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Bacterial meningitis fulminans most probably symptomatic of meningococcal disease, ex-Krakow, Poland

Catholic Herald

Health alert for Italian WYD pilgrims after young woman dies of meningitis 


by Catholic News Service

posted Tuesday, 2 Aug 2016

The Italian bishops' conference advised all pilgrims who visited or attended events at its Casa Italia centre to see a doctor

After an Italian pilgrim to World Youth Day in Krakow, Poland, died of meningitis, the Italian bishops’ conference advised all pilgrims who visited or attended events at its Casa Italia centre in Kraków to see a doctor, especially if they have a high fever, severe headache and rash.

The young female pilgrim from Rome died on August 1 in Vienna, where her group stopped on the way back from Italy, according to a note from the Italian bishops’ conference, which did not release the young woman’s name.

As a precaution, the bishops’ statement said, doctors in Vienna administered the antibiotic ciprofloxacin to all the members of the young woman’s group and recommended the same for other pilgrims who stayed at Casa Italia or spent a significant amount of time there.

The Casa Italia centre was set up at Kraków’s Church of St Bernard of Siena and the adjoining convent. Some Italian pilgrims stayed there during World Youth Day and hundreds more joined them each day for catechesis and Mass in Italian.

Catholic News Agency

Meningitis death of World Youth Day pilgrim prompts health alert


By Ann Schneible
    
Rome, Italy, Aug 2, 2016 / 10:09 am (CNA/EWTN News).- 

The Italian bishops' conference has issued an advisory to pilgrims, after a young Italian girl died of meningitis while she was returning home from World Youth Day in Poland.


The Italian publication Corriere della Sera identifies the girl as Susanna Rufi, 19, who died Monday in Vienna, Austria, as she was returning home to Italy.

“She had been preparing for WYD for a year,” recounted Fr. Alessandro, the parish priest of her local Saint Polycarp parish in Rome, according to Corriere della Sera. “She was a wonderful girl, very active in the parish,” he said, adding that she got good grades, and was active in the choir.

Rufi had reported feeling ill on Sunday evening, after arriving in Vienna with some 50 young people from the parishes of Saint Polycarp and Our Lady of Good Counsel, reports the Italian agency.

Meningitis is an infection-based inflammation of the membranes surrounding the brain and spinal cord. Symptoms include a headache, fever, and stiff neck. Meningitis, which can be fatal, is spread through respiratory droplets, for example through coughing or sneezing.

According to an Aug. 1 statement issued by the Italian bishops' conference, the members of the girl's pilgrimage group have taken a prophylaxis as a precaution.

The conference advised all World Youth Day pilgrims who passed through the Italian House – the center in Krakow which served Italian pilgrims – to undergo the same prophylaxis, per the advice of the Vienna hospital.

Those at risk of exposure who experience a high fever, headache, sore throat, vision problems, or loss of consciousness should go immediately to the hospital, as these symptoms could indicate an infection, the statement advised.

The bishops' conference offered its condolences to the girl's family, “at the conclusion of an experience which was a lesson in fraternity and sharing.”

Tens of thousands of Italians were among the many pilgrims to attend World Youth Day in Krakow, which at its peak was attended by as many as 2 million people during its final days.

ERZDIÖZESE WIEN

Nach Weltjugendtag: Junge Römerin stirbt in Wien an Meningitis


Alle Personen in der Reisegruppe des verstorbenen Mädchens haben eine Prophylaxe-Behandlung erhalten, heißt es vom Wiener Gesundheitsdienst. In Wien gebe es demnach aktuell keine weiteren Meningitis-Erkrankungen.
Eine junge Italienerin, die in den vergangenen Tagen am katholischen Weltjugendtag in Krakau teilgenommen hat, ist an Meningitis erkrankt und in einem Krankenhaus in Wien gestorben. Das hat die Italienische Bischofskonferenz (CEI) am späten Montagabend, 1. August 2016, bekannt gegeben und einen Teil der Weltjugendtags-Teilnehmer zur Einnahme eines Meningitis-Prophylaxe-Medikaments aufgerufen.

Die verstorbene 19-Jährige gehörte laut italienischen Presseberichten vom Dienstag einer 20-köpfigen Pilgergruppe aus der Pfarre San Policarpo im Süden Roms an, die sich auf dem Rückweg von dem katholischen Jugendtreffen in Polen befand.
 
