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Penn announced yesterday that preventive antibiotics were no longer needed for meningococcal infection, signaling a shift in the University's response to the outbreak.

Three Penn students were hospitalized last week with meningococcal infection, and two others were hospitalized for flu-like symptoms.

Student Health Service has not confirmed whether the two students with flu-like symptoms have meningococcal infection.

More than 3,000 students were given preventive doses of Ciprofloxacin - marketed as Cipro - after the University advised that all students who had attended fraternity or sorority events since Feb. 2 be treated.

Though no new cases of meningococcal infection have been reported since Friday, Esther Chernak, director of the city's Acute Communicable Disease Control program, warned that the outbreak may not be over.

She said a long period of time - at least several weeks, and perhaps months - needs to elapse before all danger of subsequent infections is eliminated.

It can take up to two weeks for symptoms to manifest after infection, and infected people can act as carriers, spreading the bacteria to others while not falling sick themselves.

"Most outbreaks tend to be two to three cases," she said. "I hope that's the case here."

Chernak also praised Penn for its response, saying her office worked closely with SHS before the recent outbreak to come up with a plan to efficiently handle any type of major infectious-disease outbreak.

She added that SHS had planned for Penn to dispense medications directly to the community, though some city personnel were on hand to help with the process.

The city also provided several hundred doses of Cipro to SHS, though most of the drugs dispensed were purchased by Penn.

A meningococcal outbreak like the one Penn is experiencing is difficult to control, Chernak said, because outbreaks are typically contained by immunizing those who had not been vaccinated against the disease.

However, the vaccine does not protect against the particular strain that was seen on campus.

The University and the city decided instead to provide post-exposure prophylaxis, which aims to eradicate any meningococcal bacteria that may have already entered a person's nasal passages.

Both Penn and the city will be on a state of "heightened surveillance" for some time, Chernak said.

This means that front-line clinicians at SHS and the Hospital of the University of Pennsylvania will be more likely to suspect meningococcal infection as the cause of a patient's illness.

The city is also on the lookout for the infection spreading outside of the Penn community, though that is more unlikely than in other types of outbreaks because of the close contact required to transmit the disease.

Philadelphia usually sees anywhere from two to nine cases of meningococcal infection each year, Chernak said, which follows the national average.

The rate of infection nation-wide dropped off about six years ago. Before then, Philadelphia saw an average of 10 to 15 cases per year.

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