Meningococcemia historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2], Usama Talib, BSc, MD [3]
Overview
The historical reports indicate that meningococci was first reported in 1805. SInce then for more than 2 hundred years, meningococcus have been causing a high degree of morbidity and mortality. It usually appear as sporadic but reports of outbreak have been reported from different parts of the world especially Sub Saharan African belt. Outbreak usually happens in close communities like schools, colleges and prisons.
Historical Perspective
- Records indicate that the first case of meningococcal meningitis was described in Geneva in 1805.[1]
- Another case was reported in New England, New Bedford, Massachusetts in 1806.[2]
- The causative agent was described as intracellular oval cocci in a cerebrospinal fluid sample by Marchiafava and Celli in 1884.
- The organism was isolated by Anton Weischselbaum in 1887 and he gave the term diplococcus intracellularis meningitidis.
- From then on for more than 2 hundred years,meningococcus has caused high rates of morbidity and mortality all around the world.
- No reports of outbreaks have been reported prior to 1806.
- The first meningococcal epidemics occurred in early 1900s in sub saharan Africa.
Outbreaks
- Usually the menigococcal meningitis cases appear sporadic. Very rarely they can occur as an outbreaks and the outbreaks are usually found in communities like schools, colleges, prisons and such close populations.
- In temperate regions the number of cases increases in winter and spring. Serogroups B and C together account for a large majority of cases in Europe and America.
- Several local outbreaks due to Neisseria meningitidis serogroup C have been reported in Canada and the United States (1992-93) and in Spain (1995-97).
- In 1998 2725 cases were reported in US and 155 cases in Canada.
- In 1995-1998 in US
- 33% were due to serotype B
- 28% due to serotype C
- 34% due to serotype Y
- In Canada during 1995-98
- 47% were due to serotype B
- 40% were due to serotype C
- 10% due to serotype Y[3]
- Major African epidemics are associated with Neisseria meningitidis serogroup A, which is usually the cause of meningococcal disease in Asia.
- In 2000 and 2001 several hundred pilgrims attending the Hajj in Saudi Arabia were infected with Neisseria meningitidis W.
- In 2002, Neisseria meningitidis W emerged in Burkina Faso, striking 13,000 people and killing 1,500.
- In 2008, subsaharan Africa with Nigeria, faced an outbreak of Meningococcal meningitis in particllarly in the northern states.[4]
- In 2017, an outbreak afected Nigeria again, killing almost 500 individuals.[5]
- Serotype C was identified as the primary cause of this outbreak
Epidemics in Africa
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- Epidemics have been happening in Africa for more than 100 years.
- The disease is usually found in Sub Saharan meningitis belt.
- Epidemics there occur in the dry season (December to June), ending during the intervening rainy season.
- Epidemics usually take place in irregular cycles every 5-12 years.
- 80-85% of all reported case is by Serogroup A meningococci.
- In 2002 there was a major outbreak of meningococcal disease in Burkina Faso with about 80% of cases due to serogroup W.
- Between 1988 and 1997, 704,000 cases and more than 100,000 deaths were reported in Africa, some 20,000 occurring in 1996, the largest epidemic year ever recorded.
- Between 1998 and 2002, African countries within the meningitis belt reported more than 224,000 new cases of meningococcal disease.
- Depicted below is a meningococcal belt in Africa where historic perspective reports numerous outbreaks.
Emergence of Fluoroquinolone-Resistant Meningococcal Disease
- Three cases were reported of fluoroquinolone-resistant meningococcal disease in North America. They occurred among residents of the border area of North Dakota and Minnesota during January 2007--January 2008.
References
- ↑ "Meningococcus".
- ↑ Stephens DS (2009). "Biology and pathogenesis of the evolutionarily successful, obligate human bacterium Neisseria meningitidis". Vaccine. 27 Suppl 2: B71–7. doi:10.1016/j.vaccine.2009.04.070. PMC 2712446. PMID 19477055.
- ↑ Pollard AJ, Scheifele D (2001). "Meningococcal disease and vaccination in North America". J Paediatr Child Health. 37 (5): S20–7. PMID 11885732.
- ↑ Iliyasu G, Lawal H, Habib AG, Hassan-Hanga F, Abubakar IS, Bashir U; et al. (2009). "Response to the meningococcal meningitis epidemic (MME) at Aminu Kano Teaching Hospital, Kano (2008-2009)". Niger J Med. 18 (4): 428–30. PMID 20120153.
- ↑ "Meningitis outbreak in Nigeria kills almost 500 - CNN.com".
- ↑ "The Centers for Disease Control and Prevention(CDC)".