Fall für Stadt Wien beendet
Der Wiener Krankenanstaltenverbund (KAV) bestätigte auf "Kathpress"-Anfrage, dass die 19-jährige Frau in einem Wiener Gemeindespital gestorben ist. In welchem Spital, werde nicht bekannt gegeben. Es liege eine ansteckende Form von Meningitis vor. Für den zuständigen Gesundheitsdienst der Stadt Wien ist der Fall nach Auskunft von Sprecher Michael Ambros "abgeschlossen". Alle Personen in der Reisegruppe des verstorbenen Mädchens hätten die Prophylaxe-Behandlung erhalten. In Wien gebe es aktuell keine weiteren Meningitis-Erkrankungen.
 
Pilger sollen auf typische Symptome achten
Wiener Ärzte hatten am Dienstag laut ORF-Wien wie auch schon die Italienische Bischofskonferenz an alle Teilnehmer des Jugendtreffens appelliert, die wie die Verstorbene in Krakau die "Casa Italia" besucht haben, sich einer Meningitis-Vorsorge zu unterziehen. Grundsätzlich sollten zudem Teilnehmer des Weltjugendtages, die an Symptomen wie hohem Fieber, Hals- und Kopfschmerzen, sowie Sehproblemen leiden, sofort ein Krankenhaus aufsuchen, riet die Italienische Bischofskonferenz.
Pilger sollen auf typische Symptome achten

Wiener Ärzte hatten am Dienstag laut ORF-Wien wie auch schon die Italienische Bischofskonferenz an alle Teilnehmer des Jugendtreffens appelliert, die wie die Verstorbene in Krakau die "Casa Italia" besucht haben, sich einer Meningitis-Vorsorge zu unterziehen. Grundsätzlich sollten zudem Teilnehmer des Weltjugendtages, die an Symptomen wie hohem Fieber, Hals- und Kopfschmerzen, sowie Sehproblemen leiden, sofort ein Krankenhaus aufsuchen, riet die Italienische Bischofskonferenz.
 
Meldepflichtige Erkrankung
Bei Meningitis handelt es sich um eine Entzündung der Hirnhaut oder der Rückenmarkshäute, oft ist auch beides betroffen. Intensive Formen dieser Entzündung greifen fast immer das Herz sowie die Nerven des Gehirns und des Rückenmarks an.

Ausgelöst werden kann sie unter anderem durch Viren oder Bakterien wie etwa Meningokokken. Meningokokken können nur direkt von Mensch zu Mensch durch Husten, Niesen oder über Speichel übertragen werden. Die Inkubationszeit einer Meningokokken-Erkrankung liegt zwischen zwei und zehn Tagen, nach denen Symptome wie Kopfschmerzen, Nackensteife, Gelenks- und Muskelschmerzen, Krämpfe, Erbrechen, Lichtscheue, Benommenheit und/oder rasch ansteigendes Fieber oder Schüttelfrost auftreten, meist gemeinsam mit roten, punktförmigen Hautflecken. Die Erkrankung ist meldepflichtig.
 
Therapie und Vorbeugung
Unbehandelt verläuft etwa die Hälfte der Meningitisfälle tödlich. Als Therapie verwendet man Sulfonamide und Penicillin. Zur Vorbeugung werden gefährdete Personen isoliert, wobei vorbeugende Behandlung nur bei den engsten Kontaktpersonen eines Erkrankten empfohlen wird, nicht aber bei Kollegen oder Mitschülern. Desinfektion und besondere Hygiene gelten als wesentliche prophylaktische Maßnahmen.

Österreichweit wird ein Fall pro 100.000 Einwohner und Jahr registriert. Jede zehnte Meningitis-Erkrankung endet tödlich. In Wien gab es im Vorjahr sieben Fälle, zwei Patienten verstarben.
erstellt von: red/kathpress
02.08.2016

========
World alert and epidemiologic surveillance of World Youth Day 2016 Krakow participants required, as minimum. Proactive immediate action including throat swabs strongly advisable for contacts.
Zbigniew Halat, MD, medical epidemiology consultant
. 
The above message was sent to ProMED-mail on 02 August 2016, 19.00 GMT. Until 03 August 2016, 17.00 GMT this information has been neglected by ProMED.

