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Meningococcal disease: treatment and prevention
1Department of Microbiology, Northwick Park Hospital, North West London Hospitals NHS Trust, Watford Road, Harrow, Middlesex, England HA1 3UJ. robert.wall@nwlh.nhs.uk
Annals of Medicine
|January 30, 2003
Summary
Meningococcal disease is rising, with septicaemia more common than meningitis. Early recognition and supportive care are crucial for reducing deaths, though vaccine options for all strains remain limited.
Area of Science:
- Medicine
- Infectious Diseases
- Public Health
Background:
- Meningococcal disease incidence is increasing globally.
- Current strains manifest more frequently as septicaemia than meningitis.
- Early recognition of disease and severity is critical for reducing mortality.
Purpose of the Study:
- To discuss the clinical management of increasing meningococcal disease.
- To review the evidence for steroid use in severe sepsis and meningitis.
- To evaluate the role of current and emerging vaccines.
Main Methods:
- Literature review on meningococcal disease manifestations and treatment.
- Discussion of clinical evidence regarding supportive care and steroid efficacy.
- Analysis of current vaccine strategies and limitations.
Main Results:
- Ceftriaxone is the recommended treatment, requiring aggressive supportive therapy for severe cases.
- The efficacy of steroids in meningococcal meningitis and sepsis is not yet established.
- Polysaccharide vaccines have a limited role; conjugate vaccines are effective against serogroup C but not B.
Conclusions:
- Prompt recognition and management are key to improving outcomes for meningococcal disease.
- Further research is needed on the role of steroids.
- Development of a serogroup B vaccine is essential to address ongoing challenges.