Behind the Scenes: Stopping a Meningitis Outbreak Before it Happens
When a serious or potentially deadly infectious disease strikes in San Luis Obispo County, the County’s Public Health Department responds quickly to identify the source of disease, find and treat people who may have been exposed, and take immediate action to stop it from infecting more people.
In many cases, these investigations and actions are carried out quickly and quietly behind the scenes. This work often remains unseen, as diseases are stopped before they become news.
This spotlight provides a glimpse behind the scenes of one such investigation.
In June 2017, a student at Cal Poly was diagnosed with meningitis, a potentially fatal disease that can move quickly among people living closely together such as in dormitories. The process described here is a tried-and-true approach used by Public Health Departments across the globe. The swift response and collaboration among Public Health Department, the Cal Poly Health Center, local hospitals, and other agencies averted a potentially serious outbreak.
The Public Health Department used this same process throughout 2017 to investigate and intervene to stop the spread of measles, norovirus, tuberculosis and other diseases before they spread. Here's a timeline of those events:
Friday, 9 p.m. – Patient diagnosed
In the emergency room of a local hospital, a college student was diagnosed with bacterial meningitis, a very serious and potentially deadly illness that is spread from person to person. The emergency room physician contacted the County Health Officer so the Public Health Department can immediately began its work investigating to prevent the spread of disease in the community. The student was diagnosed based on clinical presentation and lab tests were sent to the hospital lab for confirmation. The patient was admitted to the hospital and begins receiving treatment.
Friday, 10 p.m. – Public Health investigation begins
Public Health staff interviewed the patient by phone to determine who else may have been exposed to the disease. This includes tracing contacts closely for the past 72 hours and more generally for the past seven days.
Saturday, 2 a.m. – Lab confirmation
The lab test confirmed the diagnosis of bacterial meningitis. Hospital lab staff contacted the County Health Officer with confirmation.
Saturday, 6 a.m. – Public Health investigation continues
The County Health Officer contacted the Cal Poly Health Center director and the California Department of Public Health. The Public Health investigation continued with a second, more in-depth interview of the patient and the patient's roommates. Interviews revealed that the patient had recently traveled to a university Greek system leadership conference in Atlanta, and had carpooled to the airport.
Saturday, 6:30 a.m. – Investigators contact people who may have been exposed to the bacteria
Public Health investigators contacted the patient's roommates, people in the carpool, and other close contacts to let them know they may have been exposed to bacterial meningitis. Most important, investigators urged them to get treatment and let them know how to do so. For people who have been exposed, prompt treatment with antibiotics can prevent illness. At this point, it is urgent that people receive treatment quickly if they have been exposed to the bacteria.
Saturday, 8 a.m. – Cal Poly Health Center opens extended hours to provide preventive medication
The patient's roommates and other close contacts received preventive antibiotics at the Cal Poly Health Center. The center set up and maintained extended hours—including Saturday hours—so students could receive treatment immediately as the investigation continued and the scope widened.
Saturday, 10 a.m. – Collaborating partners connect by conference call
Representatives from the County Public Health Department, Cal Poly Health Center, and the California Department of Public Health connected by conference call to coordinate information and resources and discuss next steps. This included sharing information with other Cal Poly departments and communicating with the campus community.
Saturday, ongoing – California Department of Public Health contacts officials in Georgia
California state public health officials contacted officials in Georgia with details about the patient's travel to the state and attendance at a conference. Based on the timeline of the illness and its incubation period, officials determined that the risk was low and did not warrant an aggressive effort to provide medication to all conference attendees. As a precaution, attendees were notified of their risk and offered the option to receive the preventive antibiotic.
Saturday through Tuesday – Investigation and treatment continue in collaboration with Cal Poly
The Cal Poly Health Center continued its extended hours, brought in an extra doctor, and remained in close communication with the County Public Health Department. The university's Health Center staff communicated with County Public Health staff, who interviewed additional students and followed up on investigative leads.
Ten days after initial diagnoses – Outbreak is averted
One and a half weeks after the initial patient diagnosis, an outbreak was averted. The possible incubation period had ended, and no additional people became sick with bacterial meningitis. People who may have been exposed to the bacteria received prompt preventive medication. The patient was recovering and later returned home to be with parents. The following weekend, more than 20,000 people attend Cal Poly commencement ceremonies. None were exposed to the illness.