ProMED - the Program for Monitoring Emerging Diseases - is an Internet-based reporting system dedicated to rapid global dissemination of information on outbreaks of infectious diseases and acute exposures to toxins that affect human health, including those in animals and in plants grown for food or animal feed. Electronic communications enable ProMED to provide up-to-date and reliable news about threats to human, animal, and food plant health around the world, seven days a week.

Instead of raising world alert by ProMED-mail in English, the ProMED management restricted life-saving information to Portuguese speaking users of 
ProMED. Why so? Are the Olympic Games in Rio de Janeiro future participants more privileged than any other persons who are at risk NOW, and secondary contacts of them?

Published Date: 2016-08-03 08:31:26
Subject: PRO/PORT> Meningite - Itália (VN, ex-Polônia), óbito, peregrina, pós-evento de massa, Jornada Mundial da Juventude 
Archive Number: 20160803.4390002
MENINGITE - ITÁLIA (VENETO, EX-POLONIA), OBITO, PEREGRINA, POS-EVENTO DE MASSA, JORNADA MUNDIAL DA JUVENTUDE
*********************************************************************************************
Uma mensagem / Una mensaje / de ProMED-PORT
http://www.promedmail.org
ProMED-mail e um programa da / es un programa de la
International Society for Infectious Diseases
http://www.isid.org

Data: Terça-feira, 02 de agosto de 2016
Fonte: Jornal do Brasil [02/08/2016] [editado]
http://www.jb.com.br/internacional/noticias/2016/08/02/peregrina-da-jmj-morre-de-meningite-e-apavora-italia/?from_rss=None

Peregrina da JMJ [Jornada Mundial da Juventude] morre de meningite e apavora Itália
---------------------------------------------------------------------------------------------------------------
Uma jovem italiana que participou da Jornada Mundial da Juventude (JMJ) na Cracóvia, Polônia, morreu ontem (1) [agosto/2016] de meningite fulminante. O caso está preocupando a Itália e levando centenas de peregrinos a buscarem atendimento médico devido ao medo de contrair a doença. S.R., de 18 anos, faleceu em Viena, durante o trajeto de retorno à Itália.

Na JMJ, a jovem passou pela "Casa Italia", local criado pelo país para receber os peregrinos italianos. A estrutura recebeu mais de 100.000 pessoas, as quais estão sendo submetidas a exames médicos. Até o momento, nenhum caso de contágio foi registrado, nem de uma outra jovem que estava sendo monitorada por estar na mesma comitiva que R. e por apresentar problemas de saúde. Um dos três ônibus da comitiva da qual a jovem participava também parou imediatamente em uma unidade de pronto-atendimento. Até o bispo de Bolzano, Ivo Muser, passou por exames.

As autoridades regionais italianas colocaram em vigor na noite de ontem [01/agosto/2016] os serviços de controle de doenças para orientar a população, principalmente os pais e familiares de jovens que estiveram na Cracóvia, sobre os contágios da meningite. Os médicos recomendam que todas as pessoas que tiveram contato com alguma vítima de meningite recebam um tratamento profilático.

Em Bolzano, todos os 120 jovens que foram à Cracóvia já foram examinados. No Vêneto, o sistema sanitário atendeu 1.063 pessoas, enquanto, em Brescia, foram 1;800 peregrinos. Atrás da Polônia, que sediu a JMJ, a Itália foi o país com o maior número de peregrinos no evento presidido pelo papa Francisco e encerrado no último domingo (31) [julho/2016].

--
Comunicado por: ProMED-PORT http://www.promedmail.org/pt

[Pela evolução e com as informações sobre as medidas que estão sendo adotadas (incluindo profilaxia), difícil não pensar em doença meningocócica como hipótese diagnóstica.

Eventos de massa internacional e doenças de transmissão respiratória (influenza e outros vírus respiratórios, sarampo, rubéola, caxumba, coqueluche, pneumococo...meningococo...) formam uma combinação preocupante e sabidamente de risco para disseminação de patógenos e ocorrência de surtos, seja durante ou após o término do evento, quando o retorno dos participantes/viajantes pode propiciar a ocorrência de casos secundários e surtos mundo afora.

