Meningococcal Meningitis Prophylaxis

Meningococcal Meningitis General Information

Meningococcal Meningitis is an infection of the membrane surrounding the spinal cord and the brain, called the meninges. There are several types of bacteria that may cause this affection, and the most important of them, due to its great endemic potential, is Neisseia meningitidis. This bacterium has been identified in 1887, and subsequently twelve of its subtypes have been recognized. Each of these subtypes (or serogroups) has different epidemic capabilities, immunogenicity and pathogenicity, and it is imperative to identify the subtype present in isolated cases in order to prevent an epidemic outburst.

Among the most common symptoms of Meningococcal Meningitis are the following clinical manifestations: high grade fever, headaches and confusion. In most cases, the patient is sensitive to light and presents an abnormal stiffness of the neck. Vomiting is also common. The disease is severe; in 5 to 10 percent of the cases, the patient dies within one to two days despite treatment. Even if death does not occur, 10 to 20 percent of the survivors may sustain hearing loss, brain damage and / or learning disabilities.

Another severe form of the disease is meningococcal septicaemia, which often leads to the death of the patient. Among the most common symptoms of this affection, rapid circulatory collapse and hemorrhagic rash are frequently encountered.

Meningococcal Meningitis Prophylaxis

Meningococcal Meningitis Prophylaxis mainly relies on vaccination of the individuals in order to achieve immunization. There are several Polysaccharide vaccines available for immunization against bacterial serogroups A, C, Y, W135. A newer vaccine has also been developed recently, relying on monovalent conjugates, and it has been approved for use in children and teenagers. Unlike the polysaccharide vaccines, the monovalent conjugate vaccine is immunogenic particularly for children of less than 2 years of age. While in some rare cases the vaccines may cause mild side effects, they are generally safe for use. However, as it may take up to 14 days for complete immunity to be attained, patients may not be safe from infection within that timeframe.

Routine immunization of the population as part of Meningococcal Meningitis Prophylaxis is already employed in a number of countries. This involves mass vaccination of the population in order to prevent cases of bacterial meningitis. Vaccination of children in schools is a typical procedure employed in order to attain immunization. Some countries also offer routine vaccination of pilgrims, travelers and military personnel that travel to endemic areas, in order to prevent infection with the bacteria.

In cases where the infection does occur, individuals that come in close contact with the patient need to be vaccinated in order to ensure that the disease does not spread. Antibiotics may be employed too as a further Meningococcal Meningitis Prophylaxis measure, in order to ensure protection until the vaccine takes effect. Medication such as Ciprofloxacin, Minocycline, Rifampicin, Spiramycin and Ceftriaxone may be used.

In situations where epidemics are imminent, Meningococcal Meningitis Prophylaxis involves immediate vaccination of the entire population in the affected area, as well as in adjacent areas where the disease may spread. In some situations, this may not be possible (especially in children under 2 years of age, whose organisms lack the capability of producing the proper antibodies). As such, surveillance and prompt case management are the only means that may be employed to control the situation. Oily Chloramphenicol may be used in the case of patients who are affected by the disease. In situations where the epidemic is caused by the W135 strain of N. meningitides, the control strategy may need situational reassessment as the available polysaccharide vaccine has a very high cost, making its use impossible for large scale immunization. Current research aims at creating a vaccine with a lower cost in order to make this solution viable in all situations. However, at this time no results have been made public regarding the ongoing studies.

Meningococcal Meningitis Treatment

Treatment of Meningococcal Meningitis should always be applied as soon as possible as this disease is severe and apart from its often lethal effects, it has a very high potential of causing an epidemic outbreak. As such, any reported case should be considered a medical emergency and its treatment should be prioritized. The patient should be hospitalized in order to reduce contact with other individuals, as the bacteria are transmitted through body secretions such as sweat or saliva; however isolation is not necessary. Lumbar puncture must be performed as soon as possible in order to confirm the presence of the bacteria in the spinal fluid. Once the diagnosis is confirmed, antibiotic therapy should be started immediately.

There are several options from which the specialized health care professional may choose when deciding upon the antibiotic medication to be administered to the patient. Examples of commonly used antibiotics include Ampicillin, Penicillin, Ceftriaxone and Chloramphenicol. Due to the high effectiveness of the oily Chloramphenicol formula, it is the main choice in treating the disease in epidemic settings such as those in Africa. Further details regarding the possible side effects and drug interactions for each of the antibiotics presented above can be obtained by consulting a pharmacist, a doctor or a nurse.