Meningococcemia
Identification:This disease is also called meningococcal meningitis or cerebrospinal fever. It is an acute disease caused by a gram negative bacteria Neisseria meningitidis. The infection may be asymptomatic, may be restricted to the nasopharynx, or exhibit upper respiratory tract infections. It may cause meningococcal septicemia, or meningitis. Incubation period lasts for 2-10 days with an average of 3-4 days.
The disease is characterized by sudden onset of high grade fever (>380C) lasting for 24 hours. Other signs and symptoms are petechial and/or purpuric rashes appearing within 24 hours after onset of fever, and signs of meningeal irritation such as: headache, nausea and vomiting, stiff neck, bulging fontanel (among infants), seizure or convulsions, and sensorial changes.
Diagnosis: Diagnosis is confirmed by demonstration of the bacteria in a gram-stained smear of the cerebro-spinal fluid (CSF) and the isolation of the bacteria from the CSF blood.
Occurrence: The disease is usually sporadic (cases occur alone or may affect household members with intimate contact). Although primarily a disease of children, it may occur among adults especially in conditions of forced overcrowding such as institutions, jails and barracks. It occurs more in males than females.
Mode of transmission: Transmission is by direct contact with respiratory droplets from nose and throat of infected persons. Carriers may exist without cases of meningitis. Transmission via inanimate objects (personal belongings of cases) is insignificant.
Prevention and Control: Preventive measures are geared towards reducing overcrowding and exposure to droplet infection. Immunization of civilians is not recommended as duration of protection is limited.
Treatment and Prophylaxis: Treatment is effected by antibiotics and if given early, fatality rate is rendered less than 10%. Aqueous Penicillin G may be given to both children and adults. Chloramphenicol may be given in cases of Penicillin allergy.
Prophylaxis is reserved for those who have intimate contact with the patient; household members, boyfriend/girlfriend, sexual partners, hospital personnel who did suctioning of secretions and/or mouth resuscitation. Rifampicin is the drug of choice and may be given to both children and adults.