Meningococcal infection - Causes, symptoms and treatment. MF.

"I saw cases when a person was feeling well at breakfast, and by lunchtime was already dead!" - Dr Clayton Golledge, microbiologist, infectious disease specialist, USA.This is just the case of that infection.

Meningococcal infection is an acute infectious disease caused by a bacterium - Neisseria meningitidis. The severity of meningococcal infection ranges from nasopharyngitis to fulminant sepsis, leading to death within a few hours. Few infections have such a catastrophic course.

In our country, the incidence is an average of 5 per 100 thousand people per year, which is quite high compared to developed countries. The greatest prevalence of meningococcal infection in the world falls on Central Africa, China, South America( the so-called "meningitis belt"), where large epidemics of this disease occur regularly. Outbreaks of infection occur mainly in conditions of unsanitary and crowded population, so the disease is called a "military" infection.

About 10% of people with meningococcal disease die, and 20% have disabling complications. The basis of effective treatment is the early diagnosis of the disease, which allows you to begin treatment activities as quickly and often save a person's life and health.

Forms of meningococcal infection

Meningococcal infection begins in the nasopharynx, from which pathogens have several pathways. The easiest form of the disease is the meningococcal nasopharyngitis , which manifests itself as a common cold, and is often not correctly diagnosed. On this disease can end, and the infection can leave the body at all or go into asymptomatic carriage. However, in other less favorable cases, bacteria enter the bloodstream and cause meningococcemia( or meningococcal sepsis).In this case, the bacteria multiply in the blood and cause blood clotting disorders that lead to hemorrhages in the skin and internal organs, and often end in a fatal outcome. Meningococcal sepsis can be complicated by meningitis. Meningitis is the inflammation of the medulla that covers the brain and spinal cord. Meningitis is not only meningococcal - the cause of inflammation can be other bacteria( pneumococcus, staphylococcus), as well as viruses and even fungi. Meningococcus also has an increased tendency to affect the meninges.

Symptoms of meningococcal infection

Manifestococcal infections are insidious and deceptive. The first symptoms are nonspecific, to put the right diagnosis with the initial signs of the disease can be very difficult. However, when there is a detailed picture of the disease, the patient is often impossible to save. There are three forms of meningococcal infection, each of which can occur separately and independently, or have a consistent development: from nasopharyngitis to sepsis and meningitis.

Meningococcal nasopharyngia:

Symptoms of meningococcal nasopharyngitis are similar to those of a common cold. This increase in temperature, an average of 38 ° C, as well as all familiar and not particularly worrisome cold symptoms: runny nose, sore throat, headache. Unlike banal ARVI, when there is increased sweating and redness of the skin, with meningococcal nasopharyngitis, the skin is pale and dry.

It is very important to identify "unusual" symptoms among common cold symptoms, not to lose the deterioration that is developing, perhaps too quickly - faster than you expect.

Symptoms common to meningitis and meningococcus:

• Fever( which may not respond to febrifuge);
• Nausea and vomiting;
• Weakness;
• Confusion and disorientation in time, space;
• Dizziness;
• Anxiety and agitation.

Symptoms characteristic of meningitis:

• Severe headache, not passing after taking pain medication;
• Back pain;
• Pain and obstruction in the neck;
• Intolerance to bright light;
• Convulsions. Symptoms characteristic of meningococci:
  • High fever up to 39-40ºС, accompanied by coldness of hands and feet;
  • Chills;
  • Pain in muscles and joints;
  • Pain in abdomen or chest;
  • Pale skin, sometimes with a gray tinge;
  • Frequent breathing;
  • Diarrhea;
  • Rash: begins with pink spots 2-10 mm in size, then turns into crimson spots of irregular( stellate) shape, not protruding above the surface of the skin, not disappearing when pressed. Most often begin with the buttocks, trunk, legs.

  It is necessary to inspect the patient regularly for rashes: the appearance of any spots on the skin should be the basis for calling for emergency medical care. However, do not wait for the rash to appear - the rash may be a late symptom, or it may not appear at all. If several of the following symptoms appear( not necessarily all), you should immediately consult a doctor.

  How can you get a meningococcal infection

  Meningococcal infection occurs in all countries of the world, in all climatic zones. The source of pathogens is only a person. The path of transmission of the pathogen is as simple as possible - airborne, i.e.infection occurs when coughing, sneezing, talking, kissing.

  The danger is also that bacteria can live in the nasopharynx of perfectly healthy people who are chronic asymptomatic carriers. As a result of carriage, immunity to the corresponding strain of the pathogen appears, which can not cause disease in the carrier, but it can be dangerous for other people. Carriers can also become infected when other strains of bacteria are infected. Outside of epidemics, the prevalence of carrier is about 10%, but in closed collectives( schools, military units) can reach 60-80%.

