Advertisement

Meningococcal Infections

  • Harry A. Feldman

Abstract

The meningococcal diseases* represent a spectrum of illness caused by Neisseria meningitidis. Although sporadic endemic cases occur throughout the world, massive, devastating epidemics tend to reflect conditions of crowding, mobilization, and enclosed institutional populations. Such outbreaks tend to be extraordinarily disruptive, especially because of the fear and fright that they induce in the affected populations. Among civilians, children are most often attacked, with mortality rates of 80–90% having been noted in some epidemics that occurred before effective therapeutic agents became available. The disease is also known as “cerebral spinal fever” and “epidemic cerebral spinal meningitis” and by other names. Mobilization for war, with the induction of many young men into crowded military camps, has generally been accompanied by outbreaks.

Keywords

Carrier State Meningococcal Disease Carrier Rate Neisseria Meningitidis Household Contact 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Alexander, C. E., Sanborn, W. R., Cherriere, G., Crocker, W. H., Jr., Ewald, P. E, and Kay, C. R., Sulfadiazine-resistant Group A Neisseria meningitidis, Science 161:1019 (1968).Google Scholar
  2. 2.
    Apicella, M. A., Lipopolysaccharide-derived serotype polysaccharides from Neisseria meningitidis Group B. J. Infect. Dis. 140:62–72 (1979).PubMedCrossRefGoogle Scholar
  3. 3.
    Arkwright, J. A., Cerebro-spinal meningitis: The interpretation of epidemiological observations by the light of bacteriological knowledge. Br. Med. J. 1:494–496 (1915).PubMedCrossRefGoogle Scholar
  4. 4.
    Artenstein, M. S., Control of meningococcal meningitis with meningococcal vaccines, Yale J. Biol. Med. 48:197–200 (1975).PubMedGoogle Scholar
  5. 5.
    Beeson, P. B., and Westerman, E., Cerebrospinal fever: Analysis of 3,575 case reports with special reference to sulphonamide therapy, Br. Med. J. 1:497–500 (1943) .PubMedCrossRefGoogle Scholar
  6. 6.
    Belcher, D. W., Sherriff, A. C., Nimo, K. P., Chew, G. L. N., Voros, A., Richardson, W. D., and Feldman, H. A., Meningococcal meningitis in northern Ghana: Epidemiology and control measures, Am. J. Trop. Med. Hyg. 26:748–755 (1977).PubMedGoogle Scholar
  7. 7.
    Benenson, A. S., Control of Communicable Diseases in Man, 12th ed., p. 206, American Public Health Association, Washington, D.C., 1975.Google Scholar
  8. 8.
    Blackwell, C., Young, H., and Bain, S. S. R., Isolation of Neisseria meningitidis and Neisseria catarrhalis from the genitourinary tract and anal canal, Br. J. Vener. Dis. 54:41–44 (1978).PubMedGoogle Scholar
  9. 9.
    Bolduan, C., and Goodwin, M. E., A clinical and bacteriological study of the communicability of cerebrospinal meningitis and the probable source of contagion: Part I of an investigation of cerebrospinal meningitis carried out under the auspices of the special commission of the Department of Health of New York City, Med. News 87:1222–1228, 1250–1257 (1905).Google Scholar
  10. 10.
    Branham, S. E., Serological relationships among meningococci, Bacteriol. Rev. 17:175–188 (1953).PubMedGoogle Scholar
  11. 11.
    Carpenter, C. M., and Charles, R., Isolation of meningococcus from the genitourinary tract of seven patients, Am. J. Public Health 32:640–643 (1942).CrossRefGoogle Scholar
  12. 12.
    Cheever, F. S., The control of meningococcal meningitis by mass chemoprophylaxis with sulfadiazine, Am. J. Med. Sci. 209:74–75 (1945).CrossRefGoogle Scholar
  13. 13.
    Cheever, F. S., Breese, B. B., and Upham, H. C., The treatment of meningococcus carriers with sulfadiazine, Ann. In tern . Med. 19:602–608 (1943).Google Scholar
  14. 14.
    Corfield, W. F., Multiple attacks of cerebrospinal fever, Lancet 1:402–403 (1945).CrossRefGoogle Scholar
  15. 15.
