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[Neisseria meningitidis and meningitis]
P Nicolas1, J M Debonne, G Martet
1l'Unité du Méningocoque, l'Institut de Médecine Tropicale du Service de Santé des Armées, Marseille, France. imtssa@gulliver.fr
Medecine Tropicale : Revue Du Corps De Sante Colonial
|September 3, 1999
Summary
Meningococcal meningitis epidemics pose a significant threat, especially in Africa's meningitis belt. Early antimicrobial therapy and newer conjugate vaccines offer hope for improved survival and prevention of this serious bacterial infection.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Meningococcal meningitis epidemics occur globally, with heightened risk in sub-Saharan Africa's "Lapeyssonnie meningitis belt" during the dry season.
- This region experiences hyperendemicity and regular epidemics of Neisseria meningitidis.
- Traditional polysaccharide vaccines show limited efficacy in young children, a high-risk group.
Purpose of the Study:
- To review the epidemiology and control strategies for meningococcal meningitis.
- To highlight the role of molecular typing in monitoring virulent strains.
- To discuss the challenges and advancements in vaccination and antimicrobial therapy.
Main Methods:
- Utilized multilocus enzyme electrophoresis and multilocus sequence typing for strain identification and monitoring.
- Reviewed clinical presentation, diagnosis, and treatment outcomes.
- Analyzed vaccine effectiveness and antimicrobial resistance patterns.
Main Results:
- Multilocus sequence typing enables global monitoring of Neisseria meningitidis strains via internet databases.
- Newer conjugate vaccines (groups A and C) demonstrate effectiveness in young children, inducing long-term immunity.
- Increasing resistance to chloramphenicol and reduced sensitivity to penicillin are observed in meningococcal strains.
Conclusions:
- Early diagnosis and prompt antimicrobial therapy are crucial for survival, as untreated meningococcal meningitis is fatal.
- While treatment is feasible, rising antimicrobial resistance necessitates ongoing monitoring of meningococcal sensitivity.
- Conjugate vaccines hold promise for routine vaccination, potentially preventing future epidemics.