Skip to main content
SpringerLink
Log in

Meningococcemia

  • Chapter
Critical Care Infectious Diseases Textbook

  • 477 Accesses

Abstract

Meningococcemia literally means the presence and isolation of Neisseria meningitidis in the blood of a patient. Although it is an invariable phenomenon in the pathogenesis of meningococcal disease, it may in itself dominate the clinical picture. The clinical spectrum of meningococcemia ranges from a clinically inapparent, mostly oligo-symptomatic bacteremia as in benign or inapparent meningococcemia to overwhelming cases with early multiple-organ failure as in fulminant meninococcemia. There are few diseases which cause as much social alarm as meningococcal disease on being detected in a community. Fear of infection is justified by its sudden onset, the speed with which it spreads in the community, the fulminating evolution of some patients and its mortality. N. meningitidis can cause death within a few hours of the first symptoms, in a way unlike any other micoorganism [1].

“No microbe can kill more quickly” Harry A Feldman, 1979.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 379.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Apicella MA. Neisseria meningitidis. In Mandell GL, Bennett JE, Dolin R (eds). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 5th edn, Vol. 2, Philadelphia: Churchill Livingstone, 2000: 2228.

    Google Scholar 

  2. Knapp JS, Rice RJ. Neisseria and Branhamella. In Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds). Manual of Clinical Microbiology. 6th edn, Washington, DC: American Society for Microbiology Press, 1995: 324.

    Google Scholar 

  3. Frasch CE, Zollinger WD, Poolman JT. Serotype antigens of Neisseria meningitidis and a proposed scheme for designation of serotypes. Rev Infect Dis 7:504, 1985.

    Article  PubMed  CAS  Google Scholar 

  4. Broud DD, Griffiss JM, Baker CJ. Heterogenity of serotypes of Neisseria meningitidis that cause endemic disease. J Infect Dis 140:465, 1979.

    Article  PubMed  CAS  Google Scholar 

  5. Mandrell RE, Zollinger WD. Lipopolysaccharide serotyping of Neisseria meningitidis by hemagglutination inhibition. Infect Immun 16:471, 1977.

    PubMed  CAS  Google Scholar 

  6. Jennings HL, Johnson KG, Kenne L. The structure of the R-type oligosaccharide core obtained from some lipopolysaccharides of Neisseria meningitidis. Carbohydrate Res 121:233, 1983.

    Article  CAS  Google Scholar 

  7. Gamian A, Beurret M, Michon F, et al. Structure of the L2 lipopolysaccharide core oligosaccharides of Neisseria meningitidis. J Biol Chem 267:922, 1992.

    PubMed  CAS  Google Scholar 

  8. Scholten RJ, Kuipers B, Vankenburg A, Dankert J, Zollinger WD, Poolman JT. Lipooligosaccharide immunotyping of Neisseria meningitidis by a whole-cell ELISA with monoclonal antibodies. J Med Microbiol 41:236, 1994.

    Article  PubMed  CAS  Google Scholar 

  9. Stephens DS, Whitney AM, Rothbard j, Schoolnik GK. Pili of Neisseria meningitidis: analysis of structure and investigation of structural and antigenic relationship to gonococcal pili. J Exp Med 161:1539, 1985.

    Article  PubMed  CAS  Google Scholar 

  10. Caugant DA. Population genetics and molecular epidemiology of Neisseria meningitidis. APMIS 106:505, 1998.

    Article  PubMed  CAS  Google Scholar 

  11. Selander RK, Caugant DA, Ochman H, et al. Methods of multilocus enzyme electrophoresis for bacterial populations genetics and system-atics. Appl Environ Microbiol 132:2855, 1986.

    Google Scholar 

  12. Fox AJ, Jones DM, Gray SJ, Caugant DA, Saunders NA. An epidemiologically valuable typing method for Neisseria meningitidis by analysis of restriction fragment length polymorphisms. J Med Microbiol 34:265, 1991.

    Article  PubMed  CAS  Google Scholar 

  13. Bjorvatn B, Hassan-King B, Greenwood B, Haimanot RT, Fekade D, Sperber G. DNA fingerprinting in the epidemiology of African serogroup A Neisseria meningitidis. Scand J Infect Dis 24:323, 1992.

    Article  PubMed  CAS  Google Scholar 

  14. Woods JP, Kersulyte D, Tolan RW Jr, Berg CM, Berg DE. Use of arbitrarily primed polymerase chain reaction analysis to type disease and carrier strains of Neisseria meningitidis isolated during a university outbreak. J Infect Dis 169: 1384, 1994.

    Article  PubMed  CAS  Google Scholar 

  15. Diaz PS. The epidemiology and control of invasive meningococcal disease. Pediatr Infect Dis J 18:633, 1999.

    Article  PubMed  CAS  Google Scholar 

  16. Peltola H. Meningococcal disease: still with us. Rev Infect Dis 5:71, 1983.

    Article  PubMed  CAS  Google Scholar 

  17. Achtman M. Global epidemiology of meningococcal disease. In Cartwright K (ed). Meningococcal disease. Chichester: John Wiley & Sons, 1995: 159.

    Google Scholar 

  18. Lapeyssonnie L. La méningite cerebro-spinale en Afrique. Bull World Health Organ 28 Suppl:1, 1963.

    Google Scholar 

  19. Moore PS. Meningococcal meningitis in subsaharan Africa: a model for epidemic process. Clin Infect Dis 14:515, 1992.

    Article  PubMed  CAS  Google Scholar 

  20. van Deuren M, Brandtzaeg P, van der Meer JW. Update on meningococcal disease with emphasis on pathogenesis and clinical management. Clin Microbiol Rev 13:144, 2000.

    Article  PubMed  Google Scholar 

  21. Moore PS, Reeves MW, Schwartz B, Gellin BG, Broome CV. Intercontinental spread of an epidemic group A Neisseria meningitidis strain. Lancet ii:260, 1989.

    Google Scholar 

  22. Zhu P, Hu X, Xu L. Typing Neisseria meningitidis by analysis of restriction fragment length polymorphisms in the gene encoding the class 1 outer membrane protein: application to assessment of epidemics throughout the last 4 decades in China. J Clin Microbiol 33:458, 1995.

    PubMed  CAS  Google Scholar 

  23. Guibourdenche M, Høiby, Riou JY, Varaine F, Joguet C, Caugant DA. Epidemics of serogroup A Neisseria meningitidis of subgroup III in Africa, 1989–94. Epidemiol Infect 116:115, 1996.

