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Cause:
Neisseria
meningitidis,
mainly serogroups B, C, Y, and W135 in the United
States, and additionally serogroup A, elsewhere. Invasive
disease is reportable.
Illness and treatment:
Invasive meningococcal disease is most commonly meningitis
with symptoms of fever, headache, stiff neck, vomiting,
light sensitivity and confusion. Bloodstream infection
(meningococcemia) causes fever and often shock, as well as a
rash or bruise-like skin lesions. A case may have both
syndromes. Pneumonia and joint infections can occur. Even
with appropriate antibiotic treatment and supportive care,
case fatality rate is 9-12%.
Sources:
Humans, including
asymptomatic carriers, are the reservoir. Transmission is
through respiratory droplets or direct contact with
respiratory secretions. Secondary cases are rarely
documented, though outbreaks can occur.
Additional risks:
Rates are highest for infants under 12 months. An increasing
proportion of cases are in adolescents and young adults.
Crowded living conditions, low socioeconomic status, and
tobacco smoke exposure may increase risk, as do certain
immune deficiencies including asplenia.
Prevention:
Universal immunization of all adolescents aged 11–18 years
and persons aged 2–55 years who are considered at increased
risk is recommended. Good respiratory hygiene can reduce the
likelihood of transmission. Exposed persons should take
prophylactic antibiotics.
Recent Washington trends:
Each year 30 to 60 cases are reported, including 1 to 8
deaths.
2008:
40 cases (0.6 cases/100,000 population) were reported with 4
deaths. 29 cases had known serogroup: 12 serogroup B, 9
serogroup Y, 5 serogroup C, 2 serogroup W135, and 1
serogroup Z. Serogroup B, which is not included in the
vaccine, caused 2 deaths.
Purpose of Reporting and Surveillance
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To identify persons who have been
significantly exposed to the index case, in order to
recommend antibiotic prophylaxis (chemoprophylaxis) and
to inform them about signs and symptoms of illness.
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Under very rare circumstances, to
recommend prophylactic immunization in a defined
population or community.
Legal Reporting Requirements
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Health care providers: immediately notifiable to
local health jurisdiction.
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Hospitals:
immediately notifiable
to local health jurisdiction.
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Laboratories:
Neisseria
meningitidis notifiable to local health jurisdiction within 2 work
days; specimen submission required.
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Local health
jurisdictions: notifiable to Washington State Department
of Health (DOH) Communicable Disease Epidemiology
Section (CDES) within 7 days of case investigation
completion or summary information required within 21
days.
Last
update
November 2009
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