| Republic of the Philippines
Province of Pangasinan MUNICIPALITY OF CALASIAO MUNICIPAL HEALTH OFFICE |
| MENINGOCOCCEMIA |
| 1. What is meningococcemia disease?
A syndrome comprising meningococcemia and meningococcal meningitis caused by Neisseria Meningitidis (meningococcus), a gram-negative diplococcus. 2. Who do we report as a meningococcemia suspect? A case with sudden onset of high grade fever (38o C and above ) rashes(petechia,purpura,ecchymoses) and rapid deterioration of clinical condition within 24 hours, with or without signs of meningeal irritation, with or without findings of a positive gram stain for gram-negative diplococci from cerebrospinalfluid,blood,or skin lesions. 3. Who do we report as a confirmed case of meningococcemia? A meningococcemia suspect with a positive culture of Neisseria Meningitidis from cerebrospinal fluid (CSF), blood or skin lesions. 4. What is the causative agent? It is caused by bacteria called Neisseria Meningitidis _ a gram-negative diplococcus 5. Who may affect with the disease? This is the disease of very small children. It occurs commonly in children and young adults. In endemic areas, 0.5 to 5 per 100,000 population may be affected in a year. In countries where the disease is endemic, about 5% to 10 % of the population may be symptomatic carriers. 6. How is the disease transmitted? Through direct contact with respiratory secretions from a nasopharyngeal carrier. Infection usually causes only sub clinical infection. Fomite transmission is not significant. 7. How severe is the disease? Case fatality rate (CFR) can be as high as 50% or more but with early diagnosis, modern therapy and supportive measures, the case fatality can be reduced to 5 % to 15 %. CFR for meningococcemia without meningitis is 25% more as compared to meningococcemia meningitis 8. Reservoir or habitat of the organism? Human nasopharynx. Naso Pharyngeal carrier rate varies with age : 0.5 % to 1% in children 3 months to 1 year old;5% in 4-17 years of age;20-40% in young adults. 9. When does the person who is exposed to the organism develop signs and symptoms? Varies from 2 to 10 days commonly b3-4 days. 10. Until when can a person with meningococcemia spread the disease? Until meningococcemia are no longer present in discharges from nose and mouth. Meningococci usually disappear from nasopharynx within 24 hours after institution of treatment with antimicrobial agents. 11. Who will be given prophylaxis? Chemoprophylaxis is given only to intimate contacts. Intimate contacts are household contacts and those who shared eating utensils with a case. ADULTS: rifampicin 600 mg twice a day for 2 days CHILDREN OVER 1 MONTH: 10 mg/kg body weight twice a day for 2 days CHILDRE LESS THAN 1 MONTH: 5 mg/kg. body weight twice a day for 2 days 12. Specific Treatment: Penicillin given parenterally in adequate doses is the drug of choice; Ampicillin and chloramphenicol are also effective. 13. Preventive measures Chemoprophylaxis is indicated only among school/household contacts especially in young children with direct exposure to the secretions of a meningococcemia case through kissing, sharing of utensils or sleeps in the same dwelling in the last seven days. 14. Susceptibility to the clinical disease is low and decreases with age. |
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