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At least 19 recordsLinked to original sources
PubMed1996

Meningococcal meningitis.

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.

Africa, Eastern↗
PubMed2006

Persistent visual loss as a complication of meningococcal meningitis.

Meningococcal disease remains a major cause of morbidity and mortality in childhood. Cerebral infarction complicating meningococcal meningitis is recognized but uncommon. We describe a 3-year-old boy with parieto-occipital infarction secondary to meningococcal meningitis, resulting in permanent visual loss as the sole neurologic sequelae and, consequently, major implications for his subsequent development.

Blindness, Cortical↗
PubMed1992

Polymerase chain reaction for diagnosis of meningococcal meningitis.

Meningococcal disease is normally suspected on clinical grounds but confirmed by isolation of Neisseria meningitidis from blood or cerebrospinal fluid (CSF), or by detection of gram-negative diplococci in CSF. After parenteral antibiotics are started the isolation rate of meningococci from blood cultures drops from 50% to less than 5% and the chances of CSF being positive by culture or microscopy are also reduced. We used the polymerase chain reaction (PCR) in a blinded study to detect meningococcal DNA in 54 CSF samples from patients with meningococcal disease or from controls. The PCR primers were specific for the meningococcal insertion sequence IS1106. The sensitivity and specificity of this PCR for diagnosis of meningococcal meningitis were both 91%. Sensitivity was not affected by prior antibiotic treatment. The IS1106 PCR is a rapid and sensitive test for confirmation of the diagnosis of meningococcal meningitis.

DNA, Bacterial↗
PubMedDate not supplied

Endophthalmitis in a young child with meningococcal meningitis.

Meningococcic meningitis is still a serious infection with high rates of morbidity and mortality. It is associated with severe complications. In recent years ocular complications have occurred less frequently, and endophthalmitis has been recognized as a rare complication. We present a case of meningococcic meningitis complicated by endophthalmitis.

Ceftriaxone↗
PubMed1977

[Prevention of meningococcal meningitis].

Meningococcal meningitis as well as meningococcal sepsis must be regarded as complications of an otherwise mild meningococcal infection of the nasopharynx. Only individuals without antibodies against a given meningococcal type will contract the above-mentioned diseases. Causal prophylactic measures have proved to be ineffective because of the great number of "carriers" of meningococci. Immunprophylaxis with specific polysaccharides is effective and presently available for use against types A and C but not against type B. Chemoprophylaxis is most effective when administered to those living in close quarters. Sulfonamides are the prophylaxis of choice agianst meningococci sensitive to sulfonamides. With the appearance of sulfonamide-resistant meningococci, the sulfonamide must be replaced by rifamycin or minocyclin. Though treatment with penicillin gives protection against infection, it does not eradicate the carrier state.

Adult↗
PubMed1992

An interesting case presentation: peripartum meningococcal meningitis.

Meningococcal disease during pregnancy is extremely rare. A single reported case occurred more than 20 years ago in England. We present the case of a young woman who just hours after delivery of her baby developed fulminant meningococcal meningitis with its classic findings. Our experience illustrates the importance of early diagnosis and appropriate therapy of meningococcal disease in the gravid as well as in the nongravid population.

Adult↗
PubMed1975

Control of meningococcal meningitis with meningococcal vaccines.

The development of effective meinigococcal vaccines was based upon the finding that immunity to the meningococcus was directly correlated with serum bactericidal antibodies. Purified high molecular weight capsular polysaccharides of serogroups A and C meningococci stimulated the production of humoral antibodies which had group specific bactericidal activity. In controlled field trials in Army recruits, group C polysaccharide vaccines were highly effective in preventing group C disease. Following its use as a routine immunization in recruits in October 1971 group C meningococcal disease has been almost completely eliminated from Army training centers. Group A vaccine has been field tested in Egyptian school children with great success. Group B polysaccharide has failed to induce bactericidal antibodies in humans and, therefore, new research is underway to attempt to develop a cell wall protein antigen as a vaccine against group B disease.

Adult↗
PubMed2000

Polysaccharide vaccines for preventing serogroup A meningococcal meningitis.