    Daniels, W. B., Solomon, S., and Jaquette, W. A., Jr., Meningococcic infections in soldiers, J. Am. Med. Assoc. 123:1–9 (1943).CrossRefGoogle Scholar
  16. 16.
    Danielson, L., and Mann, E., The history of a singular and very mortal disease, which lately made its appearance in Medfield, Med. Agric. Register 1:65–69 (1806) .Google Scholar
  17. 17.
    Devine, L. F., Johnson, D. P., Hagerman, C. R., Pierce, W. E., Rhode, S. L., Iii, and Peckinpaugh, R. O., The effect of minocycline on meningococcal nasopharyngeal carrier state in naval personnel, Am. J. Epidemiol. 93:337–345 (1971).PubMedGoogle Scholar
  18. 18.
    Dingle, J. H., and Finland, M., Diagnosis, treatment and prevention of meningococcic meningitis, with a resume of the practical aspects of treatment of other acute bacterial meningitides, War Med. 2:1–58 (1942) .Google Scholar
  19. 19.
    Dingle, J. H., Thomas, L., and Morton, A. R., Treatment of meningococcic meningitis and meningococcemia with sulfadiazine, J. Am. Med. Assoc. 116:2666–2668 (1941) .CrossRefGoogle Scholar
  20. 20.
    Drew, T. M., Altman, R., Black, K., and Goldfield, M., Minocycline for prophylaxis of infection with Neisseria meningitidis: High rate of side effects in recipients, J. Infect. Dis. 133:194–198 (1976).PubMedCrossRefGoogle Scholar
  21. 21.
    Dudley, S. F., and Brennan, J. R., High and persistent carrier rates of Neisseria meningitidis, unaccompanied by cases of meningitis, J. Hyg. 34:525–541 (1934).CrossRefGoogle Scholar
  22. 22.
    Eschenbach, D. A., Buchanan, T. M., Pollock, H. M., Forsyth, P. S., Alexander, E. R., Lin, J.-S., Wang, S.-P., Wentworth, B. B., Mccormack, W. M., and Holmes, K. K., Polymicrobial etiology of acute pelvic inflammatory disease, N. Engl. J. Med. 293:166–171 (1975).PubMedCrossRefGoogle Scholar
  23. 23.
    Evans, J. R., Artenstein, M. S., and Hunter, D. H., Prevalence of meningococcal serogroups and description of three new groups, Am. J. Epidemiol. 87:643–646 (1968).PubMedGoogle Scholar
  24. 24.
    Fallon, R. J., and Robinson, E. T., Meningococcal vulvovaginitis, Scand. J. Infect. Dis. 6:295–296 (1974).PubMedGoogle Scholar
  25. 25.
    Faur, Y. C., Weisburd, M. H., and Wilson, M. E., Isolation of Neisseria meningitidis from the genito-urinary tract and anal canal, J. Clin. Microbiol. 2:178–182 (1975).PubMedGoogle Scholar
  26. 26.
    Feldman, H. A., Sulfonamide-resistant meningococci, Annu. Rev. Med. 18:495–506 (1967).PubMedCrossRefGoogle Scholar
  27. 27.
    Feldman, H. A., Neisseria infections other than gonococcal, in: Diagnostic Procedures for Bacterial, Mycotic and Parasitic Infections (H. L. Bodily, E. L. Updyke, and J. O. Mason, eds.), pp. 135–152, American Public Health Association, New York, 1970.Google Scholar
  28. 28.
    Feldman, H. A., Meningococcal infections, in: Advances in Internal Medicine (G. H. Stollerman, ed.), Vol. 18, pp. 117–140, Year Book Medical Publishers, Chicago, 1972.Google Scholar
  29. 29.
    Feldman, H. A., Editorial comment, in: Year Book of Pediatrics (S. S. Gellis, ed.), p. 81, Year Book Medical Publishers, Chicago, 1975.Google Scholar
  30. 30.
    Feldman, H. A., Sweet, L. K., and Dowling, H. F., Sulfadiazine therapy of purulent meningitis including its use in 24 consecutive patients with meningococcic meningitis, War Med. 2:995–1007 (1942).Google Scholar
  31. 31.
