Medical Microbiology and Immunology

Introduction to Meningococcal Meningitis Treatment

Ailment considered to be meningococcal disease appeared in the 16th century. In 1887, by Weichselbaum, the bacterium was first found out in the spinal fluid of patients. Neisseria meningitidis is the main root of bacterial meningitis and septicemia in the United States. It can also give rise to focal illness namely arthritis and pneumonia. In sub-Saharan Africa, Neisseria meningitides is also a source of outbreaks of bacteremia and meningitis. Meningococcal meningitis is correlated with high frequency and mortality of significant sequelae. Initial treatment of antibiotic is the most significant action to save lives and minimise difficulty. All over the world meningococcal meningitis is noticed but the excessive load of the illness is in the meningitis zone of sub-Saharan Africa, extending from west to east. Approximately 30,000 cases are still announced every year from that region. Serogroup peculiar vaccines are utilised for elimination and in reactions to outbreaks. Since 2010 the rise of a meningococcal A combine vaccine along group inhibitory vaccination strives in the meningitis zone, the section of the A serogroup has reduced greatly. A diversity of living beings including various fungi, bacteria, or viruses, can give rise to meningitis. Meningococcal meningitis, a bacterial appearance of meningitis, is a dreadful illness of the meninges that infect the brain membrane. It can result in acute brain injury and is mortal in 50% of conditions if untreated (Carod Artal, 2015).

Causes

Viruses and bacteria are the two major cause of meningitis. The Neisseria meningitidis bacterium also known as meningococcus leads to meningococcal meningitis. In teenager, meningococcus is the ultimate general cause of bacterial meningitis. In adults, it is the second ultimate ordinary cause. Meningococcal bacteria may cause inflammation in any body part such as respiratory tract or gastrointestinal tract, skin. For unspecified causes, the bacteria may then extend to the nervous system through the bloodstream. When it develops there, it results in meningococcal meningitis (Meningitis: Symptoms, Causes, Types, Treatment, Risks, & More, 2020).

Impact on health

The impact of meningococcal meningitis on health may differ from person to person. The more frequent signs and indications comprise Common feeling of illness; unexpected high temperature; acute, continuance headache; neck firmness; nausea; Irritation in intense lights; feeling of fatigue; arthritis; uncertainty or other mental problems. A reddish rash over the skin is the major symptoms to observe for. When you press a glass against it and it does not turn white than the rash may be a result of bacterial infection in the blood flow. Other signs of bacteremia may involve: swelling over soft spot or stiffness in toddlers; High-frequency crying in babies; firmness, shaky movements or drooping in toddlers; Bad mood; Inactivity; Blemished skin; Fast breathing; turnout blue or pale; Shaking or cold feet and hand (Linder and Malani, 2019).

Mechanism

Neisseria meningitidis only spread the disease to humans. Animals are not infected by this disease. The bacteria are pass on from individual-to-individual via tiny drops of the throat or respiratory secretions from the air. Direct and continue contact, for example, sneezing or kissing on someone, or staying in a crowded area with a carrier speed up the growth of the infection. Spreading of N. meningitidis is accelerated in close convection. The N. meningitidis can be present in the throat and once in a while strikes the individual's resistance letting the bacteria to develop through the flow of blood to the brain. It is considered that 1% to 10% of the community spread bacteria in their oesophagus at some specific duration. Although, the transmission rate may be inflated from10% to 25% in widespread circumstances (Singh, 2017).

Treatment

Meningococcal meningitis can result in major complications for example gangrene, paralysis, brain damage, or deafness or even cause death. This infection is possibly lethal and must always be treated as a contingency. Emergency transfer to a hospital is essential. Suitable treatment of antibiotic should be started quickly, ideally after the process of taking spinal fluid from lower back carried out instantly. If the medical care is started before this puncture procedure it could be tough to investigate the bacteria from the spinal fluid and diagnose the disease. Although detection of the disease must not hold up the treatment. A variety of antibiotics can cure the disease, such as ceftriaxone, ampicillin, and penicillin (Meningitis: Symptoms, Causes, Types, Treatment, Risks, & More, 2020).

Prevention

Vaccines are specific for serogroup and give out to different degrees of protection time. Three types of vaccines are present such as Polysaccharide, Conjugate and Protein-based vaccines (Meningococcal vaccine conjugate/ravulizumab, 2019).The polysaccharide is utilised throughout the epidemic response, largely in Africa. These vaccines are tetravalent (A, C, Y and W), trivalent (A, C and W), or bivalent ( A and C); These are not used prior to the age of 2 years; They provide protection of 3 years but do not get immunity; Conjugate vaccines are utilised in anticipation into a procedure of precautionary campaigns, immunization plan and epidemic response; They provided the deep-routed immunity of more than 5 years and prevent transmission; This vaccine can be utilised from the age of 1 year. Vaccines available are Tetravalent (A, C, Y, W) and Monovalent (C and A). A vaccine based on Protein, against Neisseria. Meningitidis B. It has been initiated into the routine immunization plan and utilised in the response of epidemic. For the close contact antibiotic prophylaxis should be provided on time which minimises the chance of spreading disease (Linder and Malani, 2019).

Infection Control Measures

Proper antimicrobial treatment must begin instantly by the E.D. department. Quarantine the infected person in a separate room. Put on a fluid shield mask if dealing with the aerosol creating plan such as intubation or suction. Put on a fluid shield mask when performing close checking of the infected person particularly if they are sneezing or coughing. Notify immediately to the Public Health Agency (PHA) (Emptage, 2018). The medical staff of PHA will set about the spotting of close contacts and plan antimicrobial protection for them. The outsider does not require to put on protective cloth except they are at chance of exposure to the secretions of nasopharyngeal, but required to clean their hands before and after visiting (Carod Artal, 2015).

Conclusion on Meningococcal Meningitis Treatment

For suspected meningococcal disease, parenteral antibiotics have to be provided at the initial stage of treatment. Emergency transfer to health care centre must not be set back to provide parenteral antibiotics. Laboratory samples can be done such as cultures blood, CSF for culture and microscopy. Inform the laboratory staff as soon as possible and to send the sample within an hour. In CSF, EBV/CMV qRT-PCR may also be incorporated where the infected person has compromised their immune system. EDTA blood for PCR to Regional Virology Laboratory such as H. influenza, S. pneumoniae, Enteroviurs, Parechovirus, N. meningitidis. Aspirate from other sterile sites suspected of being infected.

References for Meningococcal Meningitis Treatment

Carod Artal, F., 2015. Meningococcal meningitis: vaccination outbreak response and epidemiological changes in the African meningitis belt. International Health, 7(4), pp.226-227.

Emptage, S., 2018. Meningococcal disease update. Practice Management, 28(8), pp.22-25.

Linder, K. and Malani, P., 2019. Meningococcal Meningitis. JAMA, 321(10), p.1014.

Healthline. 2020. Meningitis: Symptoms, Causes, Types, Treatment, Risks, & More. [online] Available at: <https://www.healthline.com/health/meningitis> [Accessed 30 September 2020].

Immunize.org. 2020. Meningococcal ACWY Vaccine (Menacwy) Information. [online] Available at: <https://www.immunize.org/photos/meningococcal-potos.asp> [Accessed 30 September 2020].

Reactions Weekly, 2019. Meningococcal vaccine conjugate/ravulizumab. 1751(1), pp.249-249.

Singh, H., 2017. Recurrent meningitis: An unusual cause. Otolaryngology, 07(05).

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