulu, Hawaii, Cook and Dupage Counties in Illinois, and Bronx, Kings, Queens, New York and Manchester Counties in New York state.


CHOLERA

Another disease that many have thought was previously irradicated is Cholera, even though evidence would suggest that this entirely untrue. A major outbreak of Cholera has taken place in the country of Peru during the past year, causing infections in more than 300,000 people. According to the Ministry of Health there, as many as 3,000 of those infected have died. Most of the fatal infections involved young children from poor families.

Health Minister Ernesto Salmeron of Nicaragua has issued a "state of alert" in his country, due to several confirmed cases of the disease and a projected "major outbreak" to occur during the Easter holidays. Health officials in Northern Mexico have confirmed several cases in villages near the border with the United States. A recent report in USA Today indicated that public health workers in Brownsville, Texas had confirmed at least one case to be found there.

Cholera is spread by the ingestion of liquids or foods that have been previously contaminated by the excrement of someone that is already infected by the disease. It spreads most rapidly in areas where water supplies become contaminated, or where there may be cross-contamination between sewage and ground water. Additionally, several cases of the disease have been transmitted by infected food preparation workers, who may or may not be aware of proper sanitation methods. Food on an airplane flight from Lima, Peru to Los Angeles was recently found contaminated by L.A. County Health officials.

Experts predict a continued expansion of the numbers of cases, unless appropriate precautions are taken. They indicate that efficient personal hygiene, sanitary water supplies, and sewage systems in the United States and other developed nations may slow the spread. It is important, however, that physicians and prehospital care workers be aware of the dangers of the disease and the possibility of further contamination.


MENINGITIS

Symptoms of meningitis mimic those of the "flu"...mild fever, sore throat, headache, skin rashes, cough, and joint aches. Eventually, the symptoms progress to nausea and vomiting, high fever, photophobia (sensitivity to light), "stiff neck", and severe headache. Deteriorating levels of consciousness, leading to coma, are common if the patient remains untreated.

Meningitis may be bacterial, fungal, viral, or neoplastic in origin. The difference between the various forms is important because bacterial meningitis can be a true neurological emergency, with patients succumbing to it within hours of symptoms. In several of the recent cases, the deceased patients did not present with symptoms other that thjose that might be consistent with the "flu".

Public health officials in several states have been tracking the various strains of meningitis, in an attempt to draw links in the repetitive cycle of infection and disease. The infection is commonly spread by nasal and throat secretions that are shared by sneezing, couching, kissing, or other intimate contact. People who may have come into contact with meningitis are frequently given the antibiotic Rifampin, in an effort to stave off the onset of the potentially dangerous disease.

According to officials at the University of Illinois in Champaign, IL, more than 18,000 students there have been given free vaccinations for meningitis. This program was begun after an outbreak of the disease that sent seven (7) U of I students to the hospital and resulted in two deaths. Another outbreak reportedly occured at Eastern Illinois University, and it took the life of a nineteen year old student from Batavia, IL.

Health officials in Birmingham, Alabama are also said to be investigating the deaths of two youths at Hueytown High School, where a seventeen year old boy died two weeks ago. A fatal outbreak was also reported at the Delta-Delta-Delta Sorority at a major Eastern university. The USA Today newspaper has reported outbreaks of the disease in New York, New Jersey, Indiana, and California.

(c) EmergencyNet NEWS Service, 1992, All rights reserved.
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