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Meningococci relatively rarely cause severe disease. But when they attack, it's a race against time. Every hour and even the minute counts. The sooner an antibiotic is given, the greater the chance that the patient will not develop sepsis (sepsis) and will recover. What symptoms indicate a meningococcal infection? How is meningococcal disease treated?

Meningococci, compared to other pathogenic bacteria, are infrequent, but the fastest killer of humans. They can kill us in as little as 24 hours from the onset of symptoms of the disease they cause.

Fortunately, only a few of us have contact with meningococcal disease. Most often it ends in carriage. Besides, we can not be afraid of it at all, if we get vaccinated against these microorganisms.

What are meningococci?

Meningococcusare Gram-negative bacteria of the speciesNeisseria meningitidis , also known as meningitis. TheNeisseria meningitidisstrains are divided into 13 serogroups. In Poland, most cases of invasive meningococcal disease are cases caused by meningococcal groups B and C. There are also single cases caused by serogroups W135 and Y.¹​​

Who can get meningococcal disease?

Most people stay he althy after contact with meningococcus. These bacteria live in the nose and throat for weeks, months or even longer, usually without harming us. But if we pass them on to other people, they can make them very ill.

It is estimated that approx. 20 percent people are asymptomatic carriers of these bacteria, although in large and closed human clusters, such as boarding houses, youth camps, barracks, carriers can reach even several dozen percent.

These microorganisms spread quickly by droplets (coughing, sneezing), direct contact (e.g. a kiss), and indirect contact (e.g. drinking from one cup, eating with the same spoon). The source of the infection can be both a he althy carrier and a sick oneperson.

What are the symptoms of a meningococcal infection?

Early symptoms of a meningococcal infection resemble an ordinary infection, so they are usually underestimated by both parents and adult patients - that is why early diagnosis of this disease is so difficult. In the first phase, the infection manifests itself as:

  • with a weaker appetite
  • fever
  • a feeling of general breakdown
  • weakening
  • sleepy
  • muscle and joint pain
  • cough and runny nose

The initial phase of infection may last up to 3-4 days, after which the patient's condition usually deteriorates rapidly.

Who are meningococcus dangerous for?

Each of us is at risk of suffering from meningococcal infection. However, these bacteria are especially dangerous for two age groups. The first of them are children under the age of 5, especially the smallest ones who are under 2 years of age, because their immune system is not yet fully developed.

The second group consists of adolescents and young adults, i.e. people between 11 and 24 years of age. Why exactly them, if in this period of life we ​​have an educated and efficient immune system? The intensification of social contacts is decisive. Both teenagers and young adults spend a lot of time in peer groups. They learn, relax and play together.

They share sandwiches, drink from one bottle, and kiss with new partners. This is how they pass on meningococci (every fourth teenager is a carrier of these bacteria). The reason for the increased risk of developing the disease may also be the susceptibility to infections in adolescence and the properties of the bacteria itself.

What is invasive meningococcal disease?

Bacteria of the speciesNeisseria meningitidisare not particularly virulent. They cause disease in one in 100,000 people.

Unfortunately, rarely meningococcal infection is non-invasive and takes the form of, for example, pneumonia or otitis media. Meningococci usually do not attack at all, and if they do, with such enormous force that they overcome the mucosal barrier and enter the bloodstream - we are then dealing withinvasive meningococcal disease , which may take the form:

  • rapidly progressing inflammation of the meninges surrounding the brain and spinal cord; within one day from the onset of the disease, severe condition may develop, leading to coma and death,
  • sepsis(sepsis), which occurs when meningococcus enters the bloodstream and spreads rapidly throughout the body, leading togeneral infection; as a result, weakening of the heart and blood circulation as well as extensive bleeding under the skin and into internal organs.

Meningococcus can also invoke:

  • pharyngitis
  • pneumonia
  • otitis media
  • pericarditis
  • endocarditis
  • inflammation of joints and other organs.

What are the symptoms of invasive meningococcal disease?

Invasive meningococcal disease is not easy to recognize because the first symptoms are similar to the flu. They appear:

  • high fever
  • muscle pains
  • general malaise
  • headaches
  • sore throat

It is easy to ignore such symptoms, especially by a teenager, so it is worth noting that in the case of meningococcal infection, they worsen quickly. If we are dealing with meningitis, they are joined by:

  • vomiting
  • nausea
  • skin hyperesthesia
  • sleepiness
  • convulsions

A typical symptom of meningococcal infection is also a petechial rash, occurring in about half of patients, which does not fade under pressure.

