Bulletin No. 10
July 16, 1976
Meningococcal Meningitis

Three cases of meningococcal meningitis occurred in June with one death in a 53-year-old Anchorage resident. Three cases have occurred in July to date. One case is in a 46 year old fisherman in Ketchikan. Another is in a 45-year-old Anchorage woman who was a contact of the man who died in June. The third is in a 3-year-old Anchorage girl being treated at Elmendorf Hospital. We urge all health workers to have a high index of suspicion for this potentially lethal infection. Rifampin is the drug of choice for contacts of patients with meningococcal disease. Penicillin remains the drug of choice for treatment of a patient with clinical disease.

(Reported by John Finley, M.D., PHS Hospital, Anchorage, T.L. Conley, M.D., Ketchikan, Alice Howarth, Lab Supervisor, PHS Hospital, Anchorage, William Madden, M.D., Elmendorf Hospital)

BOTULISM in Glennallen

Two native families were stricken with botulism after eating a meal of fermented fish heads and eggs. Within 12 hours of ingestion of the food, symptoms occurred in the first patient. Of 13 people eating the fish, 8 developed symptoms of botulism. The predominant symptoms include nausea, vomiting, dizziness, blurred vision, dry mouth, bloated feeling, dysphagia, and change of voice. The predominant signs included dry mucous membranes, fixed and dilated pupils, and postural hypotension.

Approximately 36 hours after the meal, while preparations were underway to air evacuate the patients to Anchorage, one patient, a 44-year-old male, suffered a cardio-respiratory arrest and was resuscitated. Two other patients, age 66 and 46, required tracheostomy and ventilatory support soon after arriving in Anchorage. Six patients were air evacuated to Anchorage and all have subsequently improved.

In Alaska, all botulism outbreaks have been caused by native foods. We urge people not to store meat in plastic bags unless it is kept frozen. Learn to recognize the symptoms of botulism so the person can be treated immediately. If the patient is evacuated to the hospital and treatment begun in time, he will recover completely. Report any suspected case of botulism immediately to the State Medical Epidemiologist at 272-7534 or 279-9511.

(Reported by James Pinneo, M.D., Joe Viola, M.D., Faith Hospital, Glennallen)

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