Meningococci are gram-negative bacteria that can cause serious illnesses such as meningitis. They occur worldwide and are transmitted by droplet infection. Which symptoms you should pay attention to and everything about meningococcal vaccination.
What are meningococci?
Meningococci (Neisseria meningitidis) are bacteria. They can settle in the human mouth and nose and lead to a serious, sometimes even life-threatening disease. Most of the time, a purulent meningitis develops, and sepsis is also possible.
In the case of meningococcal infection, a distinction must be made between invasive and non-invasive infections:
invasive: Meningococci can be detected in the blood, liquor (cerebrospinal fluid) or hemorrhagic skin infiltrates (bleeding accumulations of the pathogens in the skin). Meningococcal infection is also invasive when the typical symptoms occur.
non-invasive: In around ten percent of the population, meningococci can be detected in the nasopharynx without symptoms occurring. We are then also talking about non-pathogenic, non-invasive meningococci.
There are twelve different meningococcal serogroups (A, B, C, E, H, I, K, L, W, X, Y, Z). The distinction is made based on the structure of the capsule that surrounds the bacteria.
Occurrence of meningococci
Mening cocci occur worldwide. The so-called meningitis belt is located in the sub-Saharan zone and in Asia. Large epidemics triggered by meningococci have occurred there over and over again in recent years.
Europe, the United States, New Zealand, and Australia have had fewer than two cases per 100,000 people in the past few decades. In Germany, the number of cases has been falling since 2004. According to the Robert Koch Institute, the incidence is currently 0.4 diseases per year. The decline can be explained by the increased willingness to vaccinate against groups of meningococci. A sharp reduction in the number of cases was also observed in 2020, which is partly due to the corona pandemic and the hygiene measures.
Outside the body, meningococci die off relatively quickly. Close contact is necessary so that the pathogens can be transmitted from person to person.
Path of infection and incubation time
Most of the time, meningococci are transmitted through a droplet infection. When speaking, coughing or sneezing, the bacteria then get into the air through small droplets and, when they come into close contact, into the nasopharynx of the other person. If you touch the secretion and then come into contact with your own face, infection can also occur. The incubation period, i.e. the time until the disease breaks out, is around three to four days. However, a period between two and ten days is also possible.
Meningococci: how long is it contagious?
People with meningococcal infection can be contagious as early as seven days before symptoms start. Once antibiotic therapy has started, there is no longer any risk of infection after about 24 hours.
Consequences of a meningococcal infection
Meningococcal infection usually leads to meningitis (inflammation of the meninges). Sepsis occurs in over two thirds of cases in Germany. Of this, in turn, 10 to 15 percent run as a severe form of septic shock, the Waterhouse-Friedrich syndrome. This is characterized by bleeding into the adrenal glands and is very often fatal.
An invasive meningococcal infection can rarely lead to the following diseases:
Symptoms of meningococcal disease
The first symptoms of a meningococcal infection are usually expressed as an infection of the upper respiratory tract. Suddenly, other signs may appear, including:
The condition can become life-threatening after just a few hours. Among other things, large skin hemorrhages (petechiae) develop.
If the meningococcal infection triggers meningitis, those affected also suffer from neck stiffness and vomiting. If there is a septic course, a drop in blood pressure and organ failure are possible consequences.
Symptoms of meningococcal infection often look different in infants and young children. In addition to fever and vomiting, drowsiness and cramps can also occur. A protruding, hardened fontanel (gap between skull plates in infants) is also possible.
Diagnosis of meningococci: This is how the examination works
If people suffer from the typical symptoms, they should go to a hospital immediately. In order to get an accurate diagnosis of meningococcal infection, an analysis of blood and cerebrospinal fluid (spinal cord fluid) in the laboratory is necessary. Liquor is removed by puncturing the spinal cord with a needle. This allows meningococci to be accurately determined. A throat swab is useful if therapy has already started but the exact pathogen still needs to be determined.
Therapy of meningococcal disease
As soon as an invasive infection with meningococci can be detected, therapy with antibiotics is carried out immediately. Group three cephalosporins are recommended if the person concerned is not allergic to penicillin.
Depending on how the clinical picture expresses itself, further treatment measures are necessary. In the case of sepsis, observation and further therapy in the intensive care unit are always carried out.
Close contact persons (especially household contacts) receive chemoprophylaxis with antibiotics. In addition, a meningococcal vaccination should be given, if possible. Studies show that despite antibiotic therapy, these people have an increased risk of contracting meningococci in the following year.
Vaccines exist against the various meningococcal serogroups. The STIKO (Standing Vaccination Commission) has recommended that all children at the age of 12 months be vaccinated against serogroup C meningococci since 2006. Failure to do so should be made up to the age of 18. The serogroup C is mainly found in Europe besides B.
Risk groups who are particularly at risk of meningococcal infection should be protected with a meningococcal-ACWY conjugate vaccine. It brings about protection against the four serogroups. In addition, the individual vaccine against serogroup B should be administered. The endangered groups of people include:
- People with congenital or acquired immunodeficiency
- Laboratory personnel who are particularly at risk of contracting meningococci through their work
- Household contact persons of a person infected with meningococci
- People who travel to epidemic countries and have contact with local people there. For example development workers or medical staff.
In addition, people should get vaccinated if meningococci occur regionally. In special cases, this is recommended by the local health department.
The STIKO has not yet given a general vaccination recommendation against meningococci due to the current state of studies.
Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.
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