| Clinical
Features |
Fever, headache and stiff neck in
meningitis cases, and sepsis and rash in meningococcemia. |
| Etiologic
Agent |
Multiple serogroups of Neisseria
meningitidis. |
| Incidence |
0.5-5/100,000 for endemic disease,
worldwide in distribution. During 1996-1997, 213,658 cases
with 21,830 deaths were reported in West African countries.
Up to 2% in epidemics in Africa. |
| Sequelae |
10%-15% of cases are fatal. Of
patients who recover 10%-15% have permanent hearing loss,
mental retardation, loss of limbs, or other serious sequelae.
|
| Transmission |
Generally occurs through direct
contact with respiratory secretions from a nasopharyngeal
carrier. |
| Risk
Groups |
Risk groups include general population,
infants and young children (for endemic disease), refugees,
household contacts of case patients, military recruits, college
freshmen (who live in dormitories), microbiologists who work
with isolates of N. meningitidis, and people exposed
to active and passive tobacco smoke. |
| Surveillance |
Surveillance is conducted worldwide
through International Disease Notification and in the United
States by NETSS, and NCID Emerging Infection Program’s Active
Bacterial Core surveillance (ABCs). |
| Trends |
Devastating epidemics will continue
to occur in countries throughout the meningitis belt of Africa;
emergence of epidemics due to a new serogroup in Africa; in
the United States, increased frequency of outbreaks and changes
distribution of serogroups responsible for endemic disease
as well as increased disease among adolescents and young adults. |
| Challenges |
Establishing surveillance and early
detection of epidemics in Africa, followed by emergency mass
vaccination campaigns reaching high vaccine coverage; integration
of meningitis surveillance with surveillance for other epidemic-prone
diseases; and introduction of soon to be available conjugate
meningococcal vaccines into routine childhood immunization
programs in the United States and Africa. |
| Opportunities |
Incorporation of meningococcal conjugate
vaccine in U.S. routine vaccination programs. Routine vaccination
of infants in selected African countries and mass vaccination
of children and adults using new conjugated meningococcal
vaccines. |
|
December 2003
|
