Podcast
Questions and Answers
What is the primary method of indirect transmission for this disease?
What is the primary method of indirect transmission for this disease?
What is the anticipated incubation period for this disease?
What is the anticipated incubation period for this disease?
Which group of individuals is most commonly affected in epidemics?
Which group of individuals is most commonly affected in epidemics?
What environmental factor significantly increases incidence rates of this disease?
What environmental factor significantly increases incidence rates of this disease?
Signup and view all the answers
Which vaccine is indicated for adult and older children?
Which vaccine is indicated for adult and older children?
Signup and view all the answers
What is the drug of choice for treatment of the disease?
What is the drug of choice for treatment of the disease?
Signup and view all the answers
What is the purpose of chemoprophylaxis in this context?
What is the purpose of chemoprophylaxis in this context?
Signup and view all the answers
How often do epidemics of this disease typically occur?
How often do epidemics of this disease typically occur?
Signup and view all the answers
What is a key characteristic of meningococcal meningitis?
What is a key characteristic of meningococcal meningitis?
Signup and view all the answers
Which serogroups of Neisseria meningitidis are recognized as causative agents of meningococcal disease?
Which serogroups of Neisseria meningitidis are recognized as causative agents of meningococcal disease?
Signup and view all the answers
What demographic is targeted for the quadruple vaccine (ACYW135) in Egypt?
What demographic is targeted for the quadruple vaccine (ACYW135) in Egypt?
Signup and view all the answers
How often do epidemics of meningococcal meningitis occur?
How often do epidemics of meningococcal meningitis occur?
Signup and view all the answers
During what seasons does the greatest incidence of meningococcal meningitis generally occur?
During what seasons does the greatest incidence of meningococcal meningitis generally occur?
Signup and view all the answers
What is considered a suspected case of meningococcal meningitis in individuals over one year old?
What is considered a suspected case of meningococcal meningitis in individuals over one year old?
Signup and view all the answers
What role do asymptomatic carriers play in the transmission of meningococcal infections?
What role do asymptomatic carriers play in the transmission of meningococcal infections?
Signup and view all the answers
What infection rate indicates a potential for threatened epidemics of meningococcal meningitis?
What infection rate indicates a potential for threatened epidemics of meningococcal meningitis?
Signup and view all the answers
What is the primary causative agent of pertussis?
What is the primary causative agent of pertussis?
Signup and view all the answers
Which age group has the highest incidence of pertussis?
Which age group has the highest incidence of pertussis?
Signup and view all the answers
Which of the following is a mode of transmission for pertussis?
Which of the following is a mode of transmission for pertussis?
Signup and view all the answers
What environmental condition is noted to increase the risk of pertussis infections?
What environmental condition is noted to increase the risk of pertussis infections?
Signup and view all the answers
Which vaccine is used as a part of the vaccination schedule in Egypt for pertussis?
Which vaccine is used as a part of the vaccination schedule in Egypt for pertussis?
Signup and view all the answers
Which symptom is characteristic of pertussis?
Which symptom is characteristic of pertussis?
Signup and view all the answers
In which situation is the DPT vaccine contraindicated?
In which situation is the DPT vaccine contraindicated?
Signup and view all the answers
What contributes to a good level of immunity against pertussis?
What contributes to a good level of immunity against pertussis?
Signup and view all the answers
Study Notes
Meningococcal Meningitis
- An acute infectious bacterial disease characterized by purulent meningitis
- Epidemics occur irregularly every 10 years
- In endemic areas, 5-10% of the population are asymptomatic carriers
- The greatest incidence occurs in winter and spring
- Large epidemics occur in hot dry regions, especially Mid-African countries, known as "The meningitis belt"
- Early outbreaks are expected when:
- The incidence of the disease increases 2-3 times compared to the same period in the previous 3-5 years
- Cases double week after week over 3 weeks.
- The infection rate is 5 per 100,000 population
Epidemiology of Meningococcal Meningitis in Egypt
- In 2007, a modified vaccination policy included the quadruple vaccine (ACYW135) for gatherings like the army, police, prisons, and pilgrim's camps
- This led to a decrease in the number of cases and the absence of any epidemic outbreaks since then
Case Definition
-
Suspected Case: Sudden onset of fever (>38.5C) with one or more of the following:
- Stiff neck
- Altered consciousness
- Other meningeal signs or petechial rash
- Below 1 year suspect meningitis if there is fever & bulging fontanel
- Confirmed Case: A suspected case with positive culture of CSF.
Causative Agents
- Neisseria meningitidis (the meningococcus, a Gram-negative aerobic diplococcus)
- Various serogroups are recognized including groups A, B, C, W135, X, Y and Z.
Reservoir
- Cases: Represent a very minor role in the transmission of infection.
-
Carriers: The most important source of infection in endemic areas, representing 5-10% of the normal population.
- Carriers have organisms in their nasopharynx during the inter-epidemic period
- An increased carrier rate signifies a threat of epidemics
- During epidemics, the carrier rate can increase to 70-80% of the population
Mode of Transmission
- Direct transmission: (main mode) Direct droplet spread through direct contact with carriers or cases.