BACKGROUND: Controlled trials over two decades ago showed that the polysaccharide vaccine prevented meningococcal meningitis. Subsequent observational studies suggested variations in the level and duration of protection, particularly among young children. OBJECTIVES: To determine the effect of polysaccharide serogroup A vaccine for preventing serogroup A meningococcal meningitis. SEARCH STRATEGY: MEDLINE and the Cochrane Controlled Trials Register. SELECTION CRITERIA: Randomised and other prospective controlled trials. DATA COLLECTION AND ANALYSIS: One reviewer collected data and assessed the methodologic quality of the trials. Data were pooled using the Exact method to assess vaccine efficacy at one, two and three years post-vaccination. MAIN RESULTS: The protective effect within the first year was consistent across all eight trials, including one with participants exclusively under six years of age (in Finland); overall vaccine efficacy was 95% (Exact 95% CI 87%, 99%). The Finnish trial lacked statistical power to assess the effect of a booster dose given to children less than 18 months old. In the three other trials that included children less than six years old (one in Sudan and two in Nigeria), none of the vaccinated children developed meningitis, but the statistical significance of this finding was undetermined. Protection extended into the second (in two studies) and third (in one study) years after vaccination, but these results were also not statistically significant. REVIEWER'S CONCLUSIONS: When compared with current recommendations, the methodological quality and relative incompleteness of the published reports could arguably render the trials invalid for this review. However, it was unlikely that the results of the trials in such diverse settings would have been biased towards a strong and consistent protective effect. Immunogenicity trials were not included in this review. Stage two of the review will assess the vaccine effect from observational studies.

Humans↗
PubMed1983

Meningococcal meningitis in childhood. A five-year study of meningococcal meningitis in Ibadan, southern Nigeria.

Meningococcal meningitis is uncommon in the rain belt of southern Nigeria. Only twenty-six children were treated in one hospital in five years. Almost half the total number were seen during the four dry months of the year. However, the incidence in any one year was not necessarily correlated with the season. It appears that the longer the disease lasted before admission, the better the prognosis. Also, if the disease was severe enough to require admission within 24 hours of onset, the prognosis was poor. Survivors did not develop complications.

Child↗
PubMed2000

Clinical features, laboratory findings and management of meningococcal meningitis in England and Wales: report of a 1997 survey. Meningococcal meningitis: 1997 survey report.

OBJECTIVES: To describe the epidemiological, clinical and laboratory features of meningococcal meningitis and the effects of antibiotics on laboratory investigations under current clinical practices in England and Wales. METHODS: Using a telephone questionnaire, information was gathered on 103 cases with a clinical diagnosis of meningococcal meningitis. Included were cases with samples submitted to the Public Health Laboratory Service (PHLS), Meningococcal Reference Unit (MRU) over a 5-month period in 1997. Tests included microscopic examination, latex agglutination and culture for Neisseria meningitidis, and at MRU confirmation of identification and characterization of isolates and meningococcal polymerase chain reaction (PCR) analysis on blood and cerebrospinal fluids (CSF). RESULTS: Clinically 45% of the cases had predominantly meningitis and 55% had septicaemia and meningitis. Only 29% of the cases received pre-admission benzylpenicillin, and 66% were given antibiotics within an hour of hospital attendance. Microbiological confirmation was achieved in 97 cases, 46 (44%) by traditional tests and 92 (89%) by PCR assay, including some with both. The blood culture positive rate was 23 (22%), but in predominant meningitis the rate was only 10% (5/46). PCR was the sole method of confirmation in 48 cases. Seventy percent of the plasma samples referred were reactive by PCR assay, but all samples taken more than 24 h after hospital antibiotics were non-reactive. PCR-based techniques increased the overall number of cases with a serogroup identified by 44%. Lumbar punctures were performed in 73 of the cases and microbiological confirmation was achieved in 67 (92%) of these cases, compared to 26/30 without lumbar puncture (LP). Eighty-nine percent of the CSF samples referred were reactive by PCR; 50% of the CSF samples taken more than 24 h after hospital antibiotics were reactive, whilst none were positive by culture or microscopy. CONCLUSION: Due to variable clinical manifestations, early diagnosis and treatment was difficult. Laboratory confirmation has been improved by the introduction of PCR-based techniques. Meningococcal DNA was detected by molecular methods in CSF samples taken up to 72 h after commencement of antibiotics. During this period patients could be stabilized and the chances of complications attendant upon early LP reduced. In addition to providing accurate epidemiological information, confirming the diagnosis may alter the extent and length of follow-up.

Adolescent↗
PubMed1993

[The validity of the system of obligatory disease declaration for the epidemiologic surveillance of meningococcal meningitis].

In Spain meningococcic meningitis is a disease of obligatory declaration which is declared under the name of "Meningococcic infection". In this section other process are also included with the declaration being made under suspicion, with no knowledge of the degree of fulfillment and the significance of the official data. To know this the clinical history of meningitis patients of all the hospitals in Aragon from January 1985 to December 1988 were reviewed comparing the results with those from the system of obligatory disease declaration. The degree of fulfillment for meningococcic meningitis was 90% with the annual rates of incidence of meningococcic meningitis being 1.11 to 2.13 fold higher, according to hospitalary data, higher than the rates of the obligatory disease declaration system.

Communicable Disease Control↗
PubMed2000

Meningococcal meningitis outbreak control strategies.

