New York City health officials are reporting two cases of invasive meningococcal disease (IMD) that were diagnosed in early March in persons who either live or work in Far Rockaway, Queens.
The first patient is a child who presented with two days of fever, lethargy, cough, vomiting and diarrhea in the first week of March and was diagnosed with meningococcemia.
The second patient is an adult who works in the area and became ill two days after the initial case. This patient presented with two days of subjective fever, nausea, headache, vomiting, diarrhea, generalized body aches (specifically back pain) and was diagnosed with meningitis.
The two patients had no known contact with each other. Both cases were serogroup C; further molecular testing is underway. Both patients are recovering.
There has not been an IMD case in Far Rockaway, Queens since before 2000, officials note.
Invasive meningococcal disease (IMD) is a rare but serious bacterial infection caused by the gram negative bacterium Neisseria meningitidis.
IMD is transmitted via respiratory droplets among close contacts (e.g., household members, intimate partners).
Meningitis is the most common presentation of IMD; however, other presentations include uncomplicated bacteremia, pneumonia, septic arthritis and meningococcemia. Patients may present with one or more IMD syndromes, and the highest risk of death is from meningococcemia.
Progression to meningococcemia is often abrupt and is characterized by hypotension, tachycardia, tachypnea, petechial rash or purpura, altered mental status, thrombocytopenia, and leukopenia. Death may occur within hours of onset.
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