Meningococcal meningitis is caused by the bacteria Neisseria meningitidis. It is a serious infection that can cause sudden onset of intense headache, fever, neck stiffness, and can lead to death within 24-48 hours if not treated. In India, it is endemic with over 3000 reported cases in 2013, primarily in certain states. The bacteria are transmitted through respiratory droplets from carriers, with children under 5 years of age most at risk. Vaccines exist to help prevent outbreaks, including polysaccharide and conjugate vaccines for certain serotypes of N. meningitidis. Prompt treatment with antibiotics can save over 95% of cases if started within the first two days of symptoms.

1. MENINGOCOCCAL MENINGITIS
Dr. Sushrit A. Neelopant
Assistant Professor,
Department of Community Medicine
RIMS, Raichur

2. INTRODUCTION
• Acute comm.dis.  N. meningitidis
• Intense headache, vomiting, stiff neck-
• Within few hours  coma
• Fatality
– Without treatment – 80%
– With treatment - <10%

3. PROBLEM STATEMENT

4. PROBLEM STATEMENT- INDIA
• Endemic
• 2013 – 3380 cases, 176 deaths
• Majority- DL, AP, MP, OR

5. EPIDEMIOLOGY
• Agent: N. meningitidis
– G –ve diplococci - 12 serotypes A, B, C, 29E, H, I, K,
L, W135, X, Y, Z (polysaccharide capsule)
– Majority inf.- A, B, C, X, W135, Y- endemic & outbreak
– African meningitis belt- A
• Source: carriers- nasopharynx- 4-35%- 10 months
• Period of communicability-
• Age: children, highest attack rate- 3-12months
• Env.: Dec to June, overcrowding, low SES, tobacco
smoke, asplenia, HIV, travel
• MOT: droplet, IP: 3-4d, 2-10 days

6. CLINICAL COURSE
• Most if. – no clinical disease asymptomatic
carriers- reservoir and source of inf.
• Symptoms: sudden onset intense headache, fever,
nausea, vomiting, photophobia, stiff neck
• Fatal within 24-48hrs- 5-10% even with treatment
• Permanent neurological sequelae- 15-20%
• Septicaemia- circulatory collapse, skin rash, high
fatality rate

7. CONTROL
• CASES:
– Start treatment within first 2 days of illness- 95%-
survive
– Penicillin, ceftriaxone,chloramphenicol
• CARRIERS:
– Rifampicin
• CONTACTS:
– Rifampicin, ciprof, ceftriaxone, azithromycin
• MASS CHEMOPROPHYLAXIS:
– Immediate drop in incidence
– Cipro, mino, spira, ceftr

8. PREVENTION- VACCINES
• Polysachharide vaccines:
– Biv. (A, C), triv. (A, C, W135), quadriv. (A, C, W135, Y)
– Single dose, s/c, ≥2yrs, adv- pain, transient fever
• Conjugate vaccines:
– Monov. (A or C), quadriv. (A, C, W135, Y), Hib/MenC
– Monov. – 2-12mths- 2 doses & booster, 1-29yrs-1 dose
– Quadriv. - Single dose, ≥2yrs
• Conjugate > Polysachharide- herd imm., more imm.
• Both are safe in pregnancy