    Article  PubMed  CAS  Google Scholar 

  24. McGee L, Koornhof HJ, Caugant DA. Epidemic spread of subgroup III of Neisseria meningitidis serogroup A to South Africa in 1996. Clin Infect Dis 27:1214, 1998.

    Article  PubMed  CAS  Google Scholar 

  25. Moore PS, Harrison LH, Telzak EE, Ajello GW, Broome CV. Group A meningococcal carriage in travelers returning from Saudi Arabia. JAMA 260:2686, 1988.

    Article  PubMed  CAS  Google Scholar 

  26. Stephens DS. Uncloacking the meningococcus: dynamics of carriage and disease. Lancet 353: 941, 1999.

    Article  PubMed  CAS  Google Scholar 

  27. Jones D. Epidemiology of meningococcal disease in Europe and the USA. In Cartwright K (ed). Meningococcal disease. Chichester: John Wiley & Sons, 1995: 147.

    Google Scholar 

  28. Barquet N, Domingo P, Caylà JA, et al. Meningococcal disease in a large urban population (Barcelona, 1987–1992): predictors of dismal prognosis. Arch Intern Med 159:2329, 1999.

    Article  PubMed  CAS  Google Scholar 

  29. Schwartz B, Moore PS, Broome CV. Global epidemiology of meningococcal disease. Clin Microbiol Rev 2 Suppl:S118, 1989.

    Google Scholar 

  30. Osler W. Special discussion on the epidemiology of cerebrospinal meningitis. Proc Roy Soc Med 8:41, 1915.

    Google Scholar 

  31. Goldschneider I, Gotschlich EC, Artenstein MS. Human immunity to the meningococcus: I. The role of humoral antibodies. J Exp Med 129:1307, 1969.

    Article  PubMed  CAS  Google Scholar 

  32. Bevanger L, Bergh K, Gisnås G, Caugant DA, Frøholm LO. Identification of nasopharyngeal carriage of an outbreak strain of Neisseria meningitidis by pulsed-field gel electrophoresis versus phenotypic methods. J Med Microbiol 47:993, 1998.

    Article  PubMed  CAS  Google Scholar 

  33. Cartwright KA, Stuart JM, Jones DM, Noah ND. The Stonehouse survey: nasopharyngeal carriage of meningococci and Neisseria lactamica. Epidemiol Infect 99:591, 1987.

    Article  PubMed  CAS  Google Scholar 

  34. Caugant DA, Høiby EA, Magnus P, et al. Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population. J Clin Microbiol 32:323, 1994.

    PubMed  CAS  Google Scholar 

  35. Caugant DA, Kristiansen BE, Frøholm LO, Bovre K, Seiander RK. Clonal diversity of Neisseria meningitidis from a population of asymptomatic carriers. Infect Immun 56:2060, 1988.

    PubMed  CAS  Google Scholar 

  36. Goldschneider I, Gotschlich EC, Artenstein MS. Human immunity to the meningococcus: II. Development of natural immunity. J Exp Med 129:1327, 1969.

    Article  PubMed  CAS  Google Scholar 

  37. Pether JV, Lightfood NF, Scott RJ, Morgan J, Steele-Perkins AP, Sheard SC. Carriage of Neisseria meningitidis: investigations in a military establishment. Epidemiol Infect 101:21, 1988.

    Article  PubMed  CAS  Google Scholar 

  38. Tappero JW, Reporter R, Wenger JD, et al. Meningococcal disease in Los Angeles County, California, and among men in the county jails. N Engl J Med 335:833, 1996.

    Article  PubMed  CAS  Google Scholar 

  39. Edwards EA, Devine LF, Sengbusch GH, Ward HW. Immunological investigations of meningococcal disease: III. Brevity of group C acquisition prior to disease occurrence. Scand J Infect Dis 9:105, 1977.

    PubMed  CAS  Google Scholar 

  40. Marks MI, Frasch CE, Shapera RM. Meningococcal colonization and infection in children and their household contacts. Am J Epidemiol 109:563, 1979.

    PubMed  CAS  Google Scholar 

  41. Broome CV. The carrier state: Neisseria meningitidis. J Antimicrob Chemother 18 Suppl A:25, 1986.

    PubMed  Google Scholar 

  42. Cartwright K. Meningococcal carriage and disease. In Cartwright K (ed). Meningococcal disease. Chichester: John Wiley & Sons, 1995: 115.

    Google Scholar 

  43. Kasper DL, Winkelhake JL, Zollinger WD, et al. Immunochemical similarity between polysaccharide antigens of Escherichia coli 07:K1(L):NM and group B Neisseria meningitides. J Immunol 110:262, 1973.

    PubMed  CAS  Google Scholar 

  44. Vann WF, Liu TY, Robbins JB. Bacilluspumilus polysaccharide cross-reactive with meningococcal group A polysaccharide. Infect Immun 13: 1654, 1976.

    PubMed  CAS  Google Scholar 

  45. Platonov AE, Shipulin GA, Vershinina IV, Dankert J, van de Winkel JGJ, Kuijper EJ. Association of human Fc gamma RIIa (CD32) polymorphism with susceptibility to and severity of meningococcal disease. Clin Infect Dis 27:746, 1998.

    Article  PubMed  CAS  Google Scholar 

  46. Ross SC, Densen P. Complement deficiency states and infection: epidemiology, pathogenesis and consequences of neisserial and other infections in an immune deficiency. Medicine (Baltimore) 63:243, 1984.

    CAS  Google Scholar 

  47. DeVoe IW. The meningococcus and mechanisms of pathogenicity. Microbiol Rev 46:162, 1982.

    PubMed  CAS  Google Scholar 

  48. Quagliarello V, Scheid WM. Bacterial meningitis: pathogenesis, pathophysiology, and progress. N Engl J Med 327:862, 1992.

    Google Scholar 

  49. Andersen J, Berthelsen L, Bech-Jensen B, Lind I. Dynamics of the meningococcal carrier state and characteristics of the carrier strains: a longitudinal study within three cohorts of military recruits. Epidemiol Infect 121:85, 1998.

    Article  PubMed  CAS  Google Scholar 

  50. Griffiss JMcL, Brandt BL, Jarvis GA. Natural immunity to Neisseria meningitidis. In Vedros NA (ed). Evolution of meningococcal disease. Vol. 2. Boca Raton: CRC Press, 1987: 99.