In many cases, these investigations and actions are carried out quickly and quietly behind the scenes. This work often remains unseen, as diseases are stopped before they become news.
This spotlight provides a glimpse behind the scenes of one such investigation.
In June 2017, a student at Cal Poly was diagnosed with meningitis, a potentially fatal disease that can move quickly among people living closely together such as in dormitories. The process described here is a tried-and-true approach used by Public Health Departments across the globe. The swift response and collaboration among Public Health Department, the Cal Poly Health Center, local hospitals, and other agencies averted a potentially serious outbreak.
The Public Health Department used this same process throughout 2017 to investigate and intervene to stop the spread of measles, norovirus, tuberculosis and other diseases before they spread. Here's a timeline of those events:
Friday, 9 p.m. – Patient diagnosed
In the emergency room of a local hospital, a college student was diagnosed with bacterial meningitis, a very serious and potentially deadly illness that is spread from person to person. The emergency room physician contacted the County Health Officer so the Public Health Department can immediately began its work investigating to prevent the spread of disease in the community. The student was diagnosed based on clinical presentation and lab tests were sent to the hospital lab for confirmation. The patient was admitted to the hospital and begins receiving treatment.
Friday, 10 p.m. – Public Health investigation begins
Public Health staff interviewed the patient by phone to determine who else may have been exposed to the disease. This includes tracing contacts closely for the past 72 hours and more generally for the past seven days.
Saturday, 2 a.m. – Lab confirmation
The lab test confirmed the diagnosis of bacterial meningitis. Hospital lab staff contacted the County Health Officer with confirmation.
Saturday, 6 a.m. – Public Health investigation continues
The County Health Officer contacted the Cal Poly Health Center director and the California Department of Public Health. The Public Health investigation continued with a second, more in-depth interview of the patient and the patient's roommates. Interviews revealed that the patient had recently traveled to a university Greek system leadership conference in Atlanta, and had carpooled to the airport.
Saturday, 6:30 a.m. – Investigators contact people who may have been exposed to the bacteria
Public Health investigators contacted the patient's roommates, people in the carpool, and other close contacts to let them know they may have been exposed to bacterial meningitis. Most important, investigators urged them to get treatment and let them know how to do so. For people who have been exposed, prompt treatment with antibiotics can prevent illness. At this point, it is urgent that people receive treatment quickly if they have been exposed to the bacteria.
Saturday, 8 a.m. – Cal Poly Health Center opens extended hours to provide preventive medication
The patient's roommates and other close contacts received preventive antibiotics at the Cal Poly Health Center. The center set up and maintained extended hours—including Saturday hours—so students could receive treatment immediately as the investigation continued and the scope widened.
Saturday, 10 a.m. – Collaborating partners connect by conference call
Representatives from the County Public Health Department, Cal Poly Health Center, and the California Department of Public Health connected by conference call to coordinate information and resources and discuss next steps. This included sharing information with other Cal Poly departments and communicating with the campus community.
Saturday, ongoing – California Department of Public Health contacts officials in Georgia
California state public health officials contacted officials in Georgia with details about the patient's travel to the state and attendance at a conference. Based on the timeline of the illness and its incubation period, officials determined that the risk was low and did not warrant an aggressive effort to provide medication to all conference attendees. As a precaution, attendees were notified of their risk and offered the option to receive the preventive antibiotic.
Saturday through Tuesday – Investigation and treatment continue in collaboration with Cal Poly
The Cal Poly Health Center continued its extended hours, brought in an extra doctor, and remained in close communication with the County Public Health Department. The university's Health Center staff communicated with County Public Health staff, who interviewed additional students and followed up on investigative leads.
Ten days after initial diagnoses – Outbreak is averted
One and a half weeks after the initial patient diagnosis, an outbreak was averted. The possible incubation period had ended, and no additional people became sick with bacterial meningitis. People who may have been exposed to the bacteria received prompt preventive medication. The patient was recovering and later returned home to be with parents. The following weekend, more than 20,000 people attend Cal Poly commencement ceremonies. None were exposed to the illness.