विवरण
Invasive Meningococcal Disease (IMD) is a severe infection caused by the bacterium Neisseria meningitidis, leading to potentially life-threatening conditions such as meningitis (inflammation of the brain and spinal cord membranes) and bloodstream infections. Symptoms often include high fever, severe headaches, neck stiffness, and sensitivity to light. Rapid medical attention is crucial due to the swift progression of the disease and its potential for serious complications. Preventive measures such as vaccines are important in controlling its spread.
सारांश
- Invasive Meningococcal Disease (IMD) is a life-threatening infection caused by the bacteria Neisseria meningitidis, often manifesting as meningitis and septicemia, with a high mortality rate if untreated. While it's vaccine-preventable, its severity necessitates discussion, particularly regarding prevention in children. The bacteria has 13 serogroups, with A, B, C, Y, X, and W being the most common causes of epidemics globally. Serogroups A and C are more prevalent in Asia and Africa, while B and C are dominant in Europe and North/South America.
- Globally, IMD affects 1.2 million people annually, resulting in 135,000 deaths. It's endemic in Europe and North America, with seasonal peaks and small clusters of cases. Africa experiences large periodic epidemics, with incidence reaching up to 1,000 per 100,000 population, especially in children under five. Mortality rates are highest in children under five years and can vary depending on the specific serogroup.
- In Asia, IMD is an under-recognized public health problem due to factors like the absence of surveillance, poor bacterial detection methods, and healthcare barriers to reporting. It is reported to be the third most common cause of bacterial meningitis among children under five in India, with Serogroup A being the most predominant. Outbreaks have been reported, particularly in Northern and North-Eastern India, but the burden of disease is difficult to quantify due to a lack of robust surveillance.
- Several populations are at increased risk, including infants, children, adolescents (due to crowding), travelers to endemic areas, lab personnel handling the bacteria, and immunocompromised individuals. International travelers, especially those undertaking Hajj or Umrah pilgrimages, are also at higher risk and require meningococcal vaccination. The disease has two peak incidences, making it crucial to identify vulnerable age groups.
- Neisseria meningitidis is a human-restricted pathogen transmitted via respiratory droplets. Although colonization can occur in a significant percentage of adults, rates are higher in young adults due to their social behavior. Clinical features of IMD can vary, with common symptoms including fever, headache, photophobia, and neck stiffness. Rapid progression can lead to multi-organ failure and death within hours, highlighting the importance of early diagnosis and management.
- Diagnosis of IMD can be challenging due to non-specific early symptoms and the potential for rapid progression. Mortality rates remain significant, even with early diagnosis and treatment. Long-term sequelae, including neurological impairment, deafness, and limb amputation, are also a concern. Treatment involves rapid administration of antibiotics (penicillin or third-generation cephalosporins) and supportive care.
- Prevention focuses on immunization using polysaccharide vaccines and protein polysaccharide conjugate vaccines. Conjugate vaccines offer longer duration immunity and stimulate T-cell mediated immunity. Reactive immunization is practiced in India, but it has limitations due to abrupt outbreaks. While routine vaccination is effective, challenges include high vaccine costs, limited cost-effectiveness data, and a crowded immunization schedule.
- Recommendations for vaccination differ across countries, with a primary focus on direct protection of affected age groups and reducing transmission. ACIP in the US recommends vaccination at 11-12 years with a booster at 16-18 years. Currently, there is no aggregate consensus of single optional strategy and this vaccine is not part of the routine immunization schedule in India. The key to prevention is early diagnosis, prompt treatment, and widespread immunization to reduce the incidence and mortality associated with IMD.
नमूना प्रमाण पत्र
वक्ताओं के बारे में
Dr N P Singh
Director & HOD Pediatrics · Mahavir Vatsalya Aspatal & Mahavir Heart Hospital,Delhi, India ·
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