    Google Scholar 

  51. Haneberg B, Tønjum T, Rodahl K, Gedde Dahl TW. Factors preceding the onset of meningococcal disease, with special emphasis on passive smoking, stressful events, physical fitness and general symptoms of ill health. NIPH Ann 6:169, 1983.

    PubMed  CAS  Google Scholar 

  52. Stuart JM, Cartwright KAV, Robinson PM, Noah ND. Effect of smoking on meningococcal carriage. Lancet ii:723, 1989.

    Google Scholar 

  53. Stanwell-Smith RE, Stuart JM, Hughes AO, Robinson P, Griffin MB, Cartwright K. Smoking, the environment and meningococcal disease: a case control study. Epidemiol Infect 112:315, 1994.

    Article  PubMed  CAS  Google Scholar 

  54. Fischer M, Hedberg K, Cardosi P, et al. Tobacco smoke as a risk factor for meningococcal disease. Pediatr Infect Dis J 16:979, 1997.

    Article  PubMed  CAS  Google Scholar 

  55. Levitt L, Bond JO, Hall IE, et al. Meningococcal and ECHO-9 meningitis: report of an outbreak. Neurology 20:45, 1970.

    Article  PubMed  CAS  Google Scholar 

  56. Young LS, LaForce FM, Head JJ, Feeley JC, Bennett JV. A simultaneous outbreak of meningococcal and influenza infections. N Engl J Med 287:5, 1972.

    Article  PubMed  CAS  Google Scholar 

  57. Moore PS, Hierholzer J, DeWitt W, et al. Respiratory viruses and mycoplasma as cofactors for epidemic group A meningococcal meningitis. JAMA 264:1271, 1990.

    Article  PubMed  CAS  Google Scholar 

  58. Cartwright KAV, Jones DM, Smith AJ, Stuart JM, Kaczmarski EB, Palmer SR. Influenza A and meningococcal disease. Lancet 338:554, 1991.

    Article  PubMed  CAS  Google Scholar 

  59. Raza MW, El Ahmer OR, Ogilvie MM, et al. Infection with respiratory syncytial virus enhances expression of native receptors for non-pilate Neisseria meningitidis on HEp-2 cells. FEMS Immunol Med Microbiol 23:115, 1999.

    Article  PubMed  CAS  Google Scholar 

  60. Plaut A. Microbial subversion of host defenses. In: Schaechter M, Medoff G, Schlessinger D (eds). Mechanisms on microbial diseases. Baltimore: Williams & Wilkins, 1989: 139.

    Google Scholar 

  61. Klein NJ, Ison CA, Peakman M, et al. The influence of capsulation and lipooligosaccharide structure on neutrophil adhesion molecule expression and endothelial injury by Neisseria meningitidis. J Infect Dis 173:172, 1996.

    Article  PubMed  CAS  Google Scholar 

  62. Schryvers AB, Gonzalez GC. Receptors for transferrin in pathogenic bacteria are specific for the host’s protein. Can J Microbiol 36:145, 1990.

    Article  PubMed  CAS  Google Scholar 

  63. Pettersson A, Poolman JT, van der Ley P, Tommassen J. Response of Neisseria meningitidis to iron limitation. Antonie van Leeuwenhoek 71:129, 1997.

    Article  PubMed  CAS  Google Scholar 

  64. Gold R, Goldschneider I, Lepow ML, Draper TF, Randolph M. Carriage of Neisseria meningitidis and Neisseria lactamica in infants and children. J Infect Dis 137:112, 1978.

    Article  PubMed  CAS  Google Scholar 

  65. Jones GR, Christodoulides M, Brooks JL, Miller AR, Cartwright KA, Heckeis JE. Dynamics of carriage of Neisseria meningitidis in a group of military recruits: subtype stability and specifity of the immune response following colonization. J Infect Dis 178:451, 1998.

    Article  PubMed  CAS  Google Scholar 

  66. van de Winkel JGJ, Anderson CL. Biology of human immunoglobulin G Fe receptors. J Leukocyte Biol 49:511, 1991.

    PubMed  Google Scholar 

  67. van de Winkel JGJ, Capel PJA. Human IgG Fc receptor heterogeneity molecular aspects and clinical implication. Immunol Today 14:215, 1993.

    Article  PubMed  Google Scholar 

  68. Gessner JE, Heiken H, Tamm A, Schmidt RE. The IgG Fc receptor family. Ann Hematol 76:231, 1998.

    Article  PubMed  CAS  Google Scholar 

  69. Salmon JE, Edberg JC, Brogie NL, Kimberly RP. Allelic polymorphisms of human Fey receptor IIA and Fey receptor HIB: independent mechanisms for differences human phagocyte function. J Clin Invest 89:1274, 1992.

    Article  PubMed  CAS  Google Scholar 

  70. de Kleijn ED, Hazelzet JA, Kornelisse RF, de Groot R. Pathophysiology of meningococcal sepsis in children. Eur J Pediatr 157:869, 1998.

    Article  PubMed  Google Scholar 

  71. van Gorp ECM, Suharti C, ten Cate H, et al. Infectious diseases and coagulation disorders. J Infect Dis 180:176, 1999.

    Article  PubMed  Google Scholar 

  72. Brandtzaeg P, Kierulf P, Gaustad P, et al. Plasma endotoxin as a predictor of multiple organ failure and death in systemic meningococcal disease. J Infect Dis 159:195, 1989.

    Article  PubMed  CAS  Google Scholar 

  73. Girardin E, Grau GE, Dayr JM, et al. Tumor necrosis factor and interleukin-1 in the serum of children with severe infectious purpura. N Engl J Med 319:397, 1988.

    Article  PubMed  CAS  Google Scholar 

  74. Brandtzaeg P, Mollnes TE, Kierulf P. Complement activation and endotoxin levels in systemic meningococcal disease. J Infect Dis 160: 58, 1989.

    Article  PubMed  CAS  Google Scholar 

  75. Nadel S, Newport MJ, Booy R, Levin M. Variation in the tumor necrosis factor-OC promoter region may be associated with death from meningococcal disease. J Infect Dis 174:878, 1996.

    Article  PubMed  CAS  Google Scholar 

  76. Westendorp RGJ, Langermans JAM, Huizinga TWJ, et al. Genetic influence on cytokine production and fatal meningococcal disease. Lancet 349:170, 1997.

    Article  PubMed  CAS  Google Scholar 

  77. Hermans PWM, Hibberd ML, Booy R, et al 4G/5G promoter polymorphism in the plasminogen-activator-inhibitor-1 gene and outcome of meningococcal disease. Lancet 354:556, 1999.

