The Public Health Burden of Meningococcal Meningitis
Introduction
Meningococcal Meningitis is one of the different forms of Meningitis disease. It is caused by a bacterium Neisseria meningitidis which affects the thin lining of the brain called the meninges and the cerebrospinal fluid. It has been implicated in meningitis outbreaks as far back as the 1600s and is the major causative strain of epidemics in Africa.
Bacterial meningitis is a major public health burden especially in the semi -arid region of Africa called the African Meningitis Belt which has a population of over 300 million people with majority, living below the poverty line. In the United States, Incidence is on the decline with the introduction of vaccines especially for infants and children under five years old and compulsory screening of pregnant women for group B streptococcus.
Transmission is by person to person with close contact of nasal or throat secretions of infected persons. Infection can be quick and fatal with 10-20% of survivors becoming permanently disabled. Even with the success of vaccine in the reduction of the incidence of this disease, meningococcal disease remains a great public health concern especially
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Admission to a hospital or health center is necessary, although isolation of the patient is not necessary. Appropriate antibiotic treatment must be started as soon as possible, ideally after the lumbar puncture has been carried out if such a puncture can be performed immediately. If treatment is started prior to the lumbar puncture it may be difficult to grow the bacteria from the spinal fluid and confirm the diagnosis”. (WHO, 2015) “A range of antibiotics can treat the infection, including penicillin, ampicillin, chloramphenicol and ceftriaxone. Under epidemic conditions in Africa in areas with limited health infrastructure and resources, ceftriaxone is the drug of choice”. (WHO,
The microbe Naegleria fowleri, commonly called the brain-eating-amoeba, was first identified from a fatal case of primary amebic meningoencephalitis (PAM) in Australia in 1961. In 1965, three further cases of fatal PAM were found, from which clinical and laboratory investigations pointed to a relation with acute bacterial meningitis among the cases of an unknown etiology. According to Fowler & Carter (1965), when post-death examinations of the bodies were performed researchers found that “microscopically the meningeal exudate consisted of about equal proportions of neutrophil leukocytes and chronic inflammatory cells, amongst which small, often degenerate amoebae were sparsely distributed” (p.740). The species of the organism that caused the amoeboflagellate related disease was later named Naegleria fowleri after one of the primary authors of the report, M. Fowler. Butt reports that the first case of PAM in the United States occurred in Florida in 1962 and a further retrospective study reported by dos Santos Netos suggested that additional identified cases of PAM in Virginia may have dated as far back as 1937 (as cited in Centers for Disease Control and Prevention [CDC], 2013, Pathogen). As research on the microbe ensues, more cases of PAM are beginning to surface and the search for a cure to the fatal infection is imperative.
There are five types of meningitis, each diagnosis classified according to their cause: viral, bacterial, fungal, parasitic, and non-infectious (developed as a result of HIV/AIDS, cancer, tuberculosis, and other diseases and conditions). The distinct symptoms that all five types of meningitis share are the symptoms originating from the inflamed meninges, which, as reported by the Mayo Clinic (2015), include headaches, fever, and stiffness of the neck as the most distinct few of the variety. As stated by the Centers for Disease Control and Prevention (2015), although meningitis is considered a relatively rare disease in the United States (with the usually nonfatal viral meningitis being the most commonly observed case), bacterial meningitis in particular is the epidemic type that is often times fatal and the most dangerous. It is contagious and it can be spread by respiratory fluids such as saliva and mucus (CDC, 2015). In some cases, it is possible for those who have recovered from this form of meningitis to suffer from acute complications that impact their
“Meningococcal Disease.” Centers for Disease Control and Prevention. 12 Oct. 2005. Department of Health and Human Services. 27 July 2006 .