Por esse motivo a importância das medidas de prevenção pré-evento (incluindo-se vacinação de participantes), das estratégias de monitoramento e resposta rápida durante o evento e da vigilância sensível pós-evento.

Coincidência ou não, que sirva de alerta frente ao iminente início, nos próximos dias, dos Jogos Olímpicos do Rio de Janeiro.

- Mod. RNA]
Veja também
ProMED-PORT
-----------
2016: ano 19 do ProMED-PORT

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Google translation of the above

Published Date: 08/03/2016 08:31:26
Subject: PRO / PORT> Meningitis - Italy (VN, former Poland), death, pilgrim, mass post-event, World Youth Day
Archive Number: 20160803.4390002
MENINGITIS - ITALY (VENETO, EX-POLONIA), death, PILGRIM, MASS POST-EVENT, 
WORLD YOUTH DAY
***********************************************************
A message / Una mensaje / of ProMED-PORT
http://www.promedmail.org
ProMED-mail and program / es un program de la
International Society for Infectious Diseases
http://www.isid.org

Date: Tuesday, August 2, 2016
Source: Jornal do Brazil [08/02/2016] [edit]
http://www.jb.com.br/internacional/noticias/2016/08/02/peregrina-da-jmj-morre-de-meningite-e-apavora-italia/
?from_rss=None

Pilgrim WYD [World Youth Day] dies of meningitis and terrifies Italy
---------------------------------------------------------------------------------------------------------------
A young Italian who attended the World Youth Day (WYD) in Krakow, Poland, died yesterday (1) [August / 2016] of fulminant meningitis. The case is worrying to Italy and taking hundreds of pilgrims to seek medical attention for fear of contracting the disease. S.R., 18, died in Vienna during the return path to Italy.

At WYD, the young man went through "Casa Italia" site created by the country for the Italian pilgrims. The structure received more than 100,000 people, who are undergoing medical examination. To date, no case of infection was recorded, or another young man who was being monitored by being in the same party that R. and present health problems. One of the three buses of the delegation which attended the young also stopped immediately in a unit of emergency care. Even the Bishop of Bolzano, Ivo Muser, underwent tests.

The Italian regional authorities put in place last night [01 / August / 2016] disease control services to educating the public, especially parents and relatives of young people who have been in Krakow, on the contagion of meningitis. Doctors recommend that all people who had contact with some meningitis victims receive prophylactic treatment.

In Bolzano, all 120 young people who went to Krakow have already been examined. In Veneto, the health system has met 1,063 people, while in Brescia, were 1, 800 pilgrims. Behind Poland, which sediu WYD, Italy was the country with the largest number of pilgrims in the event chaired by Francis Pope and ended last Sunday (31) [July / 2016].

-
Reported by: ProMED-PORT http://www.promedmail.org/pt

[For the evolution and the information on the measures being taken (including prophylaxis), hard not to think of meningococcal disease as a diagnosis.

international mass events and respiratory transmitted diseases (influenza and other respiratory viruses, measles, rubella, mumps, pertussis, pneumococcus, meningococcus ... ...) form a disturbing and known combination of risk for spread of pathogens and outbreaks, either during or after the event, when the return of the participants / travelers can promote the occurrence of secondary cases and outbreaks worldwide.

For this reason, the importance of pre-event preventive measures (including Vaccination of participants), the monitoring strategies and fast response during the event and post-event sensitive surveillance.

Coincidence or not, to serve as a warning against the imminent start in the coming days, the Olympic Games in Rio de Janeiro.

Finally in English (the title changed by ProMED)
:

PRO/EDR> Meningitis, meningococcal - Austria: ex Poland, fatal, pilgrim, WYD, alert
Message from: promed@promedmail.org — PRO/EDR> Meningitis, meningococcal - Austria: ex Poland, fatal, pilgrim, WYD, alert
Date: Wednesday, August 3, 2016 19:25
promed@promedmail.org
Do  promed-post@promedmail.org — promed-edr-post@promedmail.org  
MENINGITIS, MENINGOCOCCAL - AUSTRIA: ex POLAND, FATAL, PILGRIM, WORLD
YOUTH DAY, ALERT
**************************************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Tue 2 Aug 2016
Source: Catholic News Agency (CNA/EWTN News) [edited]
<http://www.catholicnewsagency.com/news/meningitis-death-of-world-youth-day-pilgrim-prompts
-health-alert-52288/>

The Italian bishops' conference has issued an advisory to pilgrims,
after a young [19-year-old] Italian girl died of meningitis [on Mon 1
Aug 2016 in Vienna, Austria, while] returning home from World Youth
Day [WYD] in Poland [Krakow, 26-31 Jul 2016].