    Article  PubMed  CAS  Google Scholar 

  78. Westendorp RGJ, Hottenga JJ, Slagboom PE. Variation in plasminogen-activator-inhibitor-1 gene and risk of meningococcal septic shock. Lancet 354:561, 1999.

    Article  PubMed  CAS  Google Scholar 

  79. Gold R. Clinical aspects of meningococcal disease. In Vedros NA (ed). Evolution of meningococcal disease. Vol. 2. Boca Raton: CRC Press, 1987: 69.

    Google Scholar 

  80. Kingston ME, Mackey D. Skin clues in the diagnosis of life-threatening infections. Rev Infect Dis 8:1, 1986.

    Article  PubMed  CAS  Google Scholar 

  81. Barquet N, Domingo P, Caylà JA, et al. Prognostic factors in meningococcal disease: development of a bedside predictive model and scoring system. JAMA 278:491, 1997.

    Article  PubMed  CAS  Google Scholar 

  82. Böhm N. Adrenal, cutaneous and myocardial lesions in fulminating endotoxinemia (Waterhouse-Friderichsen syndrome). Pathol Res Pract 174:92, 1982.

    Article  PubMed  Google Scholar 

  83. Hardman JM, Earle KM. Meningococcal infections: a review of 200 fatal cases. J Neuropathol Exp Neurol 26:119, 1967.

    PubMed  CAS  Google Scholar 

  84. Levin S, Painter MB. The treatment of acute meningococcal infection in adults. Ann Intern Med 64:1049, 1966.

    Article  PubMed  CAS  Google Scholar 

  85. Gore I, Saphir Q. Myocarditis, a classification of 1402 cases. Am Heart J 34:827, 1947.

    Article  PubMed  CAS  Google Scholar 

  86. Hardman JM. Fatal meningococcal infections: the changing pathologic picture in the ‘60’s. Milit Med 133:951, 1968.

    CAS  Google Scholar 

  87. Wolfe RE, Birbara CA. Meningococcal infections at an army training center. Am J Med 44:243, 1968.

    Article  Google Scholar 

  88. Sullivan TD, LaScolea LJ. Neisseria meningitidis bacteremia in children: quantitation of bacteremia and spontaneous clinical recovery without antibiotic therapy. Pediatrics 80:63, 1987.

    PubMed  CAS  Google Scholar 

  89. Frank ST, Gómez RM. Chronic meningococcemia. Milit Med 133:918, 1968.

    CAS  Google Scholar 

  90. Saslaw S. Chronic meningococcemia: report of a case. N Engl J Med 266:605, 1962.

    Article  PubMed  CAS  Google Scholar 

  91. Rompalo AM, Hood EW, Roberts PL, et al. The acute arthritis dermatitis syndrome: the changing importance of Neisseria gonorrhoeae and Neisseria meningitidis. Arch Intern Med 147:281, 1987.

    Article  PubMed  CAS  Google Scholar 

  92. Barquet N, Gasser I, Domingo P, Moraga FA, Macaya A, Elcuaz R. Primary meningococcal conjunctivitis: report of 21 patients and review. Rev Infect Dis 12:838, 1990.

    Article  PubMed  CAS  Google Scholar 

  93. Koppes GM, Ellenbogen C, Gebhart RJ. Group Y meningococcal disease in United States Air Force recruits. Am J Med 62:661, 1977.

    Article  PubMed  CAS  Google Scholar 

  94. Riordan FAI, Thomson APJ, Sills JA, Hart CA. Who spots the spots? Diagnosis and treatment of early meningococcal disease in children. BMJ 313:1255, 1996.

    Article  PubMed  CAS  Google Scholar 

  95. Granier S, Owen P, Pill R, Jacobson L. Recognising meningococcal disease in primary care: qualitative study of how general practitioners process clinical and contextual information. BMJ 316:276, 1998.

    Article  PubMed  CAS  Google Scholar 

  96. Meningococcal Disease Surveillance Group. Analysis of endemic meningococcal disease by serogroup and evaluation of chemoprophylaxis. J Infect Dis 134:201, 1976.

    Article  Google Scholar 

  97. Hoyne AL, Brown RH. 727 meningococcic cases: an analysis. Ann Intern Med 28:248, 1948.

    Article  PubMed  CAS  Google Scholar 

  98. Domingo P, Mancebo J, Blanch L, Coll P, Net A, Nolla J. Bacterial meningitis with “normal” cerebrospinal fluid in adults: a report of five cases. Scand J Infect Dis 22:115, 1990.

    Article  PubMed  CAS  Google Scholar 

  99. Cartwright KAV. Early management of meningococcal disease. Infect Dis Clin North Am 13:661, 1999.

    Article  PubMed  CAS  Google Scholar 

  100. Jochmann G. Versuche zur serodiagnostik und serotherapie der epidemischen genickstarre. Dtsch Med Wochenschr 32:788, 1906.

    Article  Google Scholar 

  101. Flexner S, Jobling JW. An analysis of four hundred cases of epidemic meningitis treated with the anti-meningitis serum. J Exp Med 10:690, 1908.

    Article  PubMed  CAS  Google Scholar 

  102. Schwentker FF, Gelman S, Long PH. The treatment of meningococcic meningitis with sulfanilamide: preliminary report. JAMA 108: 1407, 1937.

    Article  CAS  Google Scholar 

  103. Rosenberg DH, Arling PA. Penicillin in the treatment of meningitis. JAMA 125:1011, 1944.

    Article  Google Scholar 

  104. Scheid WM, Mandell GL. Sulfonamides and meningitis. JAMA 251:791, 1984.

    Article  Google Scholar 

  105. Sáez-Nieto JA, Lujan R, Berrón S, et al. Epidemiology and molecular basis of penicillin-resistant Neisseria meningitidis in Spain: a 5-year history (1985–1989). Clin Infect Dis 14:394, 1992.

    Article  PubMed  Google Scholar 

  106. Sutcliffe EM, Jones DM, El-Sheikh S, Percival A. Penicillin-insensitive meningococci in the UK. Lancet i:657, 1988.

    Google Scholar 

  107. Botha P. Penicillin-resistant Neisseria meningitidis in Southern Africa. Lancet i:54, 1988.

    Google Scholar 

  108. Dillon JR, Paizé M, Yeung KH. Spread of penicillinase-producing and transfer plasmids from the gonococcus to Neisseria meningitidis. Lancet i:779, 1983.

