Prevention of meningococcal disease american family. Updated recommendations on the use of meningococcal vaccines. Sepsis is characterized by abrupt onset of fever and a petechial or purpuric red or purplish spots caused by bleeding under the skin rash, and is often associated with hypotension, shock, acute adrenal. Meningococcal infection is uncommon, and not easily spread, but it can cause serious complications, including. It has a high mortality rate if untreated but is vaccinepreventable. Recognition and management of shock andor raised icp is the. Invasive disease manifests most commonly as meningitis andor meningococcemia and may progress to purpura fulminans, shock, and death within hours of onset. Prevention of meningococcal disease american family physician. Invasive meningococcal disease most commonly presents as meningitis, meningococcemia, or both.
Mar 01, 2012 march 2018 published new combined guidance on the public health management of meningococcal disease. Mmwr 20vol62no 2 american academy of pediatrics red book 2012. Meningococcal septicaemia occurs when meningococcal bacteria invade the bloodstream and release their toxic products. Is indiana demonstrating good antimicrobial stewardship. Mar 31, 2016 ciprofloxacin for the prevention of meningococcal meningitis the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. If antimicrobial agents other than ceftriaxone or cefotaxime are used for treatment of meningococcal disease, eradication of nasopharyngeal carriage with rifampin 4 doses over 2 days or single doses of ciprofloxacin or ceftriaxone. The infection spreads easily when an infected person comes into close. Other illnesses include septic arthritis, pneumonia, and rarely pericarditis.
Transmission occurs through close contact, droplets, or direct contact with respiratory secretions. Meningococcal disease is caused by bacterial infection with neisseria meningitidis. Other organisms, including several viruses, can cause meningitis. Although vaccination is the main strategy used to control meningococcal disease outbreaks, mass chemoprophylaxis has also been used as an immediate response to outbreaks, either to supplement vaccination or when vaccination is not possible. Recommendations of the advisory committee on immunization practices acip summary. Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Patients are febrile with a headache, vomiting, and lethargy. Nov 15, 2005 serogroups a, b, c, w5, and y cause almost all cases of human disease. To identify persons who have been significantly exposed to the index case, in order to recommend antibiotic prophylaxis chemoprophylaxis and to inform. Rifampin is contraindicated for individuals with a history of hypersensitivity to the rifamycins.
The most common symptoms are fever, headache, and neck stiffness. Meningococcal disease reporting and investigation guideline. Therefore, meticulous attention must be paid to appropriate treatment. Meningococcal diseaseintroductionthere are several strains of neisseria meningitidis, the causative organism of meningococcal disease.
Meningococcal infection or meningococcal disease is caused by a bacteria called meningococcus. Meningitis is inflammation of the tissues around the brain. Invasive meningococcal infections are caused by the bacterium neisseria meningitidis meningococcus, a gramnegative diplococcus. Susceptibility and resistance of meningococcal disease susceptibility to clinical disease is low, as evidenced by the typical high ratio of carriers to cases. It causes the membranes that cover the brain and spinal cord to become inflamed. Shortterm antibiotic prophylaxis is another method of prevention, particularly of meningococcal meningitis. The infection that causes meningitis often causes a blood infection as well this is known as septicaemia. Lowincome families may be at higher risk for meningitis and may therefore benefit from effective prophylaxis, but detection and response capacity is variable, and small communities could be at a disadvantage. Meningococcal prophylaxis statpearls ncbi bookshelf. Meningitis is a disease caused by inflammation and irritation of the meninges, the membranes surrounding the brain and spinal cord. Treatment guidelines have been developed over many years. The invasive meningococcal disease imd is a severe form of neisseria meningitidis infection, most commonly manifested as meningitis or septicemia.
Meningococcal conjugate vaccine disease interactions. Uptodate, electronic clinical resource tool for physicians and patients that provides information on adult primary care and internal medicine, allergy and immunology, cardiovascular medicine, emergency medicine, endocrinology and diabetes, family medicine, gastroenterology and hepatology, hematology, infectious diseases, nephrology and. Meningitis is an inflammation of the meninges which can be caused by several bacteria, the most common of which is neisseria meningitidis meningococcal, tb or viruses. This is normally caused by infection but can also have noninfectious causes. This item requires a subscription to red book online. The disease can be rapidly fatal or result in severe neurologic and vascular sequelae despite antibiotic therapy. Recommended chemoprophylaxis regimens for highrisk contacts and people with invasive meningococcal disease. Meningococcal disease is a serious and potentially lifethreatening infection caused by the bacterium neisseria meningitidis. Chemoprophylaxis of healthcare workers exposed to neisseria meningitidis.