    Feldman, R. A., Koehler, R. E., and Fraser, D. W., Race-specific differences in bacterial meningitis deaths in the United States, 1962–1968, Am. J. Public Health 66:392–396 (1976).PubMedCrossRefGoogle Scholar
  32. 32.
    Frasch, C. E., and Chapman, S. S., Classification of Neisseria meningitidis Group B into distinct serotypes. Iii. Application of a new bactericidal-inhibition technique to distribution of serotypes among cases and carriers, J. Infect. Dis. 127:149–154 (1973).PubMedCrossRefGoogle Scholar
  33. 33.
    Gauld, J. R., Nitz, R. E., Hunter, D. H., Rust, J. H., and Gauld, R. L., Epidemiology of meningococcal meningitis at Fort Ord, Am. J. Epidemiol. 82:56–72 (1965).Google Scholar
  34. 34.
    Givan, K. F., Thomas, B. W., and Johnston, A. G., Isolation of Neisseria meningitidis from the urethra, cervix, and anal canal: Further observations, Br. J. Vener. Dis. 53:109–112 (1977).PubMedGoogle Scholar
  35. 35.
    Glover, J. A., Observations of the meningococcus carrier rate, and their application to the prevention of cerebrospinal fever, Medical Research Council of the Privy Council, Special Report Series, No. 50, pp. 133–165, H. M. Stationery Offices, London, 1920.Google Scholar
  36. 36.
    Goldschneider, I., Gotschlich, E. C., and Artenstein, M. S., Human immunity to the meningococcus. I. The role of humoral antibodies, J. Exp. Med. 129:1307–1326 (1969).PubMedCrossRefGoogle Scholar
  37. 37.
    Gordon, M. H., Identification of the meningococcus, J. R. Army Med. Corps 24:455–458 (1915).Google Scholar
  38. 38.
    Gotschlich, E. C., Goldschneider, I., and Artenstein, M. S., Human immunity to the meningococcus. V. The effect of immunization with meningococcal Group C polysaccharide on the carrier state, J. Exp. Med. 129:1385–1395 (1969).PubMedCrossRefGoogle Scholar
  39. 39.
    Gotschlich, E. C., Liu, T. Y., and Artenstein, M. S., Human immunity to the meningococcus. Iii. Preparation and immunochemical properties of the Group A, Group B, and Group C meningococcal polysaccharides, J. Exp. Med. 129:1349–1365 (1969).PubMedCrossRefGoogle Scholar
  40. 40.
    Gray, F. C., and Gear, J., Sulphapyridine, M and B 693, as a prophylactic against cerebrospinal meningitis, S. Afr. Med. J. 15:139–140 (1941).Google Scholar
  41. 41.
    Greenfield, S., Sheehe, P. R., and Feldman, H. A., Meningococcal carriage in a population of “normal” families, J. Infect. Dis. 123:67–73 (1971).PubMedCrossRefGoogle Scholar
  42. 42.
    Greenwood, B. M., Bradley, A. K., Cleland, P. G., Haggie, M. H. K., Hassan-King, M., Lewis, L. S., Macfarlane, J. T., Taqi, A., and Whittle, H. C., An epidemic of meningococcal infection at Zaria, Northern Nigeria. 1. General epidemiological features, Trans. R. Soc. Trop. Med. Hyg. 73:557–562 (1979).PubMedCrossRefGoogle Scholar
  43. 43.
    Greenwood, B. M., Cleland, P. G., Hagcie, M. H. K., Lewis, L. S., Macfarlane, J. T., Taqi, A., and Whittle, H. C., An epidemic of meningococcal infection at Zaria, Northern Nigeria. 2. The changing clinical pattern, Trans. R. Soc. Trop. Med. Hyg. 73:563–566 (1979).PubMedCrossRefGoogle Scholar
  44. 44.
    Greenwood, B. M., Hassan-King, M., and Whittle, H. C., Prevention of secondary cases of meningococcal disease in household contacts by vaccination, Br. Med. J. 1:1317–1319 (1978).PubMedCrossRefGoogle Scholar
  45. 45.
