「Meningococcus」の版間の差分
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| 20行目: | 20行目: | ||
*annual outbreak during dry season in meningitis belt | *annual outbreak during dry season in meningitis belt | ||
**dry winds make people's nose drier resulting in easy | **dry winds make people's nose drier resulting in easy | ||
| − | + | *wide range difference of nasopharynx carriage between countries | |
| − | + | **reason totally unknown | |
| − | + | **NZ & 3% | |
| + | **Nigeria boarding house 30-40% | ||
==transmission== | ==transmission== | ||
| 37行目: | 38行目: | ||
*headache, neck stiffness, vomiting | *headache, neck stiffness, vomiting | ||
*irritability and/or confusion | *irritability and/or confusion | ||
| + | |||
| + | ==vaccine== | ||
| + | ===development history=== | ||
| + | *1960s - purified PS vaccines for A and C | ||
| + | **immunity short term due to lack of T-cell involvement | ||
| + | *1990s - conjugated vaccines for A and C after success of Hib conjugate vaccine | ||
| + | *2000s - monovalent A vaccine for Africa | ||
| + | [[file:Development history of meningococcal vaccine.jpg]] | ||
2021年6月1日 (火) 11:11時点における版
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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
- wide range difference of nasopharynx carriage between countries
- reason totally unknown
- NZ & 3%
- Nigeria boarding house 30-40%
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
vaccine
development history
- 1960s - purified PS vaccines for A and C
- immunity short term due to lack of T-cell involvement
- 1990s - conjugated vaccines for A and C after success of Hib conjugate vaccine
- 2000s - monovalent A vaccine for Africa
