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The fourth American meningitis-related death this year in Germany has prompted health officials to reassure the U.S. community and reiterate that there is no cause for significant concern.

“People are safe,” said Army Lt. Col. William Corr, infectious disease consultant for Landstuhl Regional Medical Center.

Corr said that military medical officials in Germany do not intend to change any practices given the recent incidence of meningitis, an infectious disease that causes inflammation of the tissues around the brain and spinal cord. It can be contracted through a virus or through bacteria. It is not considered highly infectious, according to the CDC.

The disease that killed 52-year-old Army civilian Paul Everett on Wednesday was a strain of bacterial meningitis that was rare, difficult to transmit and unrelated to the other four cases of meningitis that have been diagnosed this year among the American military community, Corr said.

All five documented cases of meningitis among Americans in Germany this year were of the bacterial form, which is more dangerous than the viral form, Corr said.

“This was not a contagious, not a highly infective form,” he said of Everett’s case. Everett, unlike the other four patients, contracted meningitis after a bout with pneumonia.

Dr. Ulrich Vogel, a professor at Germany’s national laboratory for meningococcal disease who analyzed cultures from the four previous cases, said that Everett’s case was bacterially distinct from the others.

“This is something completely different from the four cases we have observed,” he said. “Because it’s a completely different type of bacteria. This event here is completely different from what happened before.”

In the U.S., the estimated incident rate of pneumococcal meningitis is one to two cases per 100,000 population, according to the CDC. The incidence of pneumococcal meningitis is highest among children aged 6-24 months and persons aged 65 or older. Rates for blacks are twice as high as those for whites and Hispanics, according to the CDC Web site.

Pneumococcal infection causes about 40,000 deaths annually in the U.S., accounting for more deaths than any other vaccine-preventable bacterial disease, the CDC says.

Since late January, three other Americans in Germany have died, each with a different strain of the infectious disease. The patients were geographically scattered, and none of the patients knew each other. A fourth patient was diagnosed with the same strain as one of the patients who had died, although the two lived in different cities and had never met.

In the German community, Vogel said, meningitis cases have decreased this year.

“We have had a kind of decline in cases this year,” he said. “We have very few clusters of disease. So the situation in Germany at the moment is calm.”

At five documented American cases so far, 2006 has now surpassed the previous year’s four reported cases of meningitis. Between 2002 and 2004, only one U.S. case was reported each year in Germany.

Concerning this year’s apparent spike, “I find it coincidental,” Corr said. “I don’t have a ‘why.’”

Vogel was similarly unable to point out a culprit.

“This is a question many people have talked about,” he said. “It’s very hard to say.”

“It’s fairly unusual that three cases die within one week,” he said of the three cases in late January and early February, “although they’re not related epidemiologically. But statistics always has these extremes. This may be one of those cases.”

Although American doctors believe that the cases are unrelated, Corr said the American military medical community was sensitive to the risk.

“Right now, we’re looking; our antennae are up for any kind of infection,” he said. “We do expect meningococcal infections in Europe. We do expect not an increase, not a decrease, but the same amount.”

Common symptoms of meningitis

According to the Centers for Disease Control and Prevention, the common symptoms of both bacterial and viral meningitis are fever, headache, neck stiffness, light sensitivity, drowsiness, nausea and vomiting.

Viral meningitis, which is usually caused by another virus, is rarely fatal. Most patients recover within 10 days. Bacterial meningitis, which has the same symptoms, is much more severe.

Some forms of meningitis are contagious and are most effectively spread through fluid exchange, such as through coughing or kissing. Meningitis is not sexually transmitted, said Army Lt. Col. William Corr, infectious disease consultant for Landstuhl Regional Medical Center.

Corr recommended simple preventive measures, such as hand-washing and getting a pneumonia vaccine, as the best response to the current spate of meningitis cases in Germany. He also advised anyone who suspects they have the above symptoms to seek immediate medical attention.

And, as with all infectious diseases, the young, the elderly and those with compromised immune systems are at especially high risk.

For more information, visit the Meningitis Research Foundation Web site, or the Centers for Disease Control’s Web site’s page on meningococcal disease.

— Anita Powell

Unrelated patients

Since February, four Americans living in Germany have died after contracting a form of meningitis. A fifth patient recovered after contracting the disease in March. None of the patients knew each other, and doctors believe their cases are not related.

Army Pfc. Dave Robbins, 20, of the 1st Infantry Division in Kitzingen, died Jan. 28 at Würzburg Army Hospital.

Air Force civilian Lindsey Ferris, 26, of Spangdahlem Air Base, died Jan. 29 at a German hospital in Trier.

Kimberly Wesson, 23, the wife of a 1st Infantry Division soldier and an employee at the Schweinfurt commissary, died Feb. 3 at a German hospital in Schweinfurt.

Christopher Screen, 16, the son of an Army civilian in Kitzingen, contracted the same strain, Type C meningitis, as Wesson had, but survived a short bout with the illness in March. Screen said he had never met Wesson.

Army civilian Paul Everett, 52, of Wiesbaden, died Wednesday at Mainz University Hospital after developing meningitis after a case of pneumonia.

— Anita Powell


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