What is Meningococcal Infection?
Meningococcal infection is not a common disease: not every district doctor in his entire practice faces at least one such patient. And not always the students of medical, pediatric faculties in the process of learning can demonstrate the patient with meningococcemia, not to mention the students of the dental, pharmaceutical and other faculties, where the course of children’s infectious diseases has been abolished. Therefore, it will not be superfluous to remind someone, but for the first time to find out about the features of this disease. After all, mistakes that lead to the loss of precious time, sometimes costing a child’s life, more often occur precisely at the prehospital stage.
Meningococcal infection is an anthroponotic disease transmitted by airborne droplets and characterized by a wide range of clinical manifestations: from meningococcussions to meningitis and severe meningococcal sepsis with a fulminant course.
Causes of Meningococcal Infection
The causative agent of meningococcal infection is Gram-negative diplococcus Neisseria meningitidis, highly sensitive to environmental factors: it dies when the temperature, humidity, solar radiation intensity changes, and is whimsical to the conditions of cultivation. Outside the body, vitality is maintained for no more than 30 minutes. Known 13 serotypes of the pathogen. Epidemiological significance in Ukraine are serotypes A, B, C. Occasionally there are polyagglutinating strains. With direct microscopy of blood and cerebrospinal fluid, the pathogen is detected intra- and extracellularly in the form of co-located cocci in the form of coffee beans. In the cell membrane of the microbe there is a lipopolysaccharide, which is responsible for the endotoxin-like effect in meningococcal sepsis.
In most developed countries, the prevalence of meningococcal infection is 1-3 cases per 100 thousand population, occurs at any age, however, 70-80% are children up to three years. Children of the first three years, especially the first year of life, are most susceptible to the development of hypertoxic (over-acute) infections.
There are epidemiological increases in the incidence of disease every 10–20 years, which is associated with a change in the causative agent and a change in the immunological structure of the population (an increase in the susceptible stratum due to born children, reduced immunity in adults). There are also seasonal increases in the incidence (March-April-May), although patients with this infection are recorded throughout the year.
The source of the disease is a sick or bacillicarrier. The transmission mechanism is airborne. The most infectious patients with catarrhal phenomena from the nasopharynx. Healthy carriers also have epidemiological significance, since their number is hundreds of times higher than the number of patients. It is known that a harbinger of the next rise in incidence is the increase in the number of carriers of meningococcus. In children’s groups, close long-term contact indoors contributes to infecting children, especially in bedrooms. Susceptibility to meningococcus is quite high. But the peculiarity is that the characteristic clinical picture is observed only in 0.5% of those infected. Familial susceptibility to meningococcal disease is extremely rare. In these families, there were cases of meningococcemia and meningitis of different children at different times (with an interval of several years), as well as repeated cases of the disease in one of these children.
Mortality of children of the first year of life is the highest. The main reason is hyperacute meningococcal sepsis with the development of infectious toxic shock (ITS), as well as severe purulent meningitis, complicated by edema-swelling of the brain. Great impact on the outcome of the disease have the timeliness of diagnosis, timeliness and correctness of the initiated treatment.