    Gregory, J. E., and Abramson, E., Meningococci in vaginitis, Am. J. Dis. Child. 121:423 (1971).PubMedGoogle Scholar
  46. 46.
    Gruss, A. D., Spier-Michl, I. B., and Gotschlich, E. C., A method for a radioimmunoassay using microtiter plates allowing simultaneous determination of antibodies to two non cross-reactive antigens, Immunochemistry 15:777–780 (1978).PubMedCrossRefGoogle Scholar
  47. 47.
    Hammerschlag, M. R., and Baker, C. J., Mening0coccal osteomyelitis: A report of two cases associated with septic arthritis, J. Pediatr. 88:519–520 (1976).PubMedCrossRefGoogle Scholar
  48. 48.
    Hassan-Sing, M., Greenwood, B. M., and Whittle, H. C., An epidemic of meningococcal infection at Zaria, Northern Nigeria, 3. Meningococcal carriage, Trans. R. Soc. Trop. Med. Hyg. 73:567–573 (1979).CrossRefGoogle Scholar
  49. 49.
    Horn, D. W., The epidemic of cerebrospinal fever in the northern provinces of Nigeria, 1949–1950 J. R. Sanit. Inst. 71:573–588 (1951).PubMedGoogle Scholar
  50. 50.
    Jacobson, J. A., Camargos, P. A. M., Ferreira, J. T., and Mccormick, J. B., The risk of meningitis among classroom contacts during an epidemic of meningococcal disease, Am. J. Epidemiol. 104:552–555(1976).PubMedGoogle Scholar
  51. 51.
    Jacobson, J. A., Weaver, R. E., and Thornsberry, C., Trends in meningococcal disease, 1974, J. Infect. Dis. 132:480–484 (1975).PubMedCrossRefGoogle Scholar
  52. 52.
    Koppes, G. M., Ellenbogen, C., and Gebhart, R. J., Group Y meningococcal disease in United States Air Force Recruits, Am. J. Med. 62:661–714 (1977).PubMedCrossRefGoogle Scholar
  53. 53.
    Kuhns, D. M., Nelson, C. T., Feldman, H. A., and Kuhn, L. R., The prophylactic value of sulfadiazine in the control of meningococcic meningitis, J. Am. Med. Assoc. 123:335–339 (1943).CrossRefGoogle Scholar
  54. 54.
    Laird, S. M., Meningococcal epididymitis, Lancet 1:469–470 (1944).CrossRefGoogle Scholar
  55. 55.
    Lapeyssonnie, L., La méningite cérébro-spinale en Afrique, Bull. WHO 28:(Suppl.) (1963).Google Scholar
  56. 56.
    Leedom, J. M., Ivler, D., Mathies, A. W., Jr., Thrupp, L. D., Fremont, J. C., Wehrle, P. F., and Portnoy, B., The problem of sulfadiazine-resistant meningococci, Antimicrob. Agents Chemother. (1966), pp. 281–292 (1967) .Google Scholar
  57. 57.
    Mäkelä, P. H., Peltola, H., Käyhty, H., Jousimies, H., Pettay, O., Ruoslahti, E., Sivonen, A., and Renkonen, O.-V., Polysaccharide vaccines of Group A Neisseria meningitidis and Haemophilus influenzae Type b: A field trial in Finland, J. Infect. Dis. 136:S43-S50 (1977) .CrossRefGoogle Scholar
  58. 58.
    Maxcy, K. F., The relationship of meningococcus carriers to the incidence of cerebrospinal fever, Am. J. Med. Sci. 193:438–445 (1937) .Google Scholar
  59. 59.
    Mayer, R. L., and Dowling, H. F., The determination of meningococcic antibodies by a centrifuge-agglutination test, J. Immunol. 51:349–354 (1945).PubMedGoogle Scholar
  60. 60.
    Meningococcal Disease Surveillance Group, Meningococcal disease: Secondary attack rate and chemoprophylaxis in the United States, 1974, J. Am. Med. Assoc. 235:261–265 (1976).CrossRefGoogle Scholar
  61. 61.
    Millar, J. W., Siess, E. E., Feldman, H. A., Silverman, C., and Frank, P., In vivo and in vitro resistance to sulfadiazine in strains of Neisseria meningitidis, J. Am. Med. Assoc. 186:139–141 (1963).CrossRefGoogle Scholar
  62. 62.
