Meningococcal disease

Acute contagious illness, characterized by fever, petechial or purpuric rash, and signs of sepsis and/or meningitis.

May progress rapidly to septic shock, with hypotension, acidosis, and disseminated intravascular coagulation.

Highest rates of invasive infection are in children under 5 years of age, especially under 1 year of age, with a second peak occurring in 11- to 22-year-olds and third peak in people >65 years of age.

Diagnosis confirmed by isolation of Neisseria meningitidis from a normally sterile body site.

Confirmed meningococcal infection is treated with a third-generation cephalosporin. Where a cephalosporin is not appropriate, the choice of agent is based on the individual patient circumstances, antibiotic susceptibilities, and local availability.

Case fatality rate is 10% to 15%. Between 10% and 20% of survivors have moderate to severe sequelae, including hearing loss, motor and cognitive disabilities, blindness, or ischemic injuries of the skin or extremities.

Meningococcal infections are caused by Neisseria meningitidis, a gram-negative diplococcus that colonizes the nasopharynx. Bacteria invade the bloodstream or spread within the respiratory tract. A case is confirmed by detection of N meningitidis-specific nucleic acid (using a validated polymerase chain reaction assay) in a specimen obtained from a normally sterile site (e.g., blood or cerebrospinal fluid), or by isolation of N meningitidis from a normally sterile site or from purpuric lesions.[1]Centers for Disease Control and Prevention. Meningococcal disease. In: Manual for the surveillance of vaccine-preventable diseases. October 2018 [internet publication]. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt08-mening.html Probable cases include those where N meningitidis antigen is detected by immunohistochemical staining on formalin-fixed tissue, or in cerebrospinal fluid by latex agglutination.