692. Identifying and Responding to An Outbreak of Enteroviral Meningitis Using Social Networking
Session: Abstracts: Virology
Friday, October 22, 2010
Background: Symptoms of fever, headache and vomiting were seen in lower mainland British Columbia secondary school students returning from a trip to the Dominican Republic; some presented to emergency rooms with signs of meningitis.  The trip was organized through a social networking site.  We describe the ensuing epidemiologic and laboratory investigation.

Methods: We reviewed hospital records and obtained information on exposures through public health case follow-up.  Social networking was used to identify additional cases.  Cerebrospinal fluid (CSF) was obtained from four patients and stool from one.  Laboratory investigation included culture and PCR testing for bacteria, herpes simplex virus, arboviruses and enteroviruses. 

Results: From 6 to 25 April 2010, 23 cases 14 to 18 years of age were reported, predominantly males from the same high school.  Five were hospitalized, but all recovered.  The first seven cases to be reported had travelled and subsequent cases were close contacts or schoolmates of trip participants.  CSF samples were positive for enterovirus by PCR in two cases; one was a traveler also positive for enterovirus in stool and the other was a close contact of a returning traveler.  No other bacterial or viral agents of meningitis were identified.  Prevention messages were disseminated through school districts and information from public health was disseminated via social network accounts.

Conclusion: Enteroviruses are common but rarely laboratory-confirmed in Canada.  Infections were likely acquired abroad, as we found evidence of transmission from travelers to contacts.  Social networking improved case finding and epidemiological linkage in this investigation. 

Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Claudia Rank, MPH , British Columbia Centre for Disease Control, Vancouver, BC, Canada
Larry Gustafson, MD, MHSc , Fraser Health Authority, Maple Ridge, BC, Canada
Patrick Tang, M.D., Ph.D., FRCPC , Public Health Microbiology and Reference Laboratory, British Columbia Centre for Disease Control, Vancouver, BC, Canada
Mark Bigham, MD, FRCPC , Fraser Health Authority, Surrey, BC, Canada
Bonnie Henry, MD, MPH, FRCPC , British Columbia Centre for Disease Control, Vancouver, BC, Canada
Peter Tilley, MD, FRCPC , British Columbia Children's and Women's Health Centre, Vancouver, BC, Canada
Wendy Bennett, CRSP , Coquitlam School District #43, Coquitlam, BC, Canada
David M. Patrick, MD, MHSc, FRCPC , Bristish Columbia Centre for Disease Control, Vancouver, BC, Canada


C. Rank, None

L. Gustafson, None

P. Tang, None

M. Bigham, None

B. Henry, None

P. Tilley, None

W. Bennett, None

D. M. Patrick, None

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