    Miller, M. A., Millikin, P., Griffin, P. S., Sexton, R. A. and Yousuf, M., Neisseria meningitidis urethritis: A case report, J. Am. Med. Assoc. 242: 1656–1657 (1979).CrossRefGoogle Scholar
  63. 63.
    Munford, R. S., Sussuarana De Vasconcelos, Z. J., Phillips, C. J., Gell , D. S., Gorman, G. W., Risi, J. B., and Feldman, R. A., Eradication of carriage of Neisseria meningitidis in families: A study in Brazil, J. Infect. Dis. 129:644–659 (1974).PubMedCrossRefGoogle Scholar
  64. 64.
    Murray, E. G. D., Meningococcus infections of the male urogenital tract and the liability to confusion with gonococcus infection, Urol. Cutaneous Rev. 43:739–741 (1939).Google Scholar
  65. 65.
    Norton, J. F., Meningococcus meningitis in Detroit: 1928–1929. V. Secondary cases, J. Prev. Med. 5:365–367 (1931).Google Scholar
  66. 66.
    Norton, J. F., and Gordon, J. E., Meningococcus meningitis in Detroit in 1928–1929. I. Epidemiology, J. Prev. Med. 4:207–214 (1930).Google Scholar
  67. 67.
    Olcén, P., Barr, J., and Kjellander, J., Meningitis and bacteremia due to Neisseria meningitidis: Clinical and laboratory findings in 69 cases from Orebro County, 1965 to 1977, Scand. J. Infect. Dis. 11:111–119 (1979).PubMedGoogle Scholar
  68. 68.
    Pan American Health Organization, Report of the first hemispheric meeting on meningococcal disease, Pan. Am. Health Organ. Bull. 10:163–174 (1976).Google Scholar
  69. 69.
    Paul, J. R., Clinical Epidemiology, p. 192, University of Chicago Press, Chicago, 1966.Google Scholar
  70. 70.
    Petersen, B. H., Lee, T. J., Snyderman, R., and Brooks, G. F., Neisseria meningitidis and Neisseria gonorrhoeae bacteremia associated with C6, C7, or C8 deficiency, Ann. Intern. Med. 90:917–920 (1979).PubMedGoogle Scholar
  71. 71.
    Phair, J. J., Schoenbach, E. B., and Root, C. M., Meningococcal carrier studies, Am. J. Public Health 34:148–154 (1944).CrossRefGoogle Scholar
  72. 72.
    Pike, R. M., Laboratory-associated infections: Incidence, fatalities, causes, and prevention, Annu. Rev. Microbiol. 33:41–66 (1979).PubMedCrossRefGoogle Scholar
  73. 73.
    PIzzi, M., A severe epidemic of meningococcus meningitis in Chile, 1941–1942, Am. J. Public Health 34:231–238 (1944).CrossRefGoogle Scholar
  74. 74.
    Rake, G., Studies on meningococcus infection. Vi. The carrier problem, J. Exp. Med. 59:553–576 (1934).PubMedCrossRefGoogle Scholar
  75. 75.
    Reiss-Levy, E., and Stephenson, J., Vaginal isolation of Neisseria meningitidis in association with meningococcaemia, Aust. N. Z. J. Med. 6:487–489 (1976).PubMedCrossRefGoogle Scholar
  76. 76.
    Schoenbach, E. B., The meningococcal carrier state, Med. Ann. D. C. 12:417–420 (1943).Google Scholar
  77. 77.
    Sivonen, A., Renkonen, O.-V., Weckstrom, P., Koskenvuo, K., Raunio, V., and Makela, P. H., The effect of chemoprophylactic use of rifampin and minocycline on rates of carriage of Neisseria meningitidis in Army recruits in Finland, J. Infect. Dis. 137:238–244 (1978).PubMedCrossRefGoogle Scholar
  78. 78.
    Slaterus, K. W., Serological typing of meningococci by means of microprecipitation, Antonie van Leeuwenhoek, J. Microbiol. Serol. 27:304–315 (1961).CrossRefGoogle Scholar
  79. 79.
