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27. Meningococcal infections (sources of infection (temporary carriers -…
27. Meningococcal infections
types
most common pathogen of 95% bacterial meningitis is
H. influenzae
,
streptococcus pneumonia
and
Neisseria meningitidis
out of 16 serogroups, (diff poly side capsule), group A, B, C are 90% of meningococcal disease
nasopharyngeal carriage of meningococci
5-15% young children
1% adults
sources of infection
found in nasopharynx of cases and carriers
5-30% of population may harbour organism during inter-epidemic periods
temporary carriers - 10 months
during epidemics, carrier rates increase by 70-80%
cases will lose infectiousness within 24h of treatment
predominantly children and young adults (lower antibodies)
via inhalation of droplets through nasopharynx, contact with case or carrier, crowding
incubation period 3-4 days, but can be up to 10
prevention and control
cases
antibiotics, can save 95% of lives if given in first 2 days. Penicillin or otherwise chloramphenicol
carriers
rifampicin- eradicate carrier state
1/3 of secondary cases with people of close contact to the case occur in the first 4 days. They are 1000x more at risk
Polysaccharide vaccine against types A, C, W135 and Y used to immunise high risk pops.
pathogenesis (meningitis)
bacteria enter blood, carried to meninges and CSF, inflammatory response obstructs normal fluid outflow, increased pressure causes loss of brain function, damage to motor nerves- paralysis, endotoxins cause shock
bacteria lodge in skin cause petechiae
damage hearing
bacteria can exit via resp secretions