"She had been preparing for WYD for a year," recounted Fr. Alessandro,
the parish priest of her local Saint Polycarp parish in Rome,
according to Corriere della Sera. "She was a wonderful girl, very
active in the parish," he said, adding that she got good grades, and
was active in the choir.

[She] had reported feeling ill on Sunday evening [31 Jul 2016], after
arriving in Vienna with some 50 young people from the parishes of
Saint Polycarp and Our Lady of Good Counsel, reports the Italian
agency.

Meningitis is an infection-based inflammation of the membranes
surrounding the brain and spinal cord. Symptoms include a headache,
fever, and stiff neck. Meningitis, which can be fatal, is spread
through respiratory droplets, for example through coughing or
sneezing.

According to a [1 Aug 2016] statement issued by the Italian bishops'
conference, the members of the girl's pilgrimage group have taken
prophylaxis as a precaution.

The conference advised all World Youth Day pilgrims who passed through
the Italian House -- the center in Krakow, which served Italian
pilgrims -- to undergo the same prophylaxis, per the advice of the
Vienna hospital.

Those at risk of exposure who experience a high fever, headache, sore
throat, vision problems, or loss of consciousness should go
immediately to the hospital, as these symptoms could indicate an
infection, the statement advised.

The bishops' conference offered its condolences to the girl's family,
"at the conclusion of an experience which was a lesson in fraternity
and sharing."

Tens of thousands of Italians were among the many pilgrims to attend
World Youth Day in Krakow, which at its peak was attended by as many
as 2 million people during its final days.

--
Communicated by:
Zbigniew Halat, MD,
Medical Epidemiology Consultant
Health Risk Management & Communication
Poland
<
prevention_is_better@hotmail.co.uk>

******
[2]
Date: Tue 2 Aug 2016
Source: Catholic Herald, Catholic News Service report [edited]
<http://www.catholicherald.co.uk/news/2016/08/02/health-alert-for-italian-wyd-pilgrims-after-young-woman-dies
-of-meningitis/>

After an Italian pilgrim to World Youth Day in Krakow, Poland, died of
meningitis, the Italian bishops' conference advised all pilgrims who
visited or attended events at its Casa Italia centre in Krakow to see
a doctor, especially if they have a high fever, severe headache, and
rash.

The young female pilgrim from Rome died on [1 Aug 2016] in Vienna,
where her group stopped on the way back from Italy, according to a
note from the Italian bishops' conference, which did not release the
young woman's name.

As a precaution, the bishops' statement said, doctors in Vienna
administered the antibiotic ciprofloxacin to all the members of the
young woman's group and recommended the same for other pilgrims who
stayed at Casa Italia or spent a significant amount of time there.

The Casa Italia centre was set up at Krakow's Church of St Bernard of
Siena and the adjoining convent. Some Italian pilgrims stayed there
during World Youth Day and hundreds more joined them each day for
catechesis and Mass in Italian.

--
Communicated by:
Zbigniew Halat, MD,
Medical Epidemiology Consultant
Health Risk Management & Communication
Poland
<
prevention_is_better@hotmail.co.uk>

[ProMED-mail thanks Dr Zbigniew Halat for this information. Although
the news reports above do not specify the microorganism causing this
woman's meningitis, presumably it is _Neisseria meningitidis_. For
further discussion of invasive meningococcal disease, see moderator
comments in prior ProMED-mail posts listed below. - Mod.ML

A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/9382>.]

