Meningococcus is not only in Africa
This infection is widespread throughout the world. And in Africa there is even a so-called “meningitis” or “meningococcal belt”:
However, this disease does not only exist somewhere far away, on other continents; unfortunately, it is also close to us. Outbreaks of meningococcal infection are recorded every now and then in different regions of Russia.
For example, in Novosibirsk in 2021, 25 cases of the disease were registered in less than two weeks. And this is very characteristic of this infection: usually long periods of well-being (10-15 years) are interrupted by sharp increases in incidence, which have a focal outbreak nature.
The increase in incidence can be explained by the widespread carriage of meningococcal bacteria. As the number of susceptible individuals increases, the number of cases increases. And declines are ensured by an increase in the immune layer as a result of latent immunization as bacterial carriage spreads among the population of a given territory.
You need to understand that during recession years the infection does not disappear: 50% of diseases occur in children under 5 years of age; 20% - for children aged 6-14 years. As age increases, incidence rates decrease, but carriage rates increase. The age group of 15-20 years is also subject to a high degree of susceptibility, because its representatives - students, military personnel - communicate intensively in schools, dormitories, barracks, etc. First of all, those who come from remote areas get sick, i.e. not previously in contact with the pathogen.
Why are doctors sometimes unable to identify meningococcal infection in the early stages of the disease and provide timely assistance? The fact is that the first symptoms of the disease are similar to the onset of a regular acute respiratory viral infection, and later medicine turns out to be powerless against the lightning-fast course of the disease. Moreover, during periods of prosperity, cases of the disease are so rare that the alertness of even experienced doctors, not to mention young novice doctors, gradually decreases.
One of the features that can also be canceled is that meningococcal infection is characterized by a winter-spring seasonality with the maximum number of diseases in February – April.
There are many real stories about how this can happen, here is one of them (a video from our partners - Sanofi Pasteur):
Composition of cerebrospinal fluid in tuberculous meningitis
Bacteriological examination of cerebrospinal fluid in the case of tuberculous meningitis may give a false negative result. Detection of tubercle bacilli in the cerebrospinal fluid depends on the thoroughness of the research. At the Yusupov Hospital, all diagnostic procedures are performed using modern medical equipment and the use of new drugs and techniques. The results of studies conducted at the Yusupov Hospital are reliable and as informative as possible.
Tuberculous meningitis is characterized by precipitation of a taken sample of cerebrospinal fluid when it stands for 12-24 hours. The tuberculosis bacillus in most cases (80%) is detected precisely in the precipitate. Tuberculosis microbacteria may not be detected in the sample if they are present in the cisternal cerebrospinal fluid.
The cerebrospinal fluid in tuberculous meningitis is clear and colorless. Pleocytosis in this case varies and can have different indicators. Without treatment, the number of cells increases steadily over the course of the disease.
A characteristic feature of tuberculous meningitis is the diversity of cell composition in the cerebrospinal fluid. Against the background of a large number of lymphocytes, monocytes, neutrophils, macrophages and giant lymphocytes are found. In tuberculous meningitis, the level of protein in the cerebrospinal fluid is always elevated.
Epidemiological surveillance
Surveillance, from case detection to investigation and laboratory confirmation, is critical to the control of meningococcal meningitis. Main objectives of surveillance:
- detection and confirmation of disease outbreaks;
- detection and confirmation of disease outbreaks;
- assessing the burden of disease;
- monitoring antibiotic resistance profiles;
- monitoring the circulation, spread and evolution of individual meningococcal strains (clones);
- assessing the effectiveness of strategies to control meningitis, in particular preventive vaccination programs.
