On March 15, 2018, the Taiwan Centers for Disease Control (Taiwan CDC) announced 1 meningococcal meningitis death in an one-year-old girl who resides in northern Taiwan. On March 2, she developed symptoms, including cold and fever, and sought medical attention at a clinic. Her conditions improved after taking the medication. On March, 11, she developed a mild fever. On March 12, she sought further medical attention after developing fever and vomiting. On the same night, she sought medical attention at the emergency department of a hospital when her symptoms persisted. On the following day, March 13, when she became restless and developed ecchymosis, she was transferred to the intensive care unit (ICU) for further treatment. However, her conditions worsened and she unfortunately passed away.

On March 14, the hospital reported the case to the competent health authority after suspecting meningococcal strain in the case’s specimen. On March 15, infection with Neisseria meningitides was confirmed in the case. Based on the case’s maximum incubation period (March 1 and 11), a total of 32 contacts have been identified. Currently, none of them has developed any suspected symptoms. 17 contacts have taken the prophylaxis. 4 contacts (healthcare workers) wore masks during exposure and have been asked to conduct self-health management. The remaining 11 contacts are expected to take the prophylaxis on March 16. The local health authority has conducted disinfection of the case’s residence and provided the case’s family with relevant health education, and will continue to follow up on the health of all contacts.

Thus far this year, a cumulative total of 3 meningococcal meningitis cases, including 2 deaths, have been confirmed, which is the highest among the same period since 2009. All 3 cases are sporadic cases. In 2016 and 2017, a cumulative total of 8 and 12 meningococcal meningitis cases were confirmed. According to the past year surveillance data, the majority of the confirmed cases age below 6 (36%) and most of them are infected with Neisseria meningitidis serougroup B. Hence, physicians are urged to stay vigilant for suspected cases in order to ensure timely diagnosis and treatment.

Meningococcal meningitis is an acute infectious disease caused by meningococcus. Outbreaks often occur during the rainy season in winter and spring from November to March. The disease is transmitted from person-to-person through droplets of respiratory or throat secretions from carriers. The incubation period ranges from 2 to 10 days. The symptoms include fever, severe headache, nausea, vomiting, neck stiffness, hemorrhagic rash, pink spots, confusion or other mental changes, coma, and seizure. When necessary, antibiotics are prescribed as the treatment.

To ward off meningococcal meningitis, wash hands with soap and water frequently, maintain good indoor ventilation, avoid staying in poorly ventilated rooms for long hours, and seek prompt medical attention when suspected symptoms developed. Physicians are advised to be vigilant for suspected cases and prescribe antibiotics when appropriate. Travelers planning to visit areas affected by meningococcal meningitis are advised to visit the outpatient travel clinic at contracted hospitals in the nation to evaluate the need of meningococcal meningitis vaccination prior to their trip. The public is urged to seek timely medical assistance when suspected symptoms develop and inform the doctor of any recent travel history to facilitate prompt diagnosis and case reporting.  For more information, please visit the Taiwan CDC website at https://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).