...or children. The specific way of transmission is difficult to identify. Most common assumptions have been that transmission has occurred through skin lesions or by sharing blood contaminated objects. Infected saliva is another source of infection especially as a non-parental infection. The virus has the ability to enter a healthy body as an airborne disease by coughing and sneezing, from mouth-to-mouth kissing, biting or by sharing chewed toys and candies [2, airborn]
As far as vaccines go, there are two main vaccines that all adolescence should receive in order to prevent bacterial meningitis. “Around the age of 11 the Meningococcal conjugate vaccine should be given, and later on between the ages of sixteen and twenty three is when you should receive the second booster shot called the Serogroup B Meningococcal vaccine” (CDC, Meningococcal Vaccines). “Pregnant women should be tested at about their 37th week of pregnancy for group B Streptococcus,
Public health may be defined as “a social and political concept aimed at the improving the quality of life among the whole population through health promotion, disease prevention and other forms of health intervention”.(1) The purpose of public health practice is to improve the health of society rather than individuals and reduce health disparities between individuals, groups, and communities through organized effort of the communities, individuals and organizations. As Marmot points out: “creating a fairer society is fundamental to improving the health of the population and ensuring a fairer distribution of good health”.(2) Besides this, the public health field is expanding to tackling new and contemporary risks: obesity, sexually transmitted
Recent research shows that, there are three major means by which infections can be transmitted and they include direct transmission, indirect transmission and airborne transmission (Hinman,Wasserheit and Kamb,1995). Direct transmission occurs when the physical contact between an infected person and s susceptible person takes place (division of public health, 2011). An example is a health care worker who attends to an Ebola patient, without gloves, gown and mask plus forget to wash his or her hand with soap and hot water and or a person having flu without the use of mask or washes his hand after sneezing easily passes the infection to the other through hand shake or surface touch, living the bacteria there for another vulnerable person to also touch if the surface is not disinfected with bleach. Studies makes it clear that, the spreads takes effect when disease-causing microorganisms pass from the infected person to the healthy person through direct physical contact such as touching of blood, body fluids, contact with oral secretion, bites kissing, contact with body lesions and even sexual contact. However, measles and chicken pox are said to be conditions spread by direct
As you exit the bus, another passenger next to you starts to cough, and then you hold the handrail as you exit the bus. Since you’re late getting home, you take a shortcut through a field to get home quicker. These three simple acts just exposed you to bacteria, viruses, and insects that could cause illness or even death. Infectious diseases, also known as communicable disease, are spread by germs. Germs are living things that are found in the air, in the soil, and in water. You can be exposed to germs in many ways, including touching, eating, drinking or breathing something that contains a germ. Animal and insect bites can also spread germs.1
Throughout history there have been very dangerous diseases that have been able to single handedly wipe out entire civilizations because there was nothing that we could do about it. Most of the time was because we did not quite understand what was actually happening. But thanks to all of the scientific advancements humans are able to live many more times than previous years. But that doesn’t meant that every human is healthy enough. This means that although we are less prone to die from some infectious diseases, we now have other risk for example not keeping up with a healthy diet is one of the many reasons why there are so many premature deaths. Now if you don’t get treated right away it can get worst the longer you get and sometimes it can also be fatal. One of those is Meningitis which is something very serious that if it doesn’t get treated it can lead to very serious complications in the long run or even death depending on the case. The reason why I chose this one was because when I was in high school I suffered from some...
The following case study is about a lab technician who got in contact with a patients spinal fluids and began felling different symptoms like chills, fever, nausea, even had purple-red lesions on his or her neck and extremities, also throat culture grew gram-negative diplococci. From reading the case study again, I realized that the lab technician had purple-red lesions and also had something to do with spinal fluids which strongly prompt me to lead towards Meningococcemia infection. Meningococcemia infection is a serious disease that can effect the whole body but particularly the limbs and brain. Most patients with Meningococcemia may present Meningitis alone, these symptoms may include headache, sore throat, nausea and purpuric lesions all over the body. Meningitis is a disease that is the immflamuation of
Malaria (also called biduoterian fever, blackwater fever, falciparum malaria, plasmodium, Quartan malaria, and tertian malaria) is one of the most infectious and most common diseases in the world. This serious, sometimes-fatal disease is caused by a parasite that is carried by a certain species of mosquito called the Anopheles. It claims more lives every year than any other transmissible disease except tuberculosis. Every year, five hundred million adults and children (around nine percent of the world’s population) contract the disease and of these, one hundred million people die. Children are more susceptible to the disease than adults, and in Africa, where ninety percent of the world’s cases occur and where eighty percent of the cases are treated at home, one in twenty children die of the disease before they reach the age of five. Pregnant women are also more vulnerable to disease and in certain parts of Africa, they are four times as likely to contract the disease and only half as likely to survive it.
Luckily however, South Africa has the most active surveillance of antibiotic resistance of any other African country (SAMJ, 2011), so this country has a strong fighting-chance in stopping ‘the rise of the Superbug’. The South African government must take drastic measures in promoting effective antibiotic use as we cannot revert to a Pre-WW2 scenario of non-effective antibiotics!
Dr. S.M. Shamim ul Moula, “Fighting Disease” May 9, 2001 African Networks for health research and development; retrieved Dec. 9, 2003 http://www.afronets.org/archive/200105/msg00035.php
There are numerous public health problems that can be addressed in my Southside of Chicago community. Among the several public health problems facing my Southside of Chicago community there are two that are more urgent. Health education or one might say lack thereof is a problem that needs to be addressed. My community is plagued with many of the residents suffering from high blood pressure, diabetes, and the killer virus known as HIV. In most cases these conditions can be prevented with healthier lifestyles and access to nutritious organic foods. In addition, environmental health is another urgent problem my community is facing. Access to clean, safe water and air is supposed to be a fundamental human right aimed at a healthy environment. Yet, my community consists a waste contaminated beach, numerous deteriorated building that are still occupied, and a countless number of restaurant and stores supplying our residents with services that are endangering their health.
I have always been intrigued by the field of science and that is the reason I pursued the field of Biochemistry for my undergraduate studies. How The Human body works and the different determinants that can affect one's health or a community as a whole have always been captivating to me. I wanted to emerge in a profession that is beneficial for me, my community, and the world I live in. I came to realize through various science courses and health care experiences that a career in health care was the best path for me to outreach my community and the world.