Viral Meningitis Cases More Than Doubled in 1998
The number of viral meningitis cases for 1998 was more than double the amount from the previous year--the second-highest number of cases recorded over the 41 years the county has tabulated such data--but health officials don’t have a clear explanation as to why.
A total of 586 incidents of viral meningitis were reported, up significantly from the 1997 total of 275 and the sharpest increase of any communicable disease recorded by the county. Health officials believe that number is closest to the record high of 718 set six years ago.
“It’s more than we have seen since 1992,” said Dr. Hildy Meyers, the county’s medical director of epidemiology.
Figures were also slightly up for a few sexually transmitted diseases and AIDS. But those totals were lower by far than those from previous years.
The county data will be useful in helping public health officials control key diseases through prevention and treatment programs. A more complete 1998 report on about 70 communicable diseases in the county is expected to be available later this month.
Viral meningitis is difficult to control because there is no specific treatment for it, officials said. It can be prevented with good hygiene such as washing hands after using the bathroom and before handling food.
“Unfortunately, there are not a lot of measures to take to prevent transmission” of the virus, Meyers said. “The best way is good hygiene.”
It remains unclear why the number of viral meningitis cases swelled in 1998, but Meyers said the disease is cyclical. The cycles may be related to levels of immunity in the community or the introduction of new viruses, she added. But health officials can’t be sure because few doctors do a culture test in cases of viral meningitis.
However, limited laboratory tests at the county and state levels in 1998 found that Echovirus 30--a potent strain of the disease--was predominant. Echovirus 30 also was the predominant strain in the 1992 outbreak.
Although the figure rose dramatically in 1998, officials believe the actual number of incidents could have been even higher because some cases may have gone unreported. Viral meningitis can be hard to detect because it is a flu-like disease whose symptoms include fever, headaches, sore throat, diarrhea, nausea and vomiting.
Victims react in various ways. Some break out in rashes or become sensitive to light. Other cases are so mild that an infected person shows no symptoms.
The disease causes inflammation in the lining of the spinal cord. Although infectious, it is usually not life-threatening but sometimes can lead to hospitalization for people who have lost an extensive amount of food or fluids from vomiting, experts said.
Other diseases that showed an increase in reported cases in 1998 included AIDS, chlamydia and gonococcal infections. AIDS cases increased to 310 from 283; chlamydia increased to 3,497 from 3,290; and gonococcal infections jumped 13% to 521 cases reported, up from 461.
Meanwhile, the number of tuberculosis cases decreased significantly to 282 from 330 in 1997. Officials attribute the downward trend to stepped-up investigations of tuberculosis cases and community outreach programs.
“We are seeing the results of our efforts,” said Penny Weismuller, county manager of disease control. “But there’s more work to be done with patients and the general community.”
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Return of the Germ
Viral meningitis returned to Orange County with a vengeance in 1998. The number of cases reported in the first 50 weeks was the highest total since 1992. Here are the trends in cases reported and the rate per 100,000 residents:
Cases
1992: 718
1998: 586
Rate/100,000
1992: 28.4
1998: 21.6*
* Based on January population total
Source: Orange County Health Care Agency
