The theme of great relevance, deserves further development of this serious disease responsible, however, of meningitis in children. THE CAUSES AND SYMPTOMS The
meningococcal meningitis is caused by five serogroups of meningococci (Neisseria meningitidis or): A, B, C, Y, W-135.
sometimes appear scattered petechiae and hemorrhage, severe hypotension, massive hemorrhage of the adrenal glands, coma and death within hours.
If you have symptoms of meningitis only speaks of "fulminant sepsis brain" as if there is an acute adrenal insufficiency by bleeding-heart failure of the adrenals, it is called Waterhouse-Friderichsen syndrome (septic shock + + disseminated intravascular coagulation), which has 3% of patients who die from meningococcal infection.
The inflammation of the endothelium of small vessels and capillaries (endothelium), determines the diapedesis of red blood cells and perivascular infiltration bleeding (petechiae) and in the most severe forms inflammation (or inflammation) 's endothelium results in endovascular obliterans with partial or total obstruction of blood vessels and resulting in large areas and disfiguring ulcers and necrosis (purpura hemorrhagic gangrenous) requiring surgery sometimes dramatic as happened in the little girl who lost limbs and despite everything, for his great will power, has become a good fencer.
meningococcal meningitis is caused by five serogroups of meningococci (Neisseria meningitidis or): A, B, C, Y, W-135.
sometimes appear scattered petechiae and hemorrhage, severe hypotension, massive hemorrhage of the adrenal glands, coma and death within hours.
If you have symptoms of meningitis only speaks of "fulminant sepsis brain" as if there is an acute adrenal insufficiency by bleeding-heart failure of the adrenals, it is called Waterhouse-Friderichsen syndrome (septic shock + + disseminated intravascular coagulation), which has 3% of patients who die from meningococcal infection.
The inflammation of the endothelium of small vessels and capillaries (endothelium), determines the diapedesis of red blood cells and perivascular infiltration bleeding (petechiae) and in the most severe forms inflammation (or inflammation) 's endothelium results in endovascular obliterans with partial or total obstruction of blood vessels and resulting in large areas and disfiguring ulcers and necrosis (purpura hemorrhagic gangrenous) requiring surgery sometimes dramatic as happened in the little girl who lost limbs and despite everything, for his great will power, has become a good fencer.
incidence in the population
The incidence of meningococcal disease, approximately 2000 cases per year in years 50-70, was significantly reduced in the 90 to several hundred cases (200-300)
In the past, the fatality rate exceeded 50%, but the very early diagnosis, proper treatment and support measures can lead to healing. Nevertheless, in 10-20% of cases the disease is rapid and acute, with a fulminant course that can lead to death within hours even with adequate therapy.
Organisms of group A, B and C are responsible for most cases: the most common serogroup C is responsible for the disease in the United States in Italy and Europe are the most frequent serogroups B and C. In Italy the incidence is low compared to the rest of Europe (3-6 cases / 1,000,000 inhabitants than the European average of 14.5 cases), and in recent years, was most responsible for the group B (65% of cases), followed by group C (35% of cases).
The incidence of meningococcal disease, approximately 2000 cases per year in years 50-70, was significantly reduced in the 90 to several hundred cases (200-300)
In the past, the fatality rate exceeded 50%, but the very early diagnosis, proper treatment and support measures can lead to healing. Nevertheless, in 10-20% of cases the disease is rapid and acute, with a fulminant course that can lead to death within hours even with adequate therapy.
Organisms of group A, B and C are responsible for most cases: the most common serogroup C is responsible for the disease in the United States in Italy and Europe are the most frequent serogroups B and C. In Italy the incidence is low compared to the rest of Europe (3-6 cases / 1,000,000 inhabitants than the European average of 14.5 cases), and in recent years, was most responsible for the group B (65% of cases), followed by group C (35% of cases).
especially affects young children under 5 years but also adolescents and young adults.
AS IS The contagion
Transmission occurs by inter-human contagion semidirect by air, through droplets and secretions from the nose and throat infection while the infection is rare indirect, due to the low resistance of the germ physical environmental agents, to sunlight, drying and the common disinfectants.
The onset of the disease is favored by:
The germ is transmitted by breathing, and the risk of developing the disease appears to be greater in people who have contracted the infection recently than those who are carriers for the longest time. It should be noted that 20 to 30% of the population are healthy carriers of meningococci in the nose and throat without any symptoms, and presence alone does not increase the risk of meningitis.
The onset of the disease is favored by:
- community life: people who live and / or sleeping in common areas, such as children who attend the nursery, kindergarten, colleges, camps, dormitories and university a time, recruits;
- overcrowding at airports, cinemas;
- smoking and exposure to secondhand smoke: time above the cinemas and dance clubs;
- other respiratory tract infections such as influenza during the winter months.
HOW TO DEFEND
In fight meningococcal infection, are currently available conjugate vaccine against serogroup C, responsible for 30-40% of meningococcal meningitis in Italy, also effective in small child and is practiced by the 3rd month of life as other vaccines. In some countries with high incidence of disease has been introduced vaccination for all newborns. In Italy the meningococcal C vaccine has been available since 2002 and has helped to prevent such cases of meningitis in vaccine recipients. There is also a polysaccharide vaccine, with serotypes A, C, W135, Y, that has a good efficacy but short-lived 3 years in vaccinated older than 4 years, against the serotypes in the vaccine. It is not capable of stimulating the immune system in children younger than two years. E 'therefore suitable for people who travel to countries where the strains A, C, W135 and Y are the cause of widespread epidemics. Finally
next marketing of a vaccine against five pathogens A, B, C, W135, Y, which seems to give good results to prevent such meningitis.
from the foregoing that, besides the common vaccination (Hexavalent between the 60th and 90th day of life) all infants should practice meningococcal and pneumococcal vaccination that has demonstrated excellent efficacy with low side effects, effects that have prevented their widespread use.
The new pneumococcal vaccine is already available, will further extend the protection from childhood to the elderly against the most dangerous pneumococcal meningococcal vaccine and the next will give lasting protection against all five meningococcal responsible for a pathological condition as serious.
so will definitely prevent the most common responsible for meningitis in children with Haemophilus influenzae type b (the antigen has been for years already in the hexavalent vaccine: diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, Haemophilus influenzae), a disease so feared by many millennia.
