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PubMed1984

[Specific immunological reactivity in generalized forms of meningococcal infection in children].

The characteristics of immune responsiveness were studied in 455 children aged 2 months to 14 years with the generalized forms of meningococcal infection. In children of all age groups an increase in the titers of antibodies to meningococci was revealed; this increase started from day 4 of the disease, reached its maximum at the end of week 3 or the beginning of week 4 and correlated with the severity of the disease and the age of the patients. A drop in the IgG level in the course of the disease and a rise in the IgM level by the end of week 2 were observed. A decrease in the content of T-lymphocytes at the acute period of the disease and an increase in the number of B-lymphocytes, especially by the end of week 2 of the disease, were established.

Adolescent↗
PubMed1979

An epidemic of meningococcal infection at Zaria, Northern Nigeria. 1. General epidemiological features.

In 1977 Zaria, in Northern Nigeria, was affected by a severe epidemic of group A meningococcal infection, 1,257 patients being admitted to hospital with the disease during a three-month period. The epidemic started towards the end of the dry season when it was hot, dry and dusty and finished shortly after the onset of the rains. The over-all attack rate was 3.6 per 1,000 but this varied considerably from area to area within the town. Few cases occurred amongst those belonging to the upper social classes. The disease was seen most frequently amongst those from five to 14 years old and there was a strong male preponderance. The over-all mortality was 8.3% but mortality was much higher (40.6%) amongst 67 patients with acute meningococcaemia.

Adolescent↗
PubMed1988

Epidemiology of meningococcal infections in the Federal Republic of Germany, 1966-1984.

In the Federal Republic of Germany, the morbidity curve of meningococcal infections from 1966-1984 exhibited two maxima in 1970 and 1979 representing morbidity values of 2.9 and 2.3 per 100,000 of the population, and a small peak in 1974. The average morbidity of the 19 years was 2.1/10(5), the lowest morbidity 1.3/10(5) (1983/84). Meningitis occurred on an epidemic scale in 1970 in Bremen, in 1971 in Schleswig-Holstein and 1971-1977 in the Saarland. Most cases were notified during the first four four-week periods of the year, but in two years (1967, 1969), the late-summer peak exceeded the peak of winter/spring. 17.3% of the cases occurred in infants, 51.7% in the first five years of life. Morbidity was highest during the second quarter of the first year. The sex ratio (m:f) of the infections was 1.6:1, but in the aged, morbidity was about the same in both sexes (0.9:1). The case-fatality ratio varied between 7.1% (1977) and 12.1% (1971, 1982) and averaged at 9.7%. It was highest in the aged (37.1%) and second-highest in infants (18.7%). Differences of lethality due to sex could not be demonstrated. Of 1.685 meningococcal strains isolated from CSF and/or blood, 7.3% were of serogroup A, 74.4% of group B, 15% of group C, 1.5% of group Y and 1.1% of group W135. The proportion of group B infections was highest in infants, of group A infections in children (5-10 years), of group C infections in older children and adolescents (10-20 years). The sensitivity of N. meningitidis to sulfadiazine varied with serogroup and year of isolation. Since 1977, practically all group A strains, but only 13% of group B and 9% of group C strains proved to be resistant. Practically all strains were fully sensitive to rifampicin and minocycline; results of trials with spiramycin were not in support of the use of this compound as a chemoprophylactic agent.

Age Factors↗
PubMed1983

[Policy for the prevention of meningococcal infections in Belgium].

An outbreak of meningococcal disease occurred in Belgium from 1969 to 1975. It was caused by serogroup B, serotype 2 organisms. As there is no effective vaccine against serogroup B meningococci, the aim of prophylaxis is to prevent the occurrence of secondary cases among contacts of patients. Epidemiologic studies were carried out during the outbreak. A significant risk of secondary case was shown to be associated with household, day-care nursery, and pre-elementary school exposure. In most instances, the prophylactic measures prescribed by physicians were inappropriate. The effectiveness of prevention was low. A new prophylactic policy was defined, combining the identification of high risk contacts, the close medical supervision of these contacts ant the prescription of effective chemoprophylactic drugs. The Belgian experience illustrates some of the problems and difficulties associated with the use of the results of epidemiologic studies for health policy making.

Adolescent↗
PubMed1990

[New approach to the diagnosis of meningococcal infection: latex-erythrocyte agglutination].

