Meningococcus

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pathogen

• Neisseria meningitidis
• gram negative diplococci
• carriage in nasopharynx
• 12 identified capsular serogroups
• common pathogenic serogroup A, B, C, W, X, Y
• seasonal epidemics by group A, C
  • meningitis belt
• sporadic cases by e.g. group B
  • Latin America
  • Norway
  • New Zealand
• immunity generated by polysaccharide capsule except B
  • may be the reason that herd immunity development relatively slow and sporadic outbreaks continue in above countries

epidemiology

• highest < 2 y/o and adolescent
• annual outbreak during dry season in meningitis belt
  • dry winds make people's nose drier resulting in easy

why natural carriage differs between countries? why ANZAC are the highest in the world outside meningitis belt

transmission

• aerosol
• fomite
• adolescent activity

clinical picture

• fever
• distinctive petechiae anywhere in whole body
• no fading by pressure with glass tumbler - "tumbler test"
• resulting in purple bruising of skin
• photophobia
• headache, neck stiffness, vomiting
• irritability and/or confusion