    Google Scholar 

  109. Hieber JP, Nelson JD. A pharmacologic evaluation of penicillin in children with purulent meningitis. N Engl J Med 297:410, 1977.

    Article  PubMed  CAS  Google Scholar 

  110. Abramson JS, Spika JS. Persistence of Neisseria meningitidis in the upper respiratory tract after intravenous antibiotic therapy for systemic meningococcal disease. J Infect Dis 151:370, 1985.

    Article  PubMed  CAS  Google Scholar 

  111. Meningococcal Disease Surveillance Group. Meningococcal disease: secondary attack rate and chemoprophylaxis in the United States, 1974. JAMA 235:261, 1976.

    Article  Google Scholar 

  112. Voss L, Lennon D. Epidemiology, management, and prevention of meningococcal infections. Curr Opin Pediatr 6:23, 1994.

    Article  PubMed  CAS  Google Scholar 

  113. Älvarez F, Aguilera A, García-Gago M. Effect of chemoprophylaxis on the meningococcal carrier state after infection. Pediatr Infect Dis J 10:700, 1991.

    Google Scholar 

  114. Weis N, Lind I. Pharyngeal carriage of Neisseria meningitidis before and after treatment of meningococcal disease. J Med Microbiol 41: 339, 1994.

    Article  PubMed  CAS  Google Scholar 

  115. Grubbauer HM, Dornbusch HJ, Weippli G, et al. Ceftriaxone monotherapy for bacterial meningitis in children. Chemotherapy 36:441, 1990.

    Article  PubMed  CAS  Google Scholar 

  116. Neu HC. Cephalosporins in the treatment of meningitis. Drugs 34(Suppl 2): 135, 1987.

    Article  PubMed  Google Scholar 

  117. Shaad UB, Krucko J, Pfenninger J. An extended experience with cefuroxime therapy of childhood bacterial meningitis. Pediatr Infect Dis 3:410, 1984.

    Article  Google Scholar 

  118. Begg N. Reducing mortality from meningococcal disease. BMJ 305:133, 1992.

    Article  PubMed  CAS  Google Scholar 

  119. Strang JR, Pugh EJ. Meningococcal infections: reducing the case fatality rate by giving penicillin before admission to hospital. BMJ 305: 141, 1992.

    Article  PubMed  CAS  Google Scholar 

  120. Cartwright K, Reilly S, White D, Stuart J. Early treatment with parenteral penicillin in meningococcal diseases. BMJ 305:143, 1992.

    Article  PubMed  CAS  Google Scholar 

  121. Palmer SR, Corson J, Hall R, et al. Meningococcal disease in Wales: clinical features, outcome and public health management. J Infect 25:321, 1992.

    Article  PubMed  CAS  Google Scholar 

  122. Woodward CM, Jessop EG, Wale MC. Early management of meningococcal disease. Commun Dis Rep Rev 5:R135, 1995.

    Google Scholar 

  123. Wilks D, Lever AMM. Reasons for delay in administration of antibiotics to patients with meningitis and meningococcaemia. J Infect 32:49, 1996.

    Article  PubMed  CAS  Google Scholar 

  124. Jacobs RF, Sowell MK, Moss MM, Fiser DH. Septic shock in children: bacterial etiologies and temporal relationships. Pediatr Infect Dis J 9:196, 1990.

    Article  PubMed  CAS  Google Scholar 

  125. van Deuren M, Neeleman C, van’t Hek LGFM, van der Meer JWM. A normal platelet count at admission in acute meningococcal disease does not exclude a fulminant course. Intensive Care Med 24:157, 1998.

    Article  PubMed  Google Scholar 

  126. Mercier JC, Beaufils F, Hartmann JF, Azema D. Hemodynamic patterns of meningococcal shock in children. Crit Care Med 16:27, 1988.

    Article  PubMed  CAS  Google Scholar 

  127. Kennedy NJ, Duncan AW. Acute meningococ-caemia: recent advances in management (with particular reference to children). Anaesth Intensive Care 24:197, 1996.

    PubMed  CAS  Google Scholar 

  128. Kirsch EA, Barton RP, Kitchen L, Giroir BR Pathophysiology, treatment and outcome of meningococcemia: a review and recent experience. Pediatr Infect Dis J 15:967, 1996.

    Article  PubMed  CAS  Google Scholar 

  129. Hodgetts TJ, Brett A, Castle N. The early management of meningococcal disease. J Accid EmergMed 15:72, 1998.

    Article  CAS  Google Scholar 

  130. Waage A, Brandtzaeg P, Halstensen A, et al. The complex pattern of cytokines in serum from patients with meningococcal septic shock. J Exp Med 169:333, 1989.

    Article  PubMed  CAS  Google Scholar 

  131. Prins JM, Lauw FN, Derkx BH, et al. Endotoxin release and cytokine production in acute and chronic meningococcaemia. Clin Exp Immunol 114:215, 1998.

    Article  PubMed  CAS  Google Scholar 

  132. Nassif X, Mathison JC, Wolfson E, Koziol JA, Ulevitch RJ, So M. Tumour necrosis factor alpha antibody protects against lethal meningococcaemia. Mol Microbiol 6:591, 1992.

    Article  PubMed  CAS  Google Scholar 

  133. Wester JP, Breumelhof R, Geers AB. Monoclonal antibodies in the treatment of adult fulminant meningococcaemia. Eur J Med 1:372, 1992.

    PubMed  CAS  Google Scholar 

  134. Villard J, Roux-Lombard P, Hugh A, Dayer JM. Could natural inhibitors of tumor necrosis factor-α modify the clinical course of fulminant meningococcemia? Crit Care Med 21:1396, 1993.

    Article  PubMed  CAS  Google Scholar 

  135. Hameter BM, Westra P, van der Zande FL, et al. Immunotherapy with human monoclonal antibody against endotoxin (HA-IA) in meningococcal sepsis/shock. Clin Intensive Care 4:116, 1993.

    Google Scholar 

  136. J5 Study Group. Treatment of severe infectious purpura in children with human plasma from donors immunized with Escherichia coli J5: a prospective double-blind study. J Infect Dis 165:695, 1992.

    Google Scholar 

  137. Derkx B, Wittes J, McCloskey R. Randomized placebo-controlled trial of HA-IA, a human monoclonal anti-endotoxin antibody, in children with meningococcal septic shock. Clin Infect Dis 28:770, 1999.