Meningococcal infections, including meningococcemias. Meningococcemia is defined as dissemination of meningococci neisseria meningitidis into the bloodstream see the image below. Meningococcal meningitis and sepsis early and appropriate antibiotic treatment markedly improves the outcome of meningococcal infections. Invasive meningococcal disease fact sheet including. W5 causes a small proportion of disease, and serogroup a causes disease in developing countries and the meningitis belt of subsaharan africa. The highest rates of disease are in children under 5 years, with a secondary peak of meningococcal meningitis in adolescents and young adults aged 1519 years. Meningococcal disease describes infections caused by the bacterium neisseria meningitidis also termed meningococcus. Signs and symptoms of meningococcal meningitis are indistinguishable from those associated with acute meningitis caused by other meningeal pathogens eg, streptococcus pneumoniae. Clients who are identified as exposed contacts and recommended to receive postexposure prophylaxis should be directed to an appropriate resource to receive their pep. The signs and symptoms of meningococcemia include an early upper respiratory tract infection with coryza, pharyngitis, tonsillitis, and laryngitis. Meningitis bacterial meningitis and meningococcal disease.
Listing a study does not mean it has been evaluated by the u. These are regularly updated and are useful reminders of the management principles for infants, children, and young adults with meningococcal septicemia and meningitis, leading to substantial improvements in mortality figure 1, figure 2, figure 3. Ciprofloxacin for the prevention of meningococcal meningitis. Meningococcal meningitis is primarily caused by neisseria meningitidis bacteria transmitted from person to person through infected air droplets, saliva, or respiratory secretions. Persons previously diagnosed with guillainbarre syndrome gbs may be at increased risk of gbs following receipt of meningococcal conjugate vaccine. Initially, nonspecific symptoms of infection with fever, often lead to a rapid deterioration of the. Symptoms of meningococcal meningitis include acute onset of fever, headache, and stiff neck, often accompanied by nausea, vomiting, photophobia, and altered mental status.
Children with bacterial meningitis presenting to the emergency department during the pneumococcal conjugate vaccine era. Meningococcal meningitis is a rare but serious bacterial infection. Onset can be insidious and nonspecific but typically is abrupt, with fever, chills, malaise, myalgia, limb pain, prostration. Most cases of meningococcal disease occur sporadically, with meningococcal disease. Neisseria meningitidis is a leading cause of bacterial meningitis and sepsis in the united states. Invasive infection can cause meningitis or meningococcemia meningococcal sepsis which can be severe and potentially. In severe and fatal cases of meningococcal meningitis, raised intracranial pressure is a predominant presenting feature. Pediatric bacterial meningitis is a lifethreatening illness that results from bacterial infection of the meninges and leaves some survivors with significant sequelae. Neisseria meningitidis is a gramnegative diplococci spheres clumped in pairs bacteria. Jul 16, 2018 once an accurate diagnosis of meningococcal meningitis is established, appropriate changes can be made. Aug, 2019 meningococcemia is defined as dissemination of meningococci neisseria meningitidis into the bloodstream see the image below. For duration in definite or presumed meningococcal meningitis. Prevention and control of meningococcal disease recommendations of the advisory committee on immunization practices acip.
However, public health guidelines regarding the use of mass chemoprophylaxis for outbreak control vary by country, partly. What are the idsa guidelines on the duration of antibiotic. It most commonly presents as septicaemia andor meningitis. Although the majority of cases of meningococcal disease are sporadic. Since the last policy statement from the american academy of pediatrics aap concerning meningococcal vaccine was published in 2011, 2 meningococcal conjugate vaccines have been licensed for use in infants hibmencytt and menacwycrm. Meningococcal serogroups are classified according to the immunological reactivity of the capsular polysaccharide. Centers for disease control and prevention, department of health and community services.
Invasive infections can be complicated by arthritis, myocarditis, pericarditis, and endophthalmitis. The patient should be told that this medication might cause the urine, feces, saliva, sputum, sweat, and tears to temporarily turn redorange. Neisseria meningitidis is a gramnegative bacterium that inhabits the mucosal surface of the nasopharynx in approximately 10% of healthy persons. If the referring doctor strongly suspects meningococcaemia, parenteral antibiotics should be given immediately. Neisseria meningitidis, a gramnegative diplococcus bacterium carried by 510% of the population.