[See Also:
Meningitis, meningococcal - Italy (04): (TC) fatal, sg C, genotype,
epidemiology http://promedmail.org/post/20160325.4118731
Meningitis, meningococcal - Myanmar: (ML) fatal, sg B, RFI
http://promedmail.org/post/20160324.4115532
Meningitis, meningococcal - Italy (03): (TC) fatal, sg C, genotype,
RFI http://promedmail.org/post/20160306.4073441
Meningitis, meningococcal - Italy (02): (TC) fatal, sg C, RFI
http://promedmail.org/post/20160305.4071047
Meningitis, meningococcal - Russia: (VO) fatal
http://promedmail.org/post/20160222.4040007
Meningitis, meningococcal - Italy (TC): increased incidence, sg. C
http://promedmail.org/post/20160210.4009797
2015
----
Meningitis, meningococcal - Europe (02): (Sweden, UK) ex Japan, Boy
Scouts alert http://promedmail.org/post/20150826.3604861
Meningitis, meningococcal - Europe: (Sweden, UK) ex Japan, Boy Scouts,
RFI http://promedmail.org/post/20150820.3591304
Meningitis, meningococcal - Ireland: 2010-2013, ext. family, sg.B,
sg.B vaccine http://promedmail.org/post/20150529.3394758]
.................................................ml/mj/mpp
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Pathogenesis

● Organism colonizes nasopharynx
● In some persons organism enters the bloodstream and causes infection at distant site
● Antecedent URI may be a contributing factor

Neisseria meningitidis
 Clinical Features

● Incubation period 3-4 days (range 2-10 days)
● Abrupt onset of fever, meningeal symptoms, hypotension, and rash

● Fatality rate 10%-15%, up to 40% in meningococcemia

Meningococcal Meningitis

● Most common presentation of invasive disease
● Results from hematogenous dissemination
● Clinical findings
■ fever
■ headache
■ stiff neck


Meningococcemia
● Bloodstream infection
● May occur with or without meningitis
● Clinical findings
■ fever
■ petechial or purpuric rash
■ hypotension
■ shock
■ acute adrenal hemorrhage
■ multiorgan failure

Cochrane Library: Cochrane Database of Systematic Reviews 
Pre-admission antibiotics for suspected cases of meningococcal disease

Plain language summary
Meningococcal disease is a contagious, bacterial disease caused by Neisseria meningitidis (N. meningitidis) that, if not treated early, can rapidly lead to death or disabling consequences such as visual, hearing and intellectual impairments.

Administering antibiotics as soon as the condition is suspected and before the diagnosis is confirmed, has been advocated to prevent death and disabling consequences. However, this might result in treating people without the disease with unnecessary antibiotics. (...)

Authors' conclusions: 
We found no reliable evidence to support or refute the use of pre-admission antibiotics for suspected cases of non-severe meningococcal disease. Evidence of moderate quality from one RCT (Randomized Controlled Trial) indicated that single intramuscular injections of ceftriaxone (100 mg/kg; max 4 g) and single intramuscular injections of long-acting (oily) chloramphenicol (100 mg/kg; max 3 g) were equally effective, safe and economical in reducing serious outcomes. The choice between these antibiotics would be based on affordability, availability and patterns of antibiotic resistance. (...)

ZENIT

La ragazza, di ritorno da Cracovia, è morta a Vienna. A tutti i giovani transitati a Casa Italia si consiglia l’assunzione di una compressa di Ciprofloxacina 500 mg

2 AGOSTO 2016REDAZIONEGIORNATA MONDIALE DELLA GIOVENTÙ

Www.Gmg2016.It
Ieri a Vienna è morta una ragazza di una parrocchia romana per meningite, durante il viaggio di rientro da Cracovia dove aveva partecipato alla Giornata Mondiale della Gioventù. Lo riferisce l’Ufficio nazionale per le comunicazioni sociali della Cei con una nota diffusa ieri pomeriggio in tutta Italia.
“I membri del gruppo di cui faceva parte – informa la Cei – sono stati già sottoposti alla necessaria profilassi, che consiste nell’assunzione di una compressa di Ciprofloxacina da 500 mg. Essendo la giovane transitata per Casa Italia – quartier generale a Cracovia del Servizio nazionale per la pastorale giovanile della Cei – l’ospedale di Vienna, a livello cautelativo, invita coloro che abbiano visitato la struttura ad effettuare il medesimo trattamento”.
“Nel caso in cui qualcuno accusasse sintomi quali febbre alta, mal di testa o di gola, problemi di vista o perdita di conoscenza, deve recarsi subito in ospedale, indicando quale potrebbe esserne la causa”, spiega la nota della Chiesa italiana, che “si stringe nel cordoglio attorno ai familiari della ragazza rimasta vittima, a conclusione di un’esperienza che è stata all’insegna della fraternità e della condivisione”.


