Fever, headache, bruises? Parents, don't be careless! Beware of epidemic cerebrospinal meningitis!

Fever, cough, headache...

Do you think it's a cold?

But it could also be meningococcal meningitis

I believe everyone is familiar with the term "meningococcal disease".

Some impressions

Do you know its true face?

Let’s learn about it together today

01 What is meningococcal disease?

Meningococcus is a Gram-negative diplococcus that is the pathogen that causes meningococcal disease.

The earliest record of meningococcal disease was in the first century BC. It became popular in Europe and America in the 16th century and spread to the world by the end of the 19th century. In 1887, Weichselhaum was first isolated from the cerebrospinal fluid of a patient.

my country first detected meningococcal meningitis in a laboratory in Wuhan in 1896. Since then, there has been an epidemic of varying degrees of meningococcal meningitis almost every 8 to 10 years. In the spring of 1967, the largest meningococcal meningitis epidemic in my country's history broke out, infecting more than 3 million people and killing 160,000 people.

(Photo source: China Education Daily official account)

Even if a person survives the infection with treatment, there is a 12% to 20% chance of developing serious sequelae such as paralysis, deafness, and amputation. Globally, the mortality rate of meningococcal meningitis exceeds 10%, the disability rate is high, and the disease burden is severe[1].

02 Family members of Neisseria meningitidis

Nm is divided into 12 serogroups and unclassifiable serogroups based on the differences in surface-specific capsular polysaccharide antigens. The Nm serogroups that cause meningococcal cases are mainly serogroups A, B, C, W, Y and X.

Currently, the world is facing the threat of multiple serogroups Nm spreading and changing. In my country, the meningococcal group is gradually changing from group A to group C, and then there is a trend of more diverse serotypes such as B, W and Y. In addition, the proportion of W and Y types is also increasing. This characteristic of diversified prevalence of multiple serogroups such as A, B, C, W, X, and Y will continue to exist in the future [2].

03 Pathogenicity of meningococcal disease

The adhesion and colonization of Neisseria meningitidis in the human nasopharynx is the early stage of bacterial infection. Adhesion and colonization can be asymptomatic or lead to local inflammatory response.

The incubation period of meningococcal meningitis is 1 to 10 days, with an average of 3 to 4 days. The disease progresses rapidly, with an estimated mortality rate of 5% to 20%. Among the various pathogens that cause meningitis, Nm has the highest risk of causing meningitis epidemics [3]. Among the survivors, 12% to 20% suffer from serious sequelae such as paralysis, deafness, mental disorders, amputation, and epilepsy, which have considerable emotional, social, and economic impacts on individuals, families, and society [2].

04 Susceptible population and source of infection for meningococcal meningitis

Neisseria meningitidis is generally susceptible in the population, and the incidence rate is higher in children.

The sources of infection for meningococcal meningitis include healthy carriers and patients with meningococcal meningitis . Nm has a high latent infection rate, with the carrier rate in the population reaching 25% to 50% during epidemics. After infection, Nm parasitizes in the human nasopharynx[4]. Nm is mainly transmitted directly through the respiratory tract via droplets from coughing and sneezing.

05 Preventive measures for meningococcal meningitis

Although meningococcal meningitis seems very dangerous, there is no need to panic as it is preventable and treatable.

Vaccination

Vaccination is an important means of preventing meningococcal meningitis. The meningococcal vaccines currently available in my country cover four serogroups: group A, group C, group Y, and group W. For specific vaccination indications, please refer to the "Chinese Expert Consensus on Meningococcal Vaccine Immunization (2023 Edition)" [5].

Develop good living habits

Pay attention to personal and environmental hygiene, cover your mouth and nose when sneezing, and wash your hands frequently; open windows for ventilation to keep the indoor air circulating; brush your teeth and rinse your mouth with salt water at night; wash and dry clothes and bedding frequently.

Timely diagnosis and treatment

Because the early symptoms of meningococcal disease are similar to those of a cold, they are often confused and easily misdiagnosed.

After being infected with Neisseria meningitidis, common symptoms include: fever, severe headache, nausea, vomiting, neck stiffness, photophobia, skin bruises, etc. If you have the above symptoms, you should seek medical attention immediately.

Fujian CDC Tips

Nowadays, it is sometimes warm and sometimes cold. The temperature difference between morning and evening is large. The immunity is relatively low, and it is easier for germs, viruses and other pathogenic microorganisms to take advantage of the opportunity to enter. Therefore, you must pay attention to personal hygiene and add clothes to keep warm! Be careful to prevent diseases from harming your body!

References:

［1］Dennis Kasper, Anthony Fauci. Harrison’s Infectious Diseases, 3rd Edition: English Edition［M］. Beijing: Beijing United Publishing Company, 2017: 466-475.

［2］JAFRI RZ, ALI A, MESSONNIER NE, et al. Global epidemiology of invasive meningococcal disease［J］． Popul Health Metr,2013,11(1):17．

［3］WHO. Defeating meningitis 2030: baseline situation analysis[EB/OL].(2019-02-19).

[4]AYE AMM, BAI X, BOＲＲOW R, et al. Meningococcal disease surveillance in the Asia-Pacific region (2020): the global meningococcal initiative［J］． J Infect, 2020, 81(5): 698-711．

［5］Chinese experts’ consensus on meningococcal vaccination (2023 edition)[J]. Chinese Journal of Vaccines and Immunization, 2023, 29(01): 90-101.