Currently, a thirdgeneration cephalosporin ceftriaxone or cefotaxime is the drug of choice for the treatment of meningococcal meningitis and septicemia. Infection, by some strains of the organism can be prevented by. Prophylaxis for household contacts meningitis outbreak. Meningococcal infections red book 2018 red book online. Kansas department of health and environment investigation guidelines version 052018 meningococcal infections, page 3 epidemiology neisseria meningitidis is a leading cause of bacterial meningitis and other serious infections worldwide with a rate for endemic disease of 0. There are strains of meningococcus and five of these can be prevented by vaccines a, b, c, w and y strains. Household contacts of cases of meningococcal meningitis.
Meningococcal meningitis may be associated with kidney and adrenal gland failure and shock. Meningococcal disease generally occurs 110 days after exposure and presents as meningitis in. Meningococcal infections red book 2015 red book online. Meningococcal meningitis is a form of bacterial meningitis. The centers for disease control and prevention cdc has published new recommendations, prevention and control of meningococcal.
Surveillance manual meningococcal vaccine preventable. Meningococcal b has historically caused most meningococcal disease in australia. Individuals with encephalitis often show mild flulike symptoms. Meningococcal polysaccharide vaccine disease interactions. Distinctive rashes are typically seen in some forms of the disease. Invasive meningococcal disease is most frequently characterized by bacteremia, sepsis and meningitis, although cases may also present as pneumonia, septic. Meningococcal disease is caused by neisseria meningitidis, a gramnegative, diplococcus.
Mar 16, 2020 meningitis often appears with flulike symptoms that develop over 12 days. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. These recommendations update information regarding the polysaccharide vaccine licensed in the united states for use against disease caused by neisseria meningitidis serogroups a, c, y, and w5, as well as antimicrobial agents for chemoprophylaxis against. In cases of meningococcal meningitis, preventative treatment in close contacts with antibiotics e. Meningococcal disease the australian immunisation handbook. Routine throat or nasopharyngeal culture of contacts is not helpful in determining who warrants chemoprophylaxis. Septicaemia in the absence of signs of meningitis can be even more lifethreatening than meningitis alone. Meningococcal disease han chicago health alert network. Less common manifestations of meningococcal infection include conjunctivitis, septic arthritis, and chronic meningococcemia.
While best known as a cause of meningitis, it can also result in sepsis, which is an even more damaging and dangerous condition. According to the aap red book, the various components of the vaccine are immunogenic at various ages. Meningococcal meningitis is characterized by sudden onset of headache, fever, and stiffness of the neck, sometimes accompanied by nausea, vomiting, photophobia, or altered mental status. Jan 15, 2020 meningococcal meningitis and septicemia are the common syndromes reported although both clinical pictures present in some cases. Approximately 40% of people with meningococcal disease present with meningococcal sepsis, known as meningococcemia. Initially, nonspecific symptoms of infection with fever, often lead to a rapid. Serogroups a, b, c, w5, and y cause almost all cases of human disease. Chemoprophylaxis of healthcare workers exposed to neisseria.
Serogroups b, c, and y cause the majority of disease in the united states. The meningococcal vaccine, approved for use in children 2 years of age and older, is a quadrivalent product effective against n meningitidis groups a, c, y, and w5. Although it is rare, imd is a serious infection that can cause significant illness, disability and death. Invasive meningococcal disease imd is a rare but serious disease.
Meningococcal sepsis meningococcemia or bacteremia is the most severe form and can occur without meningitis in 520% of invasive infections. These can occur on their own, but often occur together. The decision to give this vaccine should take into account the potential benefits and risks. May 30, 2018 meningitis occurs when the membranes that cover the brain and spinal cord become inflamed. See american academy of pediatrics red book for treatment recommendations. If you suspect meningitis obtain medical help immediately. It is a serious condition, caused by various germs bacteria, viruses and fungi. The current mortality rate of meningococcal sepsis in the united states is approximately 10 to 14 percent. Penicillin g, ampicillin, chloramphenicol, fluoroquinolone, and aztreonam are. Several vaccines are available in australia to prevent meningococcal disease. Antibiotic chemoprophylaxis with rifampin, ciprofloxacin, or ceftriaxone is required for household and other close contacts. Meningococcal disease alaska department of health and.
Serogroup a, b, c, y and w5 are most commonly associated with invasive meningococcal disease imd. Meningitis and encephalitis fact sheet national institute. Menomuneacyw5 meningococcal polysaccharide vaccine. Summary bacterial meningitis is a lifethreatening condition that can affect all ages, but is most common in babies and children. Meningococcal meningitis risk risk is present in the entire country.1522 1344 376 344 1601 283 1611 1616 871 1002 1273 1169 815 1285 1434 938 864 201 1085 635 459 657 385 686 445 1109 1184