Susanna Rufi, morta di meningite a 19 anni 
di Raffaella Troili
Si trascina verso la sua chiesa e sembra pieno di dubbi. E' rientrato ieri, c'erano tutti, sani e salvi, tranne Susanna. Francesco è distrutto e non è la stanchezza, fa finta all'inizio, «chi io? Non c'ero, no a Cracovia», poi torna indietro e racconta come in trance. «Ero con Susanna, ho fatto il viaggio con lei, l'ho vista svenire, aggravarsi, era lultima tra noi che doveva morire, così solare, disponibile, attenta». Si affaccia nel tardo pomeriggio nella parrocchia di San Policarpo, ha ancora al polso il braccialetto della Giornata Mondiale della Gioventù con scritto in Jesus we trust. Guarda a terra, si passa la mano sul viso, gli occhi lucidi e lo sforzo di ricordare.

«SI STENDEVA SEMPRE» Era nel gruppo di ragazzi partiti dalla parrocchia di San Policarpo all'Appio Claudio, con loro don Pino, il vice parroco, don Davide e suor Alessandra. Oltre ad altri giovani di due parrocchie vicine. Fa fatica a raccontare quella gita che doveva essere un momento di gioia, un ricordo speciale e che si è trasformata in tragedia: la sua amica diciottenne è morta stroncata dalla meningite. Le sue condizioni sono precipitate a Vienna, dove è morta. «All'inizio sembrava un colpo di sole, la mattina di domenica con il Papa era stata caldissima, Susanna era svenuta alla fine della messa, ma non era l'unica a sentirsi male. Abbiamo fatto chilometri sotto il sole, lei aveva la febbre alta, non aveva mangiato né a pranzo né a cena, faceva fatica a camminare, si stendeva, l'aiutavamo». Si ferma ancora Francesco, come se i ricordi gli si materializzassero dolorosi davanti agli occhi. E assumessero d'improvviso un'altra luce. «Dopo tanto caldo, ci ha preso il diluvio». Susanna sempre più debole, si sdraiava dove poteva. «Dormiva sempre, abbiamo pensato a uno sbalzo termico, nessuno ha pensato a qualcosa di più grave».
 
«NEL BUS SI È AGGRAVATA» Da Cracovia a Vienna, sul pullman Susanna perde quasi conoscenza. Cinque ore, con una sosta, la giovane è pressoché immobile. «Aveva gli occhi sbarrati, dormiva, si vedeva che stava male, sì la aiutavamo, anche la sorella ma nessuno pensava che fosse in pericolo di vita, non era l'unica a sentirsi così. Eravamo stati sotto un caldo torrido e lei non si era coperta, non si era refrigerata». Il viaggio di Susanna «con lo sguardo fisso» termina nella tappa di Vienna. «E' scesa dal pullman ed è svenuta. Padre Pino e gli altri hanno immediatamente chiamato l'ambulanza, hanno subito capito che era grave». E' mezzanotte Susanna viene ricoverata: è meningite, i medici prescrivono la profilassi a tutto il gruppo, una compressa di Ciprofloxacina da 500 milligrammi, da riprendere dopo due giorni. I ragazzi restano in attesa, «verso le due e mezza del pomeriggio abbiamo saputo che Susanna è morta». Arriva la famiglia, la sorella Margherita resta a Vienna come lei il viceparroco don Pino. I ragazzi se ne ripartono muti, sconvolti, in lacrime. Non doveva finire così questa Giornata Mondiale della Gioventù, quell'incontro tanto desiderato, fatto di preghiere, scherzi, risate.
 