A principal possibility and advantages of the diagnosis of meningococcal infection by means of agglutination of sensibilized latex particles with erythrocytes have been demonstrated. Polysterene carboxylated latex has been sensibilized by rabbit JgG to meningococcus of serogroup A. Dynamics of absorption of meningococcal polysaccharide on erythrocytes in vivo has been studied in mice.

Animals↗
PubMed1965

MENINGOCOCCAL INFECTIONS. FORT ORD AND CALIFORNIA.

Meningococcal meningitis began to occur in outbreak proportions during 1962 at Fort Ord, Monterey County. This increase in incidence continued until basic training was stopped at that post late in 1964. Most of the cases were among basic trainees in the first eight weeks of training, although other personnel had close contacts with trainees. All of the meningococci isolated were serotype B and about 50 per cent of the military patients with meningitis had sulfadiazine resistant strains. At this time, approximately 20 per cent of the civilian male population of military age are carriers of the organism before going into service. By eight weeks of training nearly 90 per cent of the men in some barracks carried the organism. Yet there was no correlation between the carrier rate and the occurrence of cases between barracks.A feature of this outbreak was that a high proportion of healthy males (20 per cent) were carriers of type B meningococci. This finding reflects the carrier rate in the general civilian population of the same age. The organism is apparently so widely disseminated throughout the population that it is impossible to decide with certainty the source of the organism infecting any particular person. It is unlikely that military groups pose extraordinary hazard to civilians. During 1964, only one case of meningococcal meningitis was found among the civilians of Monterey County while there were 89 in military personnel and 10 among the civilian dependents of military personnel. At present there is an increasing rate of meningococcal meningitis among the total population of California, suggesting that this area is on the upward swing in the cyclical occurrence of the disease.

Adolescent↗
PubMed1993

[Arthritis as complication of acute meningococcal infection].

The incidence of meningococcal disease appears to be increasing in the Netherlands. Numerous complications, mostly involving the central nervous system, have been reported. We focus attention on arthritis by describing the case history of a 2-year-old boy who developed oligoarthritis 8 days after a disease onset characterised by general malaise, fever, signs of meningeal irritation and positive cultures of Neisseria meningitidis in CSF, blood and nasopharynx. The arthritis was probably immune complex mediated. He recovered after antibiotic therapy. There are three forms of arthritis as a complication of meningococcal disease: primary meningococcal arthritis, purulent metastatic arthritis, and immune complex arthritis.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1978

[Functional state of the sympathetic-adrenal system in meningococcal infections].

A study of the functional state of the sympathico-adrenal system by determining the diurnal urine excretion of catecholamines and DOPA was conducted in 29 patients with meningoencephalitis of a meningococcal etiology. These studies demonstrated a significant activation of its adrenal link and a tendency to an increase of activity in the sympathical link with a drop of the reserve possibilities. These changes were most distinctly expressed in cases with prevalent localization of the pathological process in the deep brain structures. These facts made it possible to conclude that there is a lesion in the link of a control of the sympathico-adrenal system. These data were confirmed by results of a study in 18 patients with meningococcal infections by physiological loadings with insulin and adrenalin and a study of the catecholamines and DOPA in the urine portions, which exert specific influence on the state of activity of the sympathico-adrenal system through the hypothalamus and reticular formation.

Adolescent↗
PubMed1999

Systemic meningococcal infection: which children may benefit from adjuvant haemostatic therapy? Results from an observational study.

UNLABELLED: The potential benefits of haemostatic therapy (heparin, antithrombin (AT) concentrate, fresh frozen plasma (FFP)) in severe systemic meningococcal infections (SMI) are controversial. A reduction of the still high case fatality rate would be an important indicator for potential benefits of adjuvant haemostatic therapy in children with SMI. Observational data from nationwide, active surveillance for SMI in children under 16 years in all German paediatric hospitals over a one-year period were used to assess whether potentially beneficial effects of haemostatic therapy are related to the severity of disease. The Neisseria sepsis index (NESI), which grades the severity of SMI from 0 to 8 and has proven to be a reliable tool for predicting the outcome of children with SMI, was used as an indicator of the severity of SMI. During the study period from July 1994 to June 1995, 305 children met the case definition; for 176 of these, complete data sets providing information on parameters underlying the NESI index and regarding the specific haemostatic therapy were available. As all recorded children with NESI 0-2 (n = 129; 73%) survived, a potential impact of haemostatic therapy (given to 45 of them) on survival would be undetectable in this group. A NESI between 3 and 8 was found in 47/176 patients (24%), 35 of whom received some kind of haemostatic therapy. The survival rates were 80% in children with haemostatic therapy (n = 35) and 50% in those without (n = 12) (odds ratio 0.25; 95% confidence interval 0.06-0.98). A subgroup analysis of patients with NESI 3-5 versus those with NESI scores above 5 showed that the beneficial effect of haemostatic therapy was almost confined to children in the NESI 3-5 subgroup. In this subgroup there were 28/31 (90%) survivors with, and 6/11 (55%) survivors without adjuvant haemostatic therapy, whereas none of the patients (n = 5) with a NESI of 6-8 survived, although 4 had received adjuvant haemostatic therapy. CONCLUSION: Studies on the impact of adjuvant haemostatic therapy on survival in children with SMI should focus on those with NESI scores 3-5. The data from this population-based, observational study suggests that haemostatic therapy might reduce the case fatality rate in these children. The optimal dosage and choice of preparations remains to be established. Alternative adjuvant therapeutic strategies may be required in children with SMI and NESI scores > 5.

