[Clinical features and prognostic factors of meningococcal disease: a case series study in Chile during the 2012-2013 outbreak]
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Introduction:
Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences.
Objective:
To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile.
Material And Methods:
Case series considering 149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihood of dying.
Results:
51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score.
Discussion:
The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.
Insights
Meningococcal disease (MD) cases in Chile, particularly serogroup W, showed a high fatality rate. Factors like age and symptoms such as diarrhea and impaired consciousness increased mortality risk.
Area of Science:
- Epidemiology
- Infectious Diseases
Context:
- Meningococcal disease (MD) poses a significant global health threat due to its high mortality and long-term complications.
- Chile has observed a concerning rise in serogroup W MD cases since 2012, characterized by atypical presentations and severe outcomes.
Purpose:
- This study aimed to delineate the epidemiological trends and clinical outcomes of MD cases in Chile from January 2012 to March 2013.
- Investigate factors influencing mortality in a Chilean MD patient cohort.
Summary:
- A case series of 149 MD patients across 7 Chilean regions was analyzed.
- Meningococcemia was prevalent (51.5%), with an overall case fatality rate of 27%. Serogroup W predominated (46.6%).
- Increased mortality risk was associated with advanced age, indigenous ethnicity, stressful events, diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation, and low Glasgow Coma Scale scores.
Impact:
- The elevated fatality rate, particularly for serogroup W, exceeded expected levels.
- The shift towards nonspecific symptoms or rapid septicemia progression in serogroup W MD challenged healthcare systems unprepared for such presentations, contributing to increased fatalities.
