Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
Meningococcal disease describes infections caused by Neisseria meningitidis (also termed meningococcus) and carries a high mortality rate if untreated. Whilst best known as a cause of meningitis, wide spread blood infection (sepsis) is more damaging and dangerous. Meningococcal septicemia and the disease Meningitis is an important causes of illness, death and disability in developed and under developed countries worldwide. The disease impact on public health, meningococcal disease is of interest and importance to microbiologists, epidemiologists, clinicians and physicians. The paradox of the host/pathogen interaction is not fully understood. The disease begins as harmless commensal in most of the population, invades the blood stream and the brain, and causes serious illness in few individuals, appears to be either host and bacterial genetic factor. Over the past few years, clinicians, clinical scientists, microbiologists and public health physicians have made an intensive effort to understand specific aspects of meningococcal biology and host interactions, although it seems likely that the development of improved treatments and effective vaccines to prevent the disease will depend on novel efforts by workers in many different fields[1] The incidence of endemic meningococcal disease during the last 13 years ranges from 1 to 5 per 100,000 in developed world, and from 10-25 per 100,000 in developing countries. During epidemics the incidence of meningococcal disease approaches 1000 per 1,000,000. There are approximately 2,600 cases of bacterial meningitis per year in the United States, and on average 333,000 cases in developing countries. The case fatality rate ranges between 10 and 20%[2]. While Meningococcal disease is not as contagious as the common cold (which is spread through casual contact), it can be transmitted through saliva and occasionally close, prolonged contact with an infected person. Further complicating efforts to halt the spread of meningitis in Africa is the fact that extremely dry, dusty weather conditions which characterize Niger and Burkina Faso from December to June favor the development of epidemics. Overcrowded villages are breeding grounds for bacterial transmission and lead to a high prevalence of respiratory tract infections, which leave the body more susceptible to infection, encouraging the spread of meningitis. Most frequently hit are 18 countries in sub-Saharan Africa’s so-called “meningitis belt.” This is an area where the disease is endemic: meningitis is “silently” present, and there are always a few cases. When the number of cases passes five per population of 100,000 in one week, teams are on alert. Epidemic levels are reached when there have been 100 cases per 100,000 populations over several weeks[3].[4]
Meningococcal disease causes life-threatening meningitis and sepsis conditions. In case of meningitis, the bacteria attack the liner around the brain called the meninges. Infected fluid from meninges run into the spinal cord causes stiff neck, fever and rash. The meninges and brain start to swell, putting pressure on essential nerves system. Five in 50 victims of meningococcal meningitis will die, but survivors are often left deaf or with permanent brain damage. The sepsis type of infection is much more deadly, result in a severe blood poisoning called meningococcal sepsis that affects the entire body. The bacterial toxins rupture blood vessels and can rapidly shut down vital organs. Within hours, patients can go from perfectly healthy to mortally ill. In this active feature, follow the progression of meningococcal bacteria as they race through the bloodstream, on a scale few diseases can match with such lightning speed[5]. Meningococcal bacteria commonly harbor in the human ear, nose and throat without causing harm, which is called asymptomatic condition and often sometimes pass through the respiratory lining and enter the bloodstream. N. meningitidis bacterium is surrounded by a slimy outer coat called capsule that contains diease causing endotoxin. While many bacteria produce endotoxin, the levels produced by meningococcal bacteria are 100 to 1,000 times greater and lethal than normal. As the bacteria multiply and move through the bloodstream and shed concentrated amounts of toxin. The endotoxin aims at the heart, affecting its ability to circulate blood and also causes pressure on blood vessels throughout the body. As some blood vessel starts to hemorrhage, major organs like the lungs and kidneys are damaged. The patients suffer from severe meningococcal disease, are treated with a large dose of antibiotic. , The systemic antibiotic flowing through the bloodstream rapidly kills the bacteria but not the endotoxin. In actuality, as the bacteria are killed and even more toxin gets released. It takes up to several days for the toxin to be neutralized from the body by using continuous liquid treatment and antibiotic therapy[6].
Meningococcal septicemia, like many gram-negative blood infections, can cause disseminated intravascular coagulation (DIC), a condition where blood starts to clot throughout the body, sometimes causing ischemic tissue damage. DIC also causes bleeding, when the clotting factors are used up, causing the characteristic purpuric rash.
Meningococcal meningitis is a consequence of bacteria entering the cerebrospinal fluid (CSF) and irritating the meninges – the membranes that line the brain and spinal cord. Sub-Saharan Africa, Americas, Western Europe, UK and Ireland are facing multifarious challenges even in this 21st century, still 200 years after the discovery of bacterial meningitis WHO/EMC/BAC/98.3. The importance of meningitis disease is as significant as HIV, TB and Malaria in Africa. Cases of meningococcal disease due to Neisseria meningitidis meningococcaemia leading to severe meningoencephalitis are common among young children and elderly. Deaths occurring in less than 24-hours are more likely during the disease epidemic seasons in Africa. Sub-Saharan Africa is hit by meningitis disease outbreaks throughout the epidemic season. Climate change[7] ruthlessly spreads the disease in Benin, Burkina Faso, Cameroon, the Central African Republic, Chad, Côte d’Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Mali, Niger, Nigeria and Togo. IRIN Africa news has been giving number of deaths for each country from 1995-2008 [8],[9],[10],[11] and mass vaccination campaign following community outbreak of Meningococcal Disease in Florida was done by CDC[12]
As any gram negative bacterium, Neisseria meningitidis can infect a variety of sites. Meningococcal pneumonia can be seen during influenza pandemics and in military camps. It is a multilobar, rapidly evolving pneumonia , sometimes associated with septic shock. With prompt treatment with penicillin or chloramphenicol, the prognosis is excellent. Pericarditis can be seen , either as a septic pericarditis with grave prognosis or as a rective pericarditis in the wake of meningitis or septicaemia. Myocarditis can be a complication of meningococcemia and can be contributive to shock seen in this form of disease. Pharyngitis and conjunctivitis can be seen and can constitute the portal of entry to invasive disease. Recently there were cases of epiglottitis and neck cellulitis associated with shock and meningococcaemia. Septic arthritis due to Neisseria meningitidis can be seen, usually acompanying disseminated infection. Other forms of disease can rarely be seen, like osteomyelitis, endophthalmitis and urethritis
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