- Indirect transmission: (minor role) Vehicle-borne: Contaminated articles.
- Rarely airborne.
Portal of Entry
- The nasopharynx
- Incubation period: 2-7 days
Susceptibility and Resistance
- Age: Usually occurs in children and young adults, but during epidemics, it may affect any age
- Sex: No significant difference
-
Immunity:
- No maternal immunity
- High ratio of carriers leads to repeated subclinical infections, moderate or high levels of immunity.
- Vaccination provides high levels of immunity for >3 years.
-
Environmental factors:
- The greatest incidence occurs in winter and spring.
- Epidemics in adults often occur in confined communities under overcrowded living conditions, such as military camps and institutions.
- The risk in household contacts is 500 to 800 times higher than in the general population.
- Epidemics usually occur every 10 years
Prevention
-
General Prevention:
- Good ventilation and prevention of overcrowding, especially in schools, workplaces, dormitories, and hospitals.
- Educating the public to reduce direct contact and exposure to droplet infection.
-
Specific Prevention:
-
Active Immunization:
- Quadrivalent vaccine containing groups A, C, Y & W 135: For adults and older children, military troops, and camps. In Egypt, it is given to school children at ages 6 & 9 years.
- Vaccine containing group A: For children 3 months to 2 years. Two doses of 0.5 ml S.C injection 3 months apart.
- Vaccine containing group A & C: For adults and older children.
-
Chemoprophylaxis:
- Rifampicin
- Ciftriaxone
- Ciprofloxacin
-
Active Immunization:
Control
-
Case:
- Notification to the local health office.
- Isolation at a fever hospital.
- Treatment: Started immediately and before isolation of the organisms.
- Antibiotics: Parenteral penicillin (the drug of choice), ampicillin, or chloramphinicol. Continue for 5 days after fever ends and CSF picture becomes normal.
- Symptomatic treatment.
- Disinfection.
- Release after 24 hours from starting treatment.
-
Contacts:
- Enlistment of age, sex, and vaccination history.
- Surveillance for early signs to start treatment without delay.
- Chemoprophylaxis.
-
Epidemic Measures:
- Surveillance: Early diagnosis and immediate treatment of suspected cases.
- Raising awareness of the disease among health service providers.
- Maintaining a backup stock of vaccines, equipment, and basic supplies.
- Preparing an emergency response plan.
- Mass vaccination when an epidemic is detected.
- Ideally, vaccinate the entire population, but in case of insufficient resources, focus on high-risk age areas.
Pertussis
- Also known as whooping cough
- A highly contagious respiratory infection characterized by a paroxysmal cough
- A significant cause of morbidity and mortality in infants less than 2 years old
Global Situation
- In 2018, there were over 151,000 cases of pertussis globally.
National Situation in Egypt
- No cases have been reported in Egypt since 2002
Causative Agent
- Bordetella pertussis bacterium
Reservoir
- Human cases are the only reservoir (no carrier state)
Infective Material
- Nasopharyngeal and bronchial secretions
Susceptibility (Host Risk Factors):
- Age: It's a disease of infants and preschool children, with the highest incidence below 5 years. Infants are susceptible from birth due to the lack of maternal immunity.
- Gender: Incidence and fatality are higher among female than male children.
-
Environmental factors:
- Pertussis occurs year-round but shows a seasonal trend, with more cases in winter and spring.
- Low socioeconomic standards increase the risk of pertussis.
- Immunity: Good after adequate immunization and following recovery from infection.
- Carriers and immunity: No carrier state.
Modes of Transmission
- Main mode: Direct droplet and direct contact
- Vehicle-borne: Freshly contaminated articles and fomites may play a role.
- Incubation period: 6-20 days
Prevention
-
General prevention:
- Health education
- Health promotion
- Sanitary environment: Good ventilation, avoid overcrowding
-
Specific prevention:
-
Active immunization:
- Pertussis killed vaccine: (In Egypt: Compulsory in Penta vaccine at 2, 4, 6 months of age, and in DPT booster dose at 18 months). In 2021, immunization against DPT in Egypt was 96%.
- DPT Vaccination is contraindicated in:
- History of epilepsy or any neurological disorders
- If the first dose is associated with convulsions
- Children > 4 years old, as it may lead to anaphylactic reactions or encephalopathy
- DPT Vaccination is contraindicated in:
- Acellular pertussis vaccine:
- DTaP: Given for children 6 weeks through 6 years. The DTaP vaccine contains full-strength doses of all three vaccines.
- Tdap: Given for children age 7 and adults. It contains less diphtheria toxoid and acellular pertussis antigen than DTaP.
- Pertussis killed vaccine: (In Egypt: Compulsory in Penta vaccine at 2, 4, 6 months of age, and in DPT booster dose at 18 months). In 2021, immunization against DPT in Egypt was 96%.
-
Active immunization:
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Explore the critical aspects of meningococcal meningitis, an acute infectious bacterial disease. This quiz covers its epidemiology, the impact of vaccination policies in Egypt, and key statistics related to outbreaks and asymptomatic carriers. Test your knowledge on this important public health topic!