«ERA TANTO CONTENTA» «Susanna era tanto contenta, stava vicino a tutti, era l'ultima che si meritava questa fine, la febbre le è venuta per lo stress». E' crollata. Perché stava bene, almeno gli altri giorni. «L'ultimo giorno lo sforzo fisico le ha fatto abbassare le difese immunitarie», ancora Francesco. «Era l'ultima che si meritava di morire», ripete «e non mi fraintenda, intendo che era speciale, solare, vicina a tutti». Sta rientrando anche un'altra ragazza del gruppo trattenuta all'ospedale di Udine dopo aver dato di stomaco e dunque potenzialmente vanificato l'effetto della copertura antibiotica). «Sta bene, è stato solo lo stress, anche per lei». Francesco se ne va, non ha più voglia di parlare. Forse in serata si riaffaccerà per una preghiera.
Mercoledì 3 Agosto 2016 - Ultimo aggiornamento: 08:43 

Massima attenzione dopo il decesso della ragazza di Roma al rientro dalla Giornata mondiale della gioventù

00012198-originalIl Sistema di sorveglianza regionale dell’Emilia-Romagna è stato attivato dopo il decesso avvenuto a Vienna, per meningite meningococcica, della giovane originaria di Roma, durante il suo viaggio di rientro da Cracovia, dove aveva partecipato alla Giornata mondiale della gioventù. I Servizi di Igiene e sanità pubblica delle singole Aziende Usl stanno effettuando infatti la profilassi nei casi ritenuti opportuni e sono a disposizione per fornire informazioni a ragazzi e ragazze provenienti da Cracovia e alle rispettive famiglie.

La meningite meningococcica si trasmette da persona a persona attraverso contatti stretti, tramite goccioline di saliva; il batterio responsabile sopravvive solo per pochi minuti fuori dell’organismo. I sintomi sono rappresentati generalmente da febbre alta, cefalea intensa, vomito e rigidità alla nuca. Il rischio di contagio è basso e sono rari i casi di trasmissione della malattia. Per ridurre ulteriormente il rischio è importante che le persone a venute a stretto contatto con i malati si sottopongano a profilassi antibiotica.

Per “contatti stretti” si intendono quelli tra persone che sono state esposte alle goccioline di saliva del malato; in questo caso, per esempio, chi ha viaggiato nello stesso pullman, dormito negli stessi locali, pranzato allo stesso tavolo o avuto comunque contatti stretti con la persona malata. In base alle ricostruzioni degli spostamenti che i ragazzi e le ragazze dell’Emilia-Romagna  hanno effettuato durante il soggiorno in Polonia, per la Giornata mondiale della gioventù, risulta improbabile che possano esserci state occasioni di contatto stretto con i gruppi di giovani provenienti da Roma.

I Servizi di Igiene e sanità pubblica delle Aziende Usl restano a disposizione per chiunque abbia dubbi o chieda approfondimenti: i recapiti nella Guida ai servizi di ER Salute.


Meningitis Research Foundation

Young adults at risk 
Meningitis and septicaemia strike suddenly and kill in hours. Babies and young children are most vulnerable but young people and students are the next most at-risk group. This is partly because as they meet new people and move away from home, they also meet new bacteria. 

Septicaemia can occur with or without meningitis. Not everyone gets all the symptoms and they can appear in any order.

We suggest young people and students share awareness and care for one another. Don’t assume an illness is a hangover or a touch of flu. Learn the symptoms of meningitis and septicaemia and if you think a friend or housemate is ill:

Meningitis and septicaemia kill. Knowing the symptoms saves lives. Meningitis and septicaemia symptoms ©2016 Meningitis Research Foundation
Meningitis and septicaemia kill. Knowing the symptoms saves lives. 
Meningitis and septicaemia symptoms: 

fever and/or vomiting
severe headache
limb, joint, muscle pain
cold hands and feeet, shivering
pale
breathing fast, breathless
rash 
(if you are seriously worried about someone who is ill, don’t wait for a rash to appear – get medical help. But if they are already ill and get a new rash or spots, use the Tumbler Test. Press a clear glass tumbler firmly against the rash. If you can see the marks clearly through the glass seek urgent medical help immediately.)

stiff neck (when the head is bent forward)
dislike of  bright lights
very sleepy, difficult to wake, vacant
confused, delirious
seizures (fits)





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Dziewiczy Wrocław, Europejska Stolica Kultury 2016. Dziewictwo do ślubu jest najlepsze dla ciebie. 
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