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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:
During the past decade, 26 to 76 cases have been reported annually, with 1 to 8 deaths each year.
2010:
33 cases (0.5 cases/100,000 population) were reported with 3 deaths. Isolates from 29 of 31
cases (93.5%) were submitted for determination of serogroup. Serogrouping results were: 13
serogroup Y (one fatal), 8 serogroup C (one fatal), 7 serogroup B, and 1 serogroup W135.
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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Health care facilities:
immediately notifiable to local health jurisdictioni
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Laboratories:
Neisseria meningitidis immediately notifiable to local health jurisdiction;
specimen submission required - culture (from sterile sites only) (2 business days)
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Local health jurisdictions:
notifiable to Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE)
within 7 days of case investigation completion or summary information required within 21 days.
Last update
December 2011 |
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