The rash can appear on any part of the body as small red spots, which in the later stages of the disease merge into large patches.

To find out if a rash may indicate meningococcal sepsis, we can do the " glass test ". In the case of meningococcal infection, the spots do not turn pale after pressing the bottom of the glass against the lesions on the skin. Sometimes the rash appears on the surface of the eyeballs, in places partially covered by the eyelids. Unfortunately, when it occurs, it may be too late to rescue. That is why prevention is so important.

How is meningococcal infection treated?

Treatment of invasive meningococcal disease always requires hospitalization, often in an intensive care unit.

If meningococcal infection is suspected, the patient's blood and cerebrospinal fluid are collected for examination, and then cultured. Until the results of the microbiological test are obtained, the patient receives intravenous high doses of the antibiotic (usually they are third-generation cephalosporins or penicillin) - if, after isolating a specific pathogen, it is necessary to change it, the doctor implements targeted therapy.

The patient also receives painkillers and antipyretics all the time, if necessary, his vital functions are also maintained, water andelectrolyte, sometimes it is also necessary to assist breathing.

How to recognize meningococcal infection in young children?

Little children will not tell us what is wrong with them, we can only observe their behavior. They are apathetic, irritable, they lie down, have no appetite, cannot be picked up on their hands or cuddled (it is related to skin hyperesthesia). And most of all, they are clearly different than during ordinary, banal infections.

It is difficult to define this difference in the behavior of babies, but mothers notice it. It may include, for example, that after the administration of an antipyretic drug and the decrease in the fever, the child does not feel like playing, and still gives the impression of being seriously ill.

The diagnosis of meningococcal infection is not easy, but medication must be given as soon as possible as it progresses rapidly. Therefore, as soon as doctors suspect meningococcal meningitis or sepsis, they immediately administer two antibiotics to which most bacteria are sensitive.

Only then do they order tests that determine whether the cause of the infection is meningococcus. If they caused the disease, antibiotics can be replaced with penicillin, to which the bacteria are still sensitive.

Meningococcal vaccination

There are various types of vaccines on the Polish market that protect against one or four groups of meningococci. Each vaccination is in the form of an injection. From the age of two months, a toddler can be vaccinated against meningococcal serogroups B and C. Older children, over 12-24 months of age, can be vaccinated against four meningococcal serogroups (A, C, W-135 and Y). The meningococcal vaccine is recommended for infants from 2 months of age, as the most cases of invasive meningococcal disease occur in the first year of life.

It is worth knowing, however, that in the case of meningococci, the vaccine given in infancy may not be effective in adolescence. These bacteria attack quickly, so the vaccine immune memory is not enough, thanks to which the immune system recognizes the enemy and starts producing antibodies against it.

A constant concentration of specific antibodies is needed, which is maintained for some time after vaccination, for protection to be effective. Meningococci are faster than the immune system. You can die before it can make antibodies. Therefore, the concept is slowly emerging at this time that children vaccinated against meningococcus during infancy should be boosted with vaccines during adolescence tomaintain enough antibody levels to stop disease progression.

According to an expertbow. Alicja Mażarska-Pazio - pediatrician and neonatologist at CM Damian

Invasive meningococcal disease is characterized by a dynamic and unpredictable course. It can take the form of sepsis (sepsis), which is blood poisoning, or inflammation of the meninges. It also happens that it runs under both characters at the same time. The fact that the disease can develop extremely quickly - even within 24 hours, resulting in the death of previously completely he althy people - is luscious to the imagination.

If proper treatment is started too late, mortality can reach 70-80%. Even after successful treatment of invasive meningococcal disease, many patients risk permanent neurological complications, skin and tissue defects, or amputation of the limbs.

If the disease can attack at an express pace and carries such serious consequences, it becomes extremely important to recognize it early and start appropriate treatment immediately. So what are the first symptoms that could put us on the right track? Experts emphasize that, unfortunately, the symptoms are not characteristic and it is easy to confuse them with, for example, influenza (fever, headache or joint and muscle pain). It is worth noting that the symptoms of invasive meningococcal disease change during its development. The symptoms accompanying the disease may include vomiting, drowsiness, lack of appetite, difficulty breathing, decreased muscle tone, convulsions and pain in the limbs.

The youngest children most often experience convulsions, loss of appetite or restlessness. A characteristic, but not always present, symptom is a petechial rash that does not fade under pressure. We can examine it by performing the so-called glass test, i.e. pressing the side of the glass against the changes on the skin. In the case of meningococcal infection, the spots will not fade under pressure.

Source: www.zasz tendsiewiedza.pl

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Infectious diseases