Meningococcal meningitis has been occurring worldwide in both endemic and epidemic forms. Serogroup A accounts for majority of cases of epidemic as well as endemic Meningococcal meningitis in developing nations, whereas group C and group B causes epidemic and endemic meningococcal meningitis in developed countries. Person to person spread of N. meningitides generally occurs through inhalation of droplets of infected nasopharyngeal secretions by direct or indirect oral contact. Incubation period varies from 2 to 10 days. N. meningitides typically causes acute infective illness characterized by sequential development of upper respiratory tract infection, meningococcemia, meningitis and focal neurological deficit. Over 90 per cent cases of adult meningococcal infections have cerebrospinal meningitis, whereas in children prevalence of meningitis is much lower (50 per cent). Acute meningitis manifests with fever, severe headache, vomiting and neck stiffness. Presentations may be non-specific in infants, elderly and in patients with fulminant meningococcemia. Diagnosis is confirmed with cerebrospinal fluid analysis. Overall mortality due to meningitis is usually around 10 per cent. In meningococcal septicemia, the case fatality rate may exceed 50 per cent. Preventive strategies include vaccination, chemoprophylaxis and early detection and treatment. Mass vaccination campaign, if appropriately carried out, has been documented to halt an epidemic of meningococcal disease due to serogroup A or C. In the present review we have discussed the available evidence with regards to prevention at primary, secondary and tertiary level. Public health approach to an outbreak of meningococcal meningitis in a community or an organization is also outlined.

Disease Outbreaks↗
PubMed1996

Listeria meningitis during treatment of a meningococcal meningitis in an immunocompetent infant.

A case report of a listeria meningitis 5 days after diagnosis of meningococcal meningitis in a immunocompetent child of 2 years is presented. The infection occurred during hospital admission. Culture results of cerebrospinal fluid (CSF) were confirmed by a listeria-specific polymerase chain reaction in 2 CSF specimens. The listeria meningitis quickly responded to antimicrobial treatment with intravenous amoxicillin combined with tobramycin.

Amoxicillin↗
PubMed1985

Measurement of growth-inhibiting (bactericidal) antibodies in patients with meningococcal meningitis and in subjects immunized with meningococcal polysaccharide vaccine by a [3H]thymidine assay.

We measured bactericidal antibodies against meningococci by a method which depends on the inhibition of [3H]thymidine uptake by bacteria in the presence of antibody and complement. A significant increase in antibody activity was found in sera from patients who had recovered from group A meningococcal meningitis (mean inhibition, 38.9 +/- 4.4%) compared with antibody activity present in sera from patients in the acute phase (mean inhibition, 7.0 +/- 2.4%) (P less than 0.001). Similarly, a significant increase in inhibitory activity against group C meningococci was observed 2 weeks after immunization with group C polysaccharide. A close correlation was obtained between the results of the thymidine assay and of a standard colony-counting method and hemagglutination assay. The assay is readily applicable to testing large numbers of samples.

Antibodies, Bacterial↗
PubMed2001

Survival and sequelae of meningococcal meningitis in Ghana.

BACKGROUND: Meningococcal meningitis epidemics are frequent in the Sahel zone of Africa but there is little information on the frequency of long-term sequelae. We analysed excess mortality in the two years following the 1997 epidemic in northern Ghana and carried out a case-control study to assess sequelae in the survivors. METHODS: Two-year survival of 696 meningitis cases recorded at the War Memorial Hospital, Navrongo, was analysed using data from a demographic surveillance system. A structured questionnaire on disability and on psychiatric, neuropsychological and behavioural problems was administered to 505 of the survivors and 505 age- sex- and location-matched controls as well as to their respective relatives. Cases and controls underwent full neurological and neuropsychological examination and were evaluated for hearing impairment by audiometry. RESULTS: Survival rates after the first month following the attack were similar in cases and controls. Hearing impairment was the major sequela, and was reported in 6 per cent of cases and 2 per cent of controls (odds ratio [OR] = 3.10; 95% CI : 1.48-7.09). Audiometry detected severe and profound hearing loss in the worse affected ear (> or =70 db) in 8/496 (1.6%) survivors but in only one control. Survivors of meningitis were more likely to suffer from feelings of tiredness (OR = 1.47; 95% CI : 1.03-2.11) and were more often reported by relatives to have insomnia (OR = 2.31; 95% CI : 1.17-4.82) and daily alcohol consumption. INTERPRETATION: Meningococcal meningitis annually causes approximately 10 000 cases of deafness in sub-Saharan Africa; there is a need for early detection of affected survivors and promotion of simple hearing devices. There is a sizeable burden of depressive disorders secondary to meningitis which should be identified and looked after appropriately.

Activities of Daily Living↗