    Article  PubMed  CAS  Google Scholar 

  138. Riordan FA, Thomson AP, Ratcliffe JM, Sills JA, Diver MJ, Hart CA. Admission Cortisol and adrenocorticotrophic hormone levels in children with meningococcal disease: evidence of adrenal insufficiency? Crit Care Med 27:2257, 1999.

    Article  PubMed  CAS  Google Scholar 

  139. Pollard AJ, Britto J, Nadel S, DeMunter C, Habibi P, Levin M. Emergency management of meningococcal disease. Arch Dis Child 80:290, 1999.

    Article  PubMed  CAS  Google Scholar 

  140. Wajchenberg BC, Lerne CE, Tambascia M, et al. The adrenal response to exogenous adrenocorti-cotropin in patients with infections due to Neisseria meningitidis. J Infect Dis 138:387, 1978.

    Article  PubMed  CAS  Google Scholar 

  141. Corrigan JJ Jr, Jordan CM. Heparin therapy in septicemia with disseminated intravascular coagulation: effect on mortality and on correction of hemostatic defects. N Engl J Med 283:778, 1970.

    Article  PubMed  Google Scholar 

  142. Smith OP, White B, Vaoghan D, et al. Use of protein-C concentrate, heparin and haemo-diafiltration in meningococcus-induced purpura fulminans. Lancet 350:1590, 1997.

    Article  PubMed  CAS  Google Scholar 

  143. Goldman AP, Kerr SJ, Butt W, et al. Extracorporeal support for intractable cardiorespiratory failure due to meningococcal disease. Lancet 349:466, 1997.

    Article  PubMed  CAS  Google Scholar 

  144. Kumar A, Kanagasundaram NS, Collyns TA, Davison AM. Plasma exchange and haemo-diafiltration in fulminant meningococcal sepsis. Nephrol Dial Transplant 13:484, 1998.

    Article  PubMed  CAS  Google Scholar 

  145. Bjorvatn B, Bjertnaes L, Fadnes HO, et al. Meningococcal septicaemia treated with combined plasmapheresis and leucapheresis or with blood exchange. BMJ (Clin Res Ed) 288:439, 1984.

    Article  CAS  Google Scholar 

  146. Drapkin MS, Wisch JS, Gelfand JA, Cannon JG, Dinarello CA. Plasmapheresis for fulminant meningococcemia. Pediatr Infect Dis J 8:399, 1989.

    Article  PubMed  CAS  Google Scholar 

  147. van Deuren M, Santman FW, van Dalen R, Sauerwein RW, Span LF, van der Meer JW. Plasma and whole blood exchange in meningococcal sepsis. Clin Infect Dis 15:424, 1992.

    Article  PubMed  Google Scholar 

  148. Churchwell KB, McManus ML, Kent P, et al. Intensive blood and plasma exchange for treatment of coagulopathy in meningococcemia. J Clin Apheresis 10:171, 1995.

    Article  PubMed  CAS  Google Scholar 

  149. Keeley SR, Matthews NT, Buist M. Tissue plasminogen activator for gangrene in fulminant meningococcaemia. Lancet 337:1359, 1991.

    Article  PubMed  CAS  Google Scholar 

  150. Zenz W, Muntean W. New therapies for severe meningococcal disease. Lancet 351:528, 1998.

    Article  PubMed  CAS  Google Scholar 

  151. Marotto MS, Marotto PC, Sztajnbok J, Seguro AC. Outcome of acute renal failure in meningo-coccemia. Renal Failure 19:807, 1997.

    Article  PubMed  CAS  Google Scholar 

  152. Havens PL, Garland JS, Brook MM, Dewitz BA, Stremski ES, Troshynski TJ. Trends in mortality in children hospitalized with meningococcal infections, 1957 to 1987. Pediatr Infect Dis J 8:8, 1989.

    Article  PubMed  CAS  Google Scholar 

  153. Hart CA, Rogers TRR Meningococcal disease. J Med Microbiol 39:3, 1993.

    Article  PubMed  CAS  Google Scholar 

  154. Cahalane SF, Waters M. Fulminant meningococcal septicaemia: a hospital experience. Lancet ii:120, 1975.

    Google Scholar 

  155. Emparanza JI, Aldamiz-Echevarria L, Perez-Yarza EG, et al. Prognostic score in acute meningococcemia. Crit Care Med 16:168, 1988.

    Article  PubMed  CAS  Google Scholar 

  156. Mok Q, Butt W. The outcome of children admitted to intensive care with meningococcal septicaemia. Intensive Care Med 22:259, 1996.

    Article  PubMed  CAS  Google Scholar 

  157. Stiehm ER, Damrosch DS. Factors in the prognosis of meningococcal infection. J Pediatr 68: 457, 1966.

    Article  PubMed  CAS  Google Scholar 

  158. Niklasson PM, Lundbergh P, Strandell T Prognostic factors in meningococcal disease. Scand J Infect Dis 3:17, 1971.

    PubMed  CAS  Google Scholar 

  159. Kahn A, Blum D. Factors for poor prognosis in fulminating meningococcemia: conclusions from observations of 67 childhood cases. Clin Pediatr (Phila) 17:680, 1978.

    Article  CAS  Google Scholar 

  160. Vik-Mo H, Lote K, Nordøy A. Disseminated intravascular coagulation in patients with meningococcal infection: laboratory diagnosis and prognostic factors. Scand J Infect Dis 10:187, 1978.

    PubMed  CAS  Google Scholar 

  161. Lewis LS. Prognostic factors in acute meningococcemia. Arch Dis Child 54:44, 1979.

    Article  PubMed  CAS  Google Scholar 

  162. Gårdlund B. Prognostic evaluation in meningococcal disease. Intensive Care Med 12:302, 1986.

    Article  PubMed  Google Scholar 

  163. Sinclair JF, Skeoch CH, Hallworth D. Prognosis of meningococcal septicaemia. Lancet ii:38, 1987.

    Google Scholar 

  164. Gedde-Dahl TW, Bjark P, Høiby EA, Høst JH, Bruun JN. Severity of meningococcal disease: assessment by factors and scores and implications for patient management. Rev Infect Dis 12:973, 1990.

    Article  PubMed  CAS  Google Scholar 

  165. Giraud T, Dhainaut JF, Schremmer B, et al. Adult overwhelming meningococcal purpura: a study of 35 cases, 1977–1989. Arch Intern Med 151:310, 1991.

    Article  PubMed  CAS  Google Scholar 

  166. Thomson APJ, Sills JA, Hart CA. Validation of the Glasgow Meningococcal Septicemia Prognostic Score: a 10-year retrospective survey. Crit Care Med 19:26, 1991.