  Prevalence of meningococcal infection

  • Children younger than 5 years. The immune system of children at this age is not completely formed;In addition, children tend to touch the mouth with unwashed hands and various objects, while they do not adhere to the rules of general hygiene - such as covering their mouths when coughing and sneezing, washing their hands. In addition, the spread of infection is promoted by preschool institutions - nurseries, kindergartens, where children communicate closely with each other, exchange toys, food.
  • Adolescents and young people aged 15 to 25 - at this age, people spend more time in nightclubs, which are distinguished by a combination of many risk factors: crowding, smoking, general drinks, kissing, the need to constantly shout over noise.
  • Smoking - reduces both general immunity and local reactivity of the nasal mucosa, nasopharynx.

  When the meningococcal infection

  is more common, the incidence is higher in winter and early spring. This is because the human immune system at this time is weakened by a large number of viruses, which are also activated at this time of year - ARVI, influenza, etc.

  In addition, hypothermia is an important triggering factor in the development of meningococcal infection.

  Prevention of meningococcal infection

  Meningococcal infection can be infected not only from a sick person, but also from healthy chronic meningococcal carriers. To prevent infection, you must follow simple rules of hygiene. We need to teach them a child;and educators in kindergartens should closely monitor their observance.

  Necessary rules:

  • You can not exchange drinks, food, ice cream, sweets, chewing gums;
  • You can not use other people's lipsticks, toothbrushes;smoke one cigarette;
  • Do not hold pen or pencil tip in mouth;
  • You can not lick a baby's nipple before giving the baby.

  Medication prophylaxis and vaccination with meningococcal infection

  Medication prophylaxis:

  Antibiotic prophylaxis is necessary for everyone who has been in contact with a sick person for 7 days before the onset of symptoms.

  Vaccination:

  There are several varieties of meningococcus: serogroups A, C, W 135, Y.The most common serogroups A and C. In Russia, vaccines against meningococcus type A and C are used. The vaccine is a bacterial particle, so it is impossible to get sick after vaccination. Usually the vaccination is well tolerated, there may be a slight redness at the site of the injection. Vaccination is carried out once, the effectiveness is about 90%, the immunity is formed on average for 5 days and lasts 3-5 years.

  Who needs to be vaccinated:

  • If in closed collectives - schools, kindergartens, military units, etc.registered 2 or more cases of meningococcal infection, all members of the team are subject to mandatory vaccination.
  • Family members of the sick person and contact persons are subject to vaccination.
  • When leaving for areas with an increased incidence rate - in Saudi Arabia, United Arab Emirates.

  Complications of meningococcal infection

  Meningococcal infection, especially occurring with the development of meningitis, often leaves behind irreversible consequences.

  • Chronic headaches;
  • Memory loss;
  • Problems with concentration;
  • Inadequate behavior;
  • Mood disorders;
  • Problems with eyesight;
  • Deafness;
  • Decreased intellectual abilities;
  • Epilepsy;
  • Paralysis - loss of movement of any parts of the body.

  Complications of meningococcemia

  • In the place of the former hemorrhages on the skin, scars form, some defects require skin transplant operations.
  • In connection with the violation of clotting in the vessels of many organs, including in the extremities, blood clots are formed, which can lead to the development of gangrene and subsequent amputation of fingers or toes, and sometimes to the entire limb.
  • Hepatic or renal failure.
  • Chronic fatigue syndrome.

  Diagnosis of meningococcal infection

  In connection with the nonspecific symptoms of meningococcal infection, even experienced doctors may be mistaken in the diagnosis. Therefore, if during examination the doctor decided that high fever and intoxication is caused by another infection, it is nevertheless necessary to closely monitor the patient's condition and examine the body for rashes.

  If the doctor decides that this is not a meningococcal infection, and the patient becomes worse, do not hesitate to call another doctor or take the patient to the hospital right away.

  For the diagnosis of meningococcal infection, it is necessary to isolate the causative agent from biological fluids - blood, cerebrospinal fluid, articular fluid - or from a skin biopsy.

  Detection of meningococci in the nasopharynx does not indicate the presence of the disease, but only about the carrier.

  Hospitalization with meningococcal infection

  The course of menengococcal infection is unpredictable. It is always regarded as life-threatening. In the first few days after hospitalization, regardless of the patient's condition, all vital functions are carefully controlled by blood pressure, heart rate, body temperature, diuresis.

  In a hospital, the patient is placed in a special closed room, access to which relatives is strictly prohibited in order to prevent the spread of infection.