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Continued from page 11 – Fear of Meningitis Hits Edmonton
11. [Maharajan G, Etta KM, Singh A, Ahuja IS, Ahuja GK -
"Thyroxine, triiodothyronine and thyrotrophin levels in
meningococcal meningitis, typhoid fever and other febrile
conditions." Clin Endocrinol (Oxf) 9(5):401-6(1978)
12. W.M. Ringsdorf, JR., D.M.D., M.S., E. Cheraskin, M.D.,
D.M.D., and R.R. Ramsay, JR., D.M.D., "Sucrose,
Neutrophilic Phagocytosis and Resistance to Disease,"
Dental Survey 52 no. 12 (December 1976): 46-48.
13. The New England Journal of Medicine -- January 20,
2000 -- Vol. 342, No. 3 .
14. Journal of Infectious Diseases, 1998 Jun;177(6):1754-7
(PUBMED abstract)
Further References:
(PUBMED abstract)
J Infect Dis 1998 Jun;177(6):1754-7
Serogroup B, electrophoretic type 15 Neisseria
meningitidis in Canada.
Kertesz DA, Coulthart MB, Ryan JA, Johnson WM,
Ashton FE
Bureau of Infectious Diseases, Laboratory Centre for
Disease Control, Health Canada, Ottawa.
Invasive meningococcal disease is nationally reportable
in Canada. In recent years, a serogroup C genotype,
designated electrophoretic type 15 (ET15), has been the
most frequently isolated meningococcal genotype in
Canada and has caused epidemics across the country.
Between August 1993 and September 1995, there were 9
cases of invasive meningococcal disease caused by a
variant of this genotype, expressing group B capsular
polysaccharide. The appearance of serogroup B:ET15
was related temporally and geographically to mass
immunization campaigns designed to control serogroup C
meningococcal disease in Canada. Since there is no
vaccine available to control serogroup B meningococcal
disease, the appearance of this variant may have publichealth
significance if it demonstrates the same epidemic
potential as its serogroup C counterpart.
http://www.vran.org/vaccines/meningitis/men-edmonton.htm
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Continued from page 7 - Bacterial Meningitis
in Europe and the United States. [7] Sub-Saharan Africa,
which is plagued by the highest meningitis disease
burden, is referred to as the "meningitis belt." [3]
How Is Meningitis Transmitted?
Meningococcal disease was first described as early as
1805, when an outbreak spread through Geneva,
Switzerland. (However, a probable description of a
meningococcal epidemic was given by Willis in 1661.)
But it wasn't until 1887 that a causative agent of
meningococcal meningitis was identified. [7] The germs
that cause bacterial meningitis are very common and live
naturally in the back of the nose and throat. At any given
time, 10% of the population are carriers of the disease but
never actually become ill. [6] In fact, most cases of
meningitis are acquired through exposure to asymptomatic
carriers. [3]
Meningitis can be spread via nose and throat secretions (eg,
coughing, sneezing, and kissing); however, meningitis is
not considered to be a highly contagious disease; casual
contact or breathing in the air where a person with
meningitis has been normally would not expose someone to
meningitis because the causative organisms cannot live
outside the body for very long.
Acute meningitis usually develops from an invasion of
bacterial and/or viral pathogens from mucosal surfaces in
the nasopharynx, sinus cavities, and middle ear space into
the bloodstream. It can also result from head injuries,
penetrating wounds, or neurologic surgeries. [6] Subacute
meningitis and chronic meningitis, which evolve more
slowly than acute meningitis, are more commonly caused
by fungi, parasites, disseminated malignancy, tuberculosis,
AIDS, sarcoidosis, Lyme disease, or syphilis. [6] Certain
medications, such as nonsteroidal anti-inflammatory drugs
and antimicrobial agents, can cause aseptic meningitis. [2]
In infants, most cases of meningitis are caused by group B
streptococcus and Gram-negative enteric bacilli (eg, E
coli). Mother-to-infant transmission and aspiration of
intestinal and genital tract secretions during labor and
delivery are common modes of transmission. [6] After
infancy, S pneumoniae is the leading bacterial cause of
meningitis.
N meningitidis is another common offending pathogen
causing bacterial meningitis. H influenzae type b
meningitis, once the most prevalent form of meningitis in
children, is now more rare in the developed world because
of successful immunization practices (H influenzae type b
conjugate vaccine) in the past 2 decades. [6] In fact,
incorporation of this vaccine into the routine immunization
schedule resulted in a 94% decline in the number of US
cases of meningitis caused by H influenzae. [5] Table 1
shows the common pathogens causing meningitis, by age
group.
People living in unsanitary and/or crowded conditions and
those with immunocompromised status are at particularly
high risk for meningitis. Incidence is at a peak in the winter
and early spring. [6] In 1995, the median age of US patients
with bacterial meningitis was 25 years. This signified a
dramatic shift: about a decade earlier, the median age was
15 months. [5]
-12- Traditional African Clinic April 2009
Antibiotic Interventions
It cannot be overemphasized that treatment must be started
early in the course of the disease if it is of bacterial
Continued on page 13