    Article  PubMed  CAS  Google Scholar 

  167. Busund R, Stamme B, Revhaug A. Fatal course in severe meningococcemia: clinical predictors and effect of transfusion therapy. Crit Care Med 21:1699, 1993.

    Article  PubMed  CAS  Google Scholar 

  168. Edwards MS, Baker CJ. Complications and sequelae of meningococcal infections in children. J Pediatr 99:540, 1981.

    Article  PubMed  CAS  Google Scholar 

  169. Genoff MC, Hoffer MM, Achauer B, Formosa P. Extremity amputations in meningococcemia-induced purpura fulminans. Plast Reconstr Surg 89:878, 1992.

    Article  PubMed  CAS  Google Scholar 

  170. Harris NJ, Gosh M. Skin and extremity loss in meningococcal septicaemia treated in a burn unit. Burns 20:471, 1994.

    Article  PubMed  CAS  Google Scholar 

  171. Huang S, Clarkle JA. Severe skin loss after meningococcal septicaemia: complications and treatment. Acta Pediatr 86:1263, 1997.

    Article  CAS  Google Scholar 

  172. De Wals P, Hertoghe L, Borlée-Grimée I, et al. Meningococcal disease in Belgium: secondary attack rate among household, day-care nursery and pre-elementary school contacts. J Infect 3(Suppl 1):53, 1981.

    Article  PubMed  Google Scholar 

  173. Cooke RPD, Riordan T, Jones DM, Painter MJ. Secondary cases of meningococcal infection among close family and household contacts in England and Wales, 1984-7. BMJ 298:555, 1989.

    Article  PubMed  CAS  Google Scholar 

  174. Schwartz B. Chemoprophylaxis for bacterial infections: principle of and application to meningococcal infections. Rev Infect Dis 13(Suppl 2):S170, 1991.

    Article  Google Scholar 

  175. Jones DM. Control of meningococcal disease: chemoprophylaxis for some carriers and some contact groups. BMJ 298:542, 1989.

    Article  PubMed  CAS  Google Scholar 

  176. Pugsley MP, Dworzack DL, Horowitz EA, Cuevas TA, Sanders WE, Sanders CC. Efficacy of ciprofloxacin in the treatment of nasopharyngeal carriers of Neisseria meningitidis. J Infect Dis 156:211, 1987.

    Article  PubMed  CAS  Google Scholar 

  177. Schwartz B, Al-Tobaigi A, Al-Ruwais A, et al. Comparative efficacy of ceftriaxone and rifampicin in eradicating pharyngeal carriage of group A Neisseria meningitidis. Lancet ii.1239, 1988.

    Google Scholar 

  178. Gilja OH, Halstensen A, Didranes A, Mylvaganan H, Aksnes A, Høiby EA. Use of single-dose ofloxacin to eradicate tonsillopha-ryngeal carriage of Neisseria meningitidis. Antimicrob Agents Chemother 37:2024, 1993.

    Article  PubMed  CAS  Google Scholar 

  179. Cuevas LE, Kazembe P, Mughogho GK, et al. Eradication of nasopharyngeal carriage of Neisseria meningitidis in children and adults in rural Africa: a comparison of ciprofloxacin and rifampin. J Infect Dis 171:728, 1995.

    Article  PubMed  CAS  Google Scholar 

  180. Anderson MS, Glodé MP, Smith AL. Meningococcal disease. In Feigin RD, Cherry JD (eds). Textbook of pediatric infectious diseases. 4th edn, Vol. 1. Philadelphia: WB Saunders 1998: 1143.

    Google Scholar 

  181. Foster G, Panigrahi H, Walker M. Failure of chemoprophylaxis to prevent meningococcal disease. BMJ (Clin Res Ed) 292:886, 1986.

    Article  CAS  Google Scholar 

  182. Stuart JM, Cartwright KA, Robinson PM, Noah ND. Does eradication of meningococcal carriage in household contacts prevent secondary cases of meningococcal disease? BMJ 298:569, 1989.

    Article  PubMed  CAS  Google Scholar 

  183. Greenwood BM, Hassan-King M, Whittle HC. Prevention of secondary cases of meningococcal disease in household contacts by vaccination. BMJ 1:1317, 1978.

    Article  PubMed  CAS  Google Scholar 

  184. Høiby EA, Moe PJ, Lystad A, Frøholm LO, Bøvre K. Phenoxymethyl-penicilin treatment of household contacts of patients with meningococcal disease. Antonie van Leeuwen-hoek 52:255, 1986.

    Article  Google Scholar 

  185. Gedde-Dahl TW, Høiby EA, Brandtzaeg P, Eskerud JR, Bøvre K. Some arguments on early hospital admission and treatment of suspected meningococcal disease cases. NIPH Ann 13:45, 1990.

    PubMed  CAS  Google Scholar 

  186. Kristiansen BE, Knapskog AB. Secondary prevention of meningococcal disease: high risk contacts should be given chemoprophylaxis and preventive treatment with penicilin. BMJ 312: 591, 1996.

    Article  PubMed  CAS  Google Scholar 

  187. Gotschlich EC, Goldschneider I, Artenstein MS. Human immunity to the meningococcus. IV. Immunogenicity of group A and group C meningococcal polysaccharides in human volunteers. J Exp Med 129:1367, 1969.

    Article  PubMed  CAS  Google Scholar 

  188. Hankins WA, Gwaltney JM Jr, Hendley JO, Farquhar JD, Samuelson JS. Clinical and serological evaluation of a meningococcal polysaccharide vaccine groups A, C, Y, and W135 (41306). Proc Soc Exp Biol Med 169:54, 1982.

    PubMed  CAS  Google Scholar 

  189. Peltola H, Mäkelä HP, Käyhty H, et al. Clinical efficacy of meningococcus group A capsular polysaccharide vaccine in children three months to five years of age. N Engl J Med 297:686, 1977.

    Article  PubMed  CAS  Google Scholar 

  190. Ceesay SJ, Allen SJ, Menon A, et al. Decline in meningococcal antibody levels in African children 5 years after vaccination and the lack of an effect of booster immunization. J Infect Dis 167:1212, 1993.

    Article  PubMed  CAS  Google Scholar 

  191. Peltola H. Group A meningococcal polysaccharide vaccine and course of the group A meningococcal epidemic in Finland. Scand J Infect Dis 10:41, 1978.

