Speaker1: Hi everyone. Today we will be discussing Meningococcal disease and what you need to
know about it in order to gain awareness on the disease.
To better understand the disease.
Let's begin with a case study.
This is Nathan.
Nathan comes to the doctor with a bunch of symptoms such as fever, headache, and stiff
neck. These are the common symptoms that are present in a person who has a meningococcal
disease. Nathan also shows symptoms of nausea, vomiting, photophobia, where his eyes
have often been sensitive to light.
And additionally, he often experiences confusion.
These are other symptoms that can be present in a person who is suffering from
meningococcal disease.
And unfortunately, Nathan occasionally shows all these symptoms.
Since the symptoms that Nathan is experiencing are similar to other diseases,
the doctor needs to first confirm if Nathan has a disease.
In order to confirm this, the doctor takes a sample of cerebrospinal fluid near Nathan's
spinal cord and sends the sample to a lab to detect the presence of the bacteria that
causes meningococcal disease.
But wait. What exactly causes meningococcal disease?
Hmm. Well, meningococcal disease is caused by the bacterium Neisseria Meningitidis,
which is a gram-negative bacteria, meaning that it does not retain crystal violet
staining that is used in a gram stating method for bacterial differentiation.
The disease is severe and potentially deadly.
Neisseria Meningitidis is resistant to antibiotics and additionally, the pathogen is
specific to humans.
The bacteria can cause infections in linings of the brain, spinal cord, and the
bloodstream. Approximately 10% of adults are carriers of the bacterium within their
nasopharynx, and carriers have the bacteria in the back of their nose and throat, yet
they show no signs of illness.
So how does this dangerous bacteria spread to other people?
Well, the bacteria, Neisseria Meningitidis is spread through respiratory and throat
secretions, such as through saliva or spit.
It can be spread through coughing, chewing food, which is infected with the bacteria or
kissing. It generally takes close or lengthy contact for the bacteria to spread, as they
are not as contagious as other bacteria, such as those responsible for the common cold
or flu. You cannot catch this bacteria through casual contact or breathing air in
which someone with the disease has been in.
So what may be the risk factors that increases your likelihood of contracting the
disease? Well, first, meningococcal disease is mostly common in infants, teens, young
adults and older adults, particularly those in the same household or those who have been
in contact with the infected individuals or secretions are at a higher risk of infection
with the bacteria.
College students also have a higher risk of contracting the disease due to their exposure
to larger group settings.
For example, living in a community setting increases the risk of developing the disease
as a bacterium is spread through the respiratory route and spreads quickly through
large groups.
Certain medical conditions can increase risk due to compromised immune systems.
This includes AIDS, alcoholism, diabetes, the use of immunosuppressant drugs and other
factors that affect your immune system.
In addition, having your spleen removed increases risk, and those without a spleen
should get vaccinated to decrease their risk of getting the disease.
Additional risk factors include traveling to the meningitis belt in sub-Saharan Africa and
skipping vaccinations throughout childhood or adulthood.
So let's come back to our case study to see what happened with Nathan's cerebrospinal
fluid sample. Well, his cerebrospinal fluid sample was analyzed in the lab to detect the
presence of the bacteria, Neisseria Meningitidis, which we now know so much
about. And unfortunately, the poor guy sample contains the bacteria.
Oh, no.
Hmm. So what exact treatments can be given to a person who now has the disease?
Treatment of meningococcal disease varies depending on its presentation and the
specific Neisseria meningitidis bacteria an individual has been infected with.
But all treatment must be aggressive and immediate.
All meningococcal disease is treated with antibiotics.
However, the specific antibiotic depends on whether the bacterial strain an individual
has been infected with is resistant to specific antibiotics, including penicillin.
Since it is vital for antibiotics to be given as soon as possible to prevent serious
complications or death, depending on the antibiotic resistance patterns in the area.
The first line of treatment will be either a penicillin or a cephalosporin.
The two most frequently given syphilis fawns are Seifert, vaccine and ceftriaxone.
The specific dosing schedule will depend on the antibiotic, but the medication is
typically given intravenously for 5 to 7 days.
Alongside this antibiotic, it is also recommended to give a high dose of
corticosteroids such as dexamethasone with the first dose of antibiotics, and it is
given for the next 2 to 4 days to help minimize the risk of future complications.
Additional treatment depends on the clinical syndromes that an individual presents with.
For example, if an individual has shock, it is recommended to start early and aggressive
fluid resuscitation providing fluid using an IV to compensate for decreased blood volume.
Depending on the patient's state, they may also have to be intubated or be given
specific treatments to address changes in the levels of molecules in their blood, such
as low glucose or calcium levels.
Shock can also cause poor perfusion of the skin and limbs, which in extreme cases can
lead to amputation.
If the individual has high intracranial pressure, which is pressure inside the brain,
they should be treated with mannitol or 3% saline, which helps decrease intracranial
pressure, and additionally, intubation protects their breathing.
Another additional treatment for a severe form of meningococcal disease is a surgical
removal of dead tissue.
And coming back to Nathan.
His condition is pretty bad, so he undergoes surgery to remove the dead tissue.
Beyond the individual themselves.
Any close contacts should receive chemoprophylaxis, which involves giving oral
antibiotics.
Additionally, family members of the person with the disease undergo intense anxiety
throughout the process of their loved ones.
Infection with meningococcal disease, especially after long ICU stays and may
require some psychological support to address anxiety, depression or PTSD symptoms.
And here, Nathan's poor parents have unfortunately developed these symptoms as
Nathan spends long periods at the ICU.
Regarding the complications, meningococcal disease has a mortality rate of 10 to 15%,
meaning around one in ten individuals who develop invasive meningococcal disease will
die. Individuals who survive also face high rates of complications, with 10 to 30% facing
permanent disabling complications depending on the clinical syndromes that occur with the
disease. Overall, there is around a 7% rate of neurological impairment, which can include
seizures and spasticity, and a 4% rate of hearing impairment in children who survived
Meningococcal disease.
They have higher rates of behavioral and psychological problems and also have
decreased academic performance.
If an individual develops shock as part of their disease, the most common complications
include chronic pain, skin scarring, predominantly to the legs, all by arms, chest
and face and around 3%.
Rate of limb.
Amputations. The most effective way to prevent meningococcal disease is through
vaccinations, which provide long lasting protection and aid in a population's herd
immunity. There are three different types of vaccinations polysaccharide and protein and
conjugate vaccines, which differ depending on their biological mechanisms.
Most significant to meningococcal disease are polysaccharide and conjugate vaccines.
Polysaccharide vaccinations contain part of the pure bacterial cell wall, whereas
conjugate vaccines contain antigens or the cells that stimulate a specific immune
response in your body bound to an immunogenic carrier protein, which also aids
with your body's immune response.
This mechanism contributes to enhanced immune response and prolonged memory of your
immune cells that fight the bacteria when infected.
Conjugate vaccines can target many different groups of the bacteria, which is necessary
for higher-risk populations and disease prevention in general.
However, polysaccharide vaccines, like many or many vaccines, are also used for
outbreak-specific control as they target one particular serogroup.
Today, vaccinations for Meningococcal disease are available for five out of the six
meningococcal disease Serogroup, A, B, C, W , and Y.
Typically in Canada, infants between the ages of 12 and 23 months are recommended to
receive the NCC vaccine for meningococcal serogroup.
C Additionally, at the age of 11 or 12 years, children should receive the meant c ac
w vaccine which protects against four of the Meningococcal disease Serogroup, AC, W, and Y
depending on where you live and local epidemiology.
Another vaccine may be given to protect against Serogroup B specifically.
We hope you now know more about meningococcal disease and hopefully now you
can educate other people on it.
Thank you for watching. And don't forget to subscribe to our channel to learn more of
demystifying medicine content.
Take care.