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Meningococcal Meningitis

Meningococcal meningitis is an acute form of bacterial meningitis caused by the bacterium Neisseria meningitidis (also termed meningococcus). Meningitis is a serious infection of the thin lining that surrounds the brain and spinal cord. The disease occurs throughout the world, and different countries have different strains of the bacterium although five sero groups, A, B, C, Y and W135 are responsible for the majority of cases of the disease in people.


How is it contracted?
The bacterium is transmitted by sneezing, coughing or direct contact with saliva or respiratory secretions. It only infects humans and is not transmitted by animals.

Signs and symptoms
Symptoms usually occur after four days and may take one of two forms or a mixed picture. Meningitis commonly presents with stiff neck, high fever, headache and vomiting, and confusion and sensitivity to light may also be present. Septicaemia (blood poisoning) can present with high fever, general unwellness, and a rash which often progresses from small spots to large dark patches which do not go away when pressed. Sometimes both sets of symptoms can be present together.

Outcome
Even when the disease is diagnosed early and adequate treatment is started, 5% to 10% of patients die, typically within 24 to 48 hours after the onset of symptoms [14]. Bacterial meningitis may result in serious medical problems including loss of limbs due to lack of circulation, brain damage, hearing loss or a learning disability in 10% to 20% of survivors.  

Treatment
Antibiotic treatment is usually commenced as soon as meningococcal disease is suspected, as delay in treatment worsens the prognosis. Hospitalisation is required and it may also be necessary for close contacts of the infected individual to also be given antibiotics. 

Recommendations for travellers
Effective vaccines are available in the UK against the most common strains of meningitis although no vaccine provides universal coverage. Individuals should consider being vaccinated if they are travelling to a country where meningococcal meningitis is present or where their stay maybe prolonged or they are involved in activities which may increase the risk of exposure to the disease. Pilgrims travelling to Saudi Arabia for Hajj are required to have proof of vaccination against the disease for visa purposes.

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Vaccination. Here’s the point...

Even when the disease is diagnosed early and adequate treatment is started, 5% to 10% of patients die, typically within 24 to 48 hours after the onset of symptoms [14].