    PubMed  CAS  Google Scholar 

  192. Greenwood BM, Wali SS. Control of meningococcal infection in the African meningitis belt by selective vaccination. Lancet i:729, 1980.

    Google Scholar 

  193. Mohammed I, Zaruba K. Control of epidemic meningococcal infection by mass vaccination. Lancet i:80, 1981.

    Google Scholar 

  194. Binkin N, Band J. Epidemic of meningococcal meningitis in Bamako, Mali: epidemiological features and analysis of vaccine efficacy. Lancet ii:315, 1982.

    Google Scholar 

  195. Cochi SL, Markowitz LE, Joshi DD, et al. Control of epidemic group A meningococcal meningitis in Nepal. Int J Epidemiol 16:91, 1987.

    Article  CAS  Google Scholar 

  196. Masterton RG, Youngs ER, Wardle JC, Croft KF, Jones DM. Control of an outbreak of group C meningococcal meningitis with a polysaccharide vaccine. J Infect 17:177, 1988.

    Article  PubMed  CAS  Google Scholar 

  197. Lennon D, Gellin B, Hood D, Voss L, Heffernan H, Thakur S. Successful intervention in a group A meningococcal outbreak in Auckland, New Zealand. Pediatr Infect Dis J 11:617, 1992.

    PubMed  CAS  Google Scholar 

  198. Rosenstein N, Levine O, Taylor JP, et al Efficacy of meningococcal vaccine and barriers to vaccination. JAMA 279:435, 1998.

    Article  PubMed  CAS  Google Scholar 

  199. Lepow ML, Perkins BA, Hughes PA, Poolman JT. Meningococcal vaccines. In Plotkin SA, Orenstein WA (eds). Vaccines. 3rd edn, Philadelphia: WB Saunders, 1999: 711.

    Google Scholar 

  200. Frasch CE. Vaccines for prevention of meningococcal disease. Clin Microbiol Rev 2(Suppl): S134, 1989.

    Google Scholar 

  201. Poolman JT. Development of a meningococcal vaccine. Infect Agents Dis 4:13, 1995.

    PubMed  CAS  Google Scholar 

  202. Granoff DM, Forrest B, Rappuoli R. Meningococcal polysaccharide-protein conjugate vaccines. Int J Infect Dis 1:152, 1997.

    Article  Google Scholar 

  203. Finne J, Leinonen M, Mäkelä PH. Antigenic similarities between brain components and bacteria causing meningitis: implications for vaccine development and pathogenesis. Lancet ii:355, 1983.

    Google Scholar 

  204. Jennings HJ. N-propionylated group B meningococcal polysaccharide glycoconjugate vaccine against group B meningococcal meningitis. Int J Infect Dis 1:158, 1997.

    Article  Google Scholar 

  205. Sierra CVG, Campa HC, Valcárcel NW. Vaccine against group B Neisseria meningitides: protection trial and mass vaccination results in Cuba. NIPH Ann 14:195, 1991.

    PubMed  CAS  Google Scholar 

  206. Zollinger WD, Boslego J, Moran E, et al. Meningococcal serogroup B vaccine protection trial and follow-up studies in Chile. NIPH Ann 14:211, 1991.

    PubMed  CAS  Google Scholar 

  207. De Moraes JC, Perkins BA, Camargo MCC, et al. Protective efficacy of a serogroup B meningococcal vaccine in Sao Paulo, Brazil. Lancet 340:1074, 1992.

    Article  PubMed  Google Scholar 

  208. Milagres LG, Ramos SR, Sacchi CT, et al. Immune response of Brazilian children to a Neisseria meningitidis serogroup B outer membrane protein vaccine: comparison with efficacy. Infect Immun 62:4419, 1994.

    CAS  Google Scholar 

  209. Boslego J, Garcia J, Cruz C, et al. Efficacy safety, and immunogenicity of a meningococcal group B (15:P1.3) outer membrane protein vaccine in Iquique, Chile. Vaccine 13:821, 1995.

    Article  PubMed  CAS  Google Scholar 

  210. Bjune G, Høiby EA, Grønnesby JK, et al. Effect of outer membrane vesicle vaccine against group B meningococcal disease in Norway. Lancet 388:1093, 1991.

    Article  Google Scholar 

  211. Herbert MA, Heath PT, Mayon-White RT. Meningococcal vaccines for the United Kingdom. Commun Dis Rep CDR Rev 5:R130, 1995.

    Google Scholar 

  212. Cartwright K, Morris R, Rumke H, et al. Immunogenicity and reactogenicity in UK infants of a novel meningococcal vesicle vaccine containing multiple class 1 (PorA) outer membrane proteins. Vaccine 17:2612, 1999.

    Article  PubMed  CAS  Google Scholar 

  213. Haneberg B, Dalseg R, Oftung F, et al. Towards a nasal vaccine against meningococcal disease, and prospects for its use as a mucosal adjuvant. Dev Biol Stand 92:127, 1998.

    PubMed  CAS  Google Scholar 

  214. Haneberg B, Dalseg R, Wedege E, et al. Intranasal administration of a meningococcal outer membrane vesicle vaccine induces persistent local mucosal antibodies and serum antibodies with strong bactericidal activity in humans. Infect Immun 66:1334, 1998.

    PubMed  CAS  Google Scholar 

  215. Oftung F, Naess LM. Wetzler LM, et al. Antigen-specific T-cell responses in humans after intranasal immunization with a meningococcal serogroup B outer membrane vesicle vaccine. Infect Immun 67:921, 1999.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Pere Domingo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicolau Barquet
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Hospital Universitari Joan XXIII, Tarragona, Spain

    Jordi Rello M.D., Ph.D.

  2. University Rovira & Virgili, Tarragona, Spain

    Jordi Rello M.D., Ph.D.

  3. Corporacio Sanitaria Parc Tauli, Sabadell, Barcelona, Spain

    Jordi Valles M.D., Ph.D.

  4. Washington University School of Medicine, St. Louis, Missouri, USA

    Marin H. Kollef M.D.

  5. Barnes-Jewish Hospital, St. Louis, Missouri, USA

    Marin H. Kollef M.D.

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer Science+Business Media New York

About this chapter

Cite this chapter

Domingo, P., Barquet, N. (2001). Meningococcemia. In: Rello, J., Valles, J., Kollef, M.H. (eds) Critical Care Infectious Diseases Textbook. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1679-8_28

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-1679-8_28

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5674-5

  • Online ISBN: 978-1-4615-1679-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation