Abstract

On January 31, 2015, the Sarasota County Office of the Medical Examiner notified the on-call epidemiologist at the Florida Department of Health, Bureau of Epidemiology of a possible death from meningococcal disease in a male child aged 17 months. The child was part of a large non-English-speaking Romani family (whose members self-identified as Gypsies), who arrived in Florida after traveling in Texas and Europe during the previous 2 months. The child had no history of prior meningococcal immunization. The family reported that the child had been sick for at least 7 days with an ear infection; however, this diagnosis was not confirmed by a physician. Because of increasing fever and onset of vomiting, emergency medical service (EMS) staff members were contacted and the child was transported to a local emergency department on January 29, 2015. Although he was reportedly interactive and alert during registration, he developed a rash while in the emergency department, his condition rapidly deteriorated, and he died within four hours. An autopsy was performed on January 30, and on January 31, the medical examiner reported Gram-negative diplococci in the cerebrospinal fluid (CSF). The on-call epidemiologist notified the Sarasota County epidemiologist to initiate investigation of the case and identify contacts at risk and needing chemoprophylaxis.

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