Anticoagulants↗
PubMed1990

[The role of fibronectin in the pathogenesis of meningococcal infection].

We have characterized an interaction of 20 strains of Neisseria meningitidis serogroups A, B, C, 29E, W-135 and Z with immobilized fibronectin of human plasma. The adhesion of meningococci to fibronectin was determined by the extent of piliated cells and did not depend on the meningococcal serogroup. Binding of non-piliated or weakly piliated strains (2-5% of piliated cells in the stock) was sufficiently greater than those piliated (8-10%), where the adhesion to fibronectin was not at all observed. The examination of two well-piliated strains showed that the loss of pili resulted in the increase of bacterial adhesion to fibronectin. Constants of association and dissociation of piliated and non-piliated strains to fibronectin were calculated. The role of meningococci-fibronectin interaction in the pathogenesis of meningococcal infection is discussed.

Bacterial Adhesion↗
PubMed1980

[Fibrin-fibrinogen degradation products in cerebrospinal fluid of patients with meningococcal infections (author's transl)].

Fibrin degradation products (FDP) D and E, total protein, cell count, and alpha-1-antitrypsin levels have been measured in the cerebrospinal fluid (CSF), and FDP-D and E, and alpha-1-antitrypsin analyzed in serum in 13 cases of meningococcal disease, six with meningococcal septicemia and seven with meningitis. Neisseria meningitidis serotype B was the responsible agent in all cases. The following conclusions are obtained: 1) The presence of FDP in the CSF has no prognostic value, and its detection only in plasma does not exclude a fatal outcome. 2) Statistical analysis of the data suggests that the presence of FDP in the CSF is not the result of passive transfer from plasma but it indicates a meningeal inflammatory reaction. 3) Alpha-1-antitrypsin levels are elevated in meningococcal infections both in plasma and in the CSF, and they significantly correlate with the intensity of the fibrinolytic activity.

Fibrin Fibrinogen Degradation Products↗
PubMed1986

[Various characteristics of the thrombohemorrhagic syndrome in a generalized form of meningococcal infection complicated by toxic-infectious shock].

Blood coagulation was studied in 19 patients with generalized meningococcal infection complicated by toxico-infectious shock (TIS). The outcomes were fatal in 42% of cases. Blood coagulation studies were done on days 1, 2, 3, 5-7 and 19-21 of treatment. Blood coagulability was found to be reduced drastically at the peak of disease: platelet aggregability was depressed substantially, and platelet secretory function showed profound disorders. The recovery of both plasma and platelet parameters of blood coagulation was rather slow. The magnitude of disorders may have a predictive value for the prognosis of the disease.

Adolescent↗
PubMed2003

Red eyes as the initial presentation of systemic meningococcal infection.

The present paper is a report of a 14-month-old boy who presented with fever, coryzal symptoms and red eyes. The patient developed a generalized tonic clonic convulsion on day 2 of his illness. Ophthalmological assessment demonstrated bilateral hypopyon and vitreous opacity resulting from endophthalmitis. Cerebrospinal fluid was positive for Neisseria meningitidis (A, C, Y, W 135) by latex agglutination. He was treated with high dose intravenous cefotaxime and intravitreal ceftazidime. He made good recovery and his vision was preserved. In view of the potential morbidity and mortality associated with systemic meningococcal infection, the presence of red eye and hypopyon provides important diagnostic clues indicating the need to investigate beyond superficial conjunctivitis. It should prompt the clinician to recognize endopthalmitis early and accurately diagnose this serious disease.

Anti-Infective Agents↗