Meningococcal Disease

This is a disease caused by meningococcus which has different forms. In external environment the microbe dies quickly at temperature of 55 C during 5 minutes, under the influence of detergents during 1 – 2 minutes, it is sensitive to  penicillin, laevomycetin, tetracycline.

People infected with meningococcus are the source of infection for people around. Infected people on the early stage of their disease do intensively release microbes in external environment  During treatment patients remain carriers for three weeks. Meningococcal disease spreads via airborne. Most frequently get diseased children of preschool age. Meningococcus is located mainly in meninx vasculosa causing there suppurative inflammation. The infection enters into central nervous system either via epipharynx along olfactory nerves or via hematogenic path.

Symptoms and course
Incubation period is from 2 to 10 days. Meningococcal disease forms:
1) localized forms, when causative mocroorganism occurs in a particular organ (acute nasopharyngitis)
2) generalized forms when the infection is spread trough the whole body (meningococcemia, meningitis, meningoencephalitis)
3) orphan forms (endocarditis, polyarthritis, pneumonia)

Acute nasopharyngitis may be the onset of purulent meningitis or an independent clinical implication. Temperature increases up to 38 C, appear signs of intoxication and affection of mucus membrane of nose and throat (stuffiness in nose, reddening,  back of the throat puffiness).

In meningococcemia the meningococcal sepsis starts suddenly and courses violently. Symptoms: chill, headache, body temperature up to 40 C. Blood vessel permeability increases, in 5 – 15 hours from the disease onset appears hemorrhagic rash.  Meningitis symptoms are not observed. Are possible arthritis, pneumonia, myocarditis and endocarditis.

Meningitis develops acutely. Some people may experience nasopharyngitis symptoms at early stages. Meningitis starts with chill, temperature rise, agitation, motor anxiety. In the beginning appear strong headache, vomit without nausea, high skin, ear and visual sensibility. By the end of the day do appear and increase meningeal symptoms: neck stiffness, impossibility to turn at right angle leg bended in joint.

Patient may experience delusions, agitation, tremor, may be damaged cerebral nerves. In half of patients on 2 – 5 days of diseases appears herpetic rash. In the blood is detected neutrophilia. In adequate treatment recovery occurs on 12 – 14 day from beginning of therapy.

Complications: deafness due to the affection of auditory nerve and inner ear; blindness due to affection of visual nerve or uvea; hydrocephaly (loss of consciousness, acute panting, tachycardia, agitation, blood pressure increase, myosis,  meningeal syndrome senility).

Treatment
Most effective treatment are penicillin therapy, taking semisynthetic penicillins (ampicillin, oxacillin). Also are performed body deintoxication, oxygen therapy, vitamins. Corticosteroids are prescribed.

Preventive measures
Early detection and isolation of patients. After discharge from the hospital it is necessary to perform double bacteriological tests.