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[Meningococcal infections: aspects of microbiology, epidemiology and prevention]
1Nationales Referenzzentrum für Meningokokken, Hygiene-Institut, Universität Heidelberg. ingrid_ehrhard@med.uni-heidelberg.de
Abstract:
Neisseria meningitidis (meningococcus) is responsible for an average of 40% of all cases of bacterial meningitis in Germany. Cerebrospinal fluids, blood cultures, throat swabs and scratches, aspirations and biopsies of the skin rash are appropriate materials for the diagnosis of meningococcal disease. The materials should reach the laboratory without delay. Since 1993, the incidence of meningococcal disease in Germany is less than 1 case per 100,000 inhabitants. The case fatality rate is about 10%. Most cases of meningococcal disease occur in the first quarter of the year. Almost half of all invasive N. meningitidis isolates are from children under five years of age. In the period 1990-1998, in Germany an average of 74% of cases were caused by serogroup B and 21% by serogroup C. In serogroup B disease, isolates of serotype 15, in group C disease strains of serotype 2a are predominating. Chemoprophylaxis should be given to all household members and all contacts living in institutions with household-like character, contacts in institutions for children under six years of age and all persons who had contact with the oropharyngeal secretions of the patient. At present, only capsular polysaccharide vaccines against serogroups A, C, Y and W135 are available for immunoprophylaxis in Germany.
Insights
Neisseria meningitidis causes 40% of bacterial meningitis in Germany. Diagnosis involves prompt lab analysis of various samples, with chemoprophylaxis recommended for close contacts.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Neisseria meningitidis (meningococcus) is a significant cause of bacterial meningitis in Germany, accounting for approximately 40% of cases.
- The incidence of meningococcal disease in Germany has been below 1 case per 100,000 inhabitants since 1993, with a case fatality rate of around 10%.
Purpose of the Study:
- To outline diagnostic methods for meningococcal disease.
- To describe the epidemiology of Neisseria meningitidis in Germany, including incidence, serogroup prevalence, and risk factors.
- To provide recommendations for chemoprophylaxis and discuss available immunoprophylaxis options.
Main Methods:
- Diagnosis relies on timely laboratory analysis of cerebrospinal fluid, blood cultures, throat swabs, skin rash aspirations, and biopsies.
- Epidemiological data from 1990-1998 in Germany were analyzed, focusing on incidence, serogroup distribution (predominantly B and C), and predominant serotypes.
- Recommendations for chemoprophylaxis target household and institutional contacts, while available vaccines cover serogroups A, C, Y, and W135.
Main Results:
- Neisseria meningitidis is a leading cause of bacterial meningitis in Germany.
- Serogroup B (74%) and C (21%) predominated between 1990-1998, with specific serotypes identified within each group.
- Children under five years old constitute nearly half of invasive N. meningitidis cases.
Conclusions:
- Prompt laboratory diagnosis is crucial for managing meningococcal disease.
- Understanding serogroup prevalence and epidemiological trends informs public health strategies and chemoprophylaxis recommendations.
- While vaccines exist for certain serogroups, broader immunoprophylaxis options may be needed.