The Directorate-General for Public Health of the Canary Islands Health Service has reported an outbreak of viral meningitis caused by enterovirus on the island of El Hierro, with three associated cases, all in children aged three, six and seven, who are pupils at a school in the municipality of La Frontera.
A statement from the Department of Health indicates that the first case in this outbreak began showing symptoms at the start of October, whilst the most recent confirmed case began showing symptoms in the middle of this month.
The three children affected have required hospitalisation, although all have shown a favourable clinical course and the first two cases have already been discharged from hospital, whilst the third child remains in hospital and is making good progress.
El Hierro: Public Health Authority activates protocol following cases of meningitis
The statement notes that, as soon as the first confirmed case came to light, the Public Health Department activated the established protocol for such situations, carried out contact tracing for those who may have been in contact with the confirmed cases, and alerted healthcare professionals in the area so that they could detect symptoms consistent with this infection in other people at an early stage.
Viral meningitis occurs sporadically or as an epidemic, and generally leads to a full recovery, with severe symptoms rarely occurring.
Approximately ninety per cent of cases of viral meningitis are caused by the enterovirus family.
It presents with a sudden onset of fever, severe headache and neck stiffness; nausea, vomiting, abdominal pain and pharyngitis may also occur.
Symptoms usually last between 10 and 14 days.
Furthermore, most enterovirus infections are asymptomatic or result in a non-specific febrile illness, often accompanied by mild and short-lived respiratory symptoms.
Enteroviruses are often spread by people who are infected but show no symptoms
The Department of Health states that enteroviruses have a human-only reservoir and are mainly transmitted from person to person via the faecal-oral route.
People who are infected but have no symptoms are often the source of infection; although their incubation period is difficult to estimate, as the source is usually an asymptomatic case, it is estimated to be between two days and two weeks, with a median of three to five days.
School tightens hygiene measures to prevent infection
The main preventive measure is to improve cleaning and hygiene practices within the home, at school and in other institutions.
The Department of Health recommends washing hands with soap and water and points out that enteroviruses are ’naked‘ viruses that are resistant to alcohol, so hand sanitiser should not be used as a substitute for washing.
At school, washing with soap and water will be compulsory before break time and before lunch, and after using the toilet; at home, this should be done frequently, before meals and after using the toilet.
It also recommends that all toilets be equipped with toilet paper, running water, soap and disposable towels.
The school’s cleaning staff, and families at home, will use diluted household bleach on high-touch surfaces: tables, door handles, toys and toilets, and cleaning of the toilets will be stepped up.
Anyone looking after a child must always wash their hands after cleaning up faeces or mucus, and nasal and throat secretions must be wiped away using disposable tissues.
At school, disposable cups will be used for the youngest children to prevent them from drinking directly from the tap, and cups, cutlery and bottles will not be shared.
In nursery school, particular care will be taken to clean any objects that children might put in their mouths. The same guidelines should be followed at home, so children should not be allowed to share the same utensils.
The children concerned will stay at home until instructed otherwise by their paediatrician.
La Frontera is looking into online learning for affected children
Furthermore, the Directorate-General for Public Health has issued a series of specific recommendations to prevent the spread of infection and to step up monitoring for possible symptoms in schools.
The Department of Health states that, as the likely cause of the outbreak is believed to be person-to-person faecal-oral transmission via a chain of asymptomatic, healthy carrier children, it is recommended that consideration be given to the possibility of introducing online learning for the classes of the affected six- and seven-year-olds, given that contact with the three-year-old has now passed the incubation period and has not resulted in any secondary cases among children of that age.
Parents and carers of children living in the municipality are also urged to avoid public places where other children may be present, in order to prevent the spread of infection.
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