    Thayer, J. D., and Martin, J. E., Jr., A selective medium for the cultivation of N. gonorrhoeae and N. meningitidis, Public Health Rep. 79:49–57 (1964f).CrossRefGoogle Scholar
  80. 80.
    Thomas, L., Smith, H. W., and Dingle, J. H., Investigation of meningococcal infection. Ii. Immunological aspects, J. Clin. Invest. 22:361–373 (1943).PubMedCrossRefGoogle Scholar
  81. 81.
    Vieusseux, M., Mémoire sur le maladie qui a regné à Génève au printemps de 1805, J. Med. Chir. Pharmacol. 11:163 (1805).Google Scholar
  82. 82.
    Wahdan, M. H., Rizk, F., El-Akkad, A. M., El Ghoroury, A. E., Hablas, R., Girgis, N. I., Amer, A., Boctar, W., Sippel, J. E., Gotschlich, E. C., Triau, R., Sanborn, W. R., and Cvjetanovic, B., A controlled field trial of a serogroup A meningococcal polysaccharide vaccine, Bull. WHO 48:667–673 (1973).PubMedGoogle Scholar
  83. 83.
    Weichselbaum, A., Ueber die Aetiologie der akuten Meningitis cerebrospinalis, Fortschr. Med. (Berlin) 5:573 (1887).Google Scholar
  84. 84.
    Zollinger, W. D., and Mandrell, R. E., Outer-membrane protein and lipopolysaccharide serotyping of Neisseria meningitidis by inhibition of a solid-phase radioimmunoassay, Infect. Immun. 18:424–433 (1977).PubMedGoogle Scholar
  85. 85.
    Centers for Disease Control, Meningococcal Infections (Total)—Reported Case Rates by Year, United States, 1920–1978, Annual Summary, 1978, Morbid. Mortal. Weekly Rep. 27:42 (1979).Google Scholar
  86. 86.
    Centers for Disease Control, Reported Morbidity and Mortality in the United States, Annual Summary 1979, Morbid. Mortal. Weekly Rep. 28:(54) (1980).Google Scholar

Suggested Reading

  1. Arkwright, J. A., Cerebro-spinal meningitis: The interpretation of epidemiological observations by the light of bacteriological knowledge, Br. Med. J. 1:494–496 (1915).PubMedCrossRefGoogle Scholar
  2. Dingle, J. H., and Finland, M., Diagnosis, treatment and prevention of meningococcic meningitis, with a resume of the practical aspects of treatment of other acute bacterial meningitides, War Med. 2 :1–58 (1942).Google Scholar
  3. Feldman, H. A., Recent developments in the therapy and control of meningococcal infections, Dis. Month (Feb. 1966).Google Scholar
  4. Feldman, H. A., Sulfonamide-resistant meningococci, Annu. Rev. Med. 18:495–506 (1967).PubMedCrossRefGoogle Scholar
  5. Feldman, H. A., Meningococcal infections, in: Advances in Internal Medicine (G. H. Stollerman, Ed.), Vol. 18, pp. 117–140, Year Book Medical Publishers, Chicago, 1972.Google Scholar
  6. Gotschlich, E. C., Liu, T. Y., and Artenstein, M. S., Human immunity to the meningococcus. Iii. Preparation and immunochemical properties of the Group A, Group B, and Group C meningococcal polysaccharides, J. Exp. Med. 129:1349–1365 (1969).PubMedCrossRefGoogle Scholar
  7. Greenfield, S., Sheehe, P. R., and Feldman, H. A., Meningococcal carriage in a population of “normal families, J. Infect. Dis. 123:67–73 (1971).PubMedCrossRefGoogle Scholar
  8. Sivonen, A., Renkonen, O.-V., Weckstrom, P., Koskenvuo, K., Raunio, V., and Makela, P. H., The effect of chemoprophylactic use of rifampin and minocycline on rates of carriage of Neisseria meningitidis in Army recruits in Finland, J. Infect. Dis. 137:238–244 (1978).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • Harry A. Feldman
    • 1
  1. 1.Department of Preventive Medicine, Upstate Medical CenterState University of New YorkSyracuseUSA

Personalised recommendations