Meningococcal Disease in Sudan Continues in declining trend

During the current dry season Sudan reported 69 suspected cases of meningococcal meningitis with no death reported. Sop far, Neisseria Meningitidis of any type especially type A, have not been confirmed. The reported cases are distributed sporadically in some of the 494 sectors in the 18 States of the Country. None of the sectors has reached alert or epidemic threshold levels

Meningococcal disease in Sudan: sporadic cases reported so far

During the current high risk season for meningococcal disease, a total of 509 suspected cases including 24 deaths [CFR: 4.2%] were reported from Sudan. These cases were reported from 01 January to end of June 2013. One of the samples collected from South Darfur state was tested positive for Neisseria meningitides [Nm] serogroup W 135. As of now, there is no report that any of the districts in Sudan reached either alert and epidemic threshold for meningococcal meningitis outbreak during the current high risk season in Sudan

Patterns of meningococcal infection in Sudan with emergence of Neisseria meningitidis serogroup W135

This study was conducted during the 2004-2006 epidemic of meningitis in Sudan to follow-up the frequency of disease outbreak or endemic waves and to evaluate the new quadrivalent vaccine for actual application. Samples were collected from Darfur, El Gedaref, Kassala and Khartoum States and transported to the National Health Central Laboratory in Khartoum. Of 196 patients with clinical symptoms and signs of meningitis, conventional culture identified Neisseria meningitidis in 37 [18.9%], confirmed by polymerase chain reaction. N. meningitidis type A was identified in 29 [78.4%] patients, type C in 3 [8.1%] and N. meningitidis W135 in 5 [15.5%]. The serotyping and molecular diagnosis patterns of N. meningitidis showed the emergence of the new strain,W 135, in patients from the borders of Sudan, 3 from the West Darfur, and 1 each from El Gedaref and Kassala. These could be related to the movement of pilgrims through the borders to Saudi Arabia in the Hajj season. Serious consideration may be needed for quadrivalent vaccination to prevent seasonal and Hajj season outbreaks

Evaluation of safety of meningococcal group AC bivalent polysaccharide conjugate vaccine in children aged 5-24 months old / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the safety of meningococcal group AC bivalent polysaccharide conjugate vaccine among children aged 5-24 months old.</p><p><b>METHODS</b>From July 2011 to June 2012, a total of 34 411 children aged 5-24 month-old who voluntarily vaccinated meningococcal group AC bivalent polysaccharide conjugate vaccine in Zhongshan city were included. The adverse effects within 72 hours were recorded and analyzed.</p><p><b>RESULTS</b>34 411 children were recruited, including 18 708 boys (54.36%), whose mean age were ( 11.4 ± 3.9 ) months old.Within 72 hours, the incidence rates of local adverse effects were 0.76% (261/34 411) for erythema,0.57% (197/34 411) for sclerosis,0.56% (191/34 411) for swelling,0.42% (143/34 411) for pain,0.15% (53/34 411) for pruritus, and 0.15% (50/34 411) for rash on the injection site. The overall incidence rate of local adverse effects was 1.61% (554/34 411; 95%CI:1.48%-1.74%). The incidence rates of systemic adverse effects were 0.98% (312/34 411) for fever,0.48% (164/34 411) for anorexia,0.31% (108/34 411) for diarrhea,0.29% (100/34 411) for malaise,0.20% (70/34 411) for nausea and vomiting, and 0.08% (26/34 411) for headache. The overall incidence rate of systemic adverse effects was 1.64% (565/34 411; 95%CI:1.51%-1.78%).25 children (0.07%) had hyperpyrexia ( > 39°C), and the time of duration lasted less than 48 hours.16 children (0.05%) had symptoms of cold, such as cough and catarrh.No accident and other serious events were reported. The incidence rate of systemic adverse effects among boys was 1.79% (334/18 708), which was higher than that of girls (1.47%, 231/15 703), the difference showed statistical significance (χ(2) = 5.22, P < 0.01). The incidence rate of systemic adverse effects among children aged 5-12 month-old was 1.78% (411/23 113), which was higher than that among children aged 13-24 month-old (1.36%, 154/11 298), the difference showed statistical significance (χ(2) = 8.10, P < 0.01). The incidence rate of local adverse effects in children vaccinated the first dose was 1.72% (536/31 129), which was higher than that in children vaccinated the second or third dose (0.55%, 18/3282), the difference showed statistical significance (χ(2) = 25.81, P < 0.01). The incidence rate of systemic adverse effects in children vaccinated the first dose was 1.73% (539/31 129), which was higher than that in children vaccinated the second or third dose (0.79%, 26/5282), whose difference also showed statistical significance (χ(2) = 16.22, P < 0.01).</p><p><b>CONCLUSION</b>The safety of meningococcal group AC bivalent polysaccharide conjugate vaccine among children aged 5-24 months old is relative good.</p>

Localized meningitis outbreak in Sudan

A localized outbreak of meningococcal meningitis has been reported from one of the localities [district] in West Darfur state of Sudan. From 01 January to 19 April, a total of 42 suspected cases including 7 deaths [CFR:16.7%] have been reported from this locality [Umdokhon] in West Darfur state. The predominant pathogen causing this outbreak has been found to be Neisseria meningitides [Nm] serogroup A

Meningococcal disease in Sudan: Sporadic cases so far in the season

During the current high risk season in Sudan, a total of 143 suspected cases of meningococcal disease including 7 deaths [CFR:4.8%] were reported from Sudan. The predominant pathogen was found to be Neisseria meningitides [Nm] serogroup A. Except for one district in North Kordofan state, no other districts in the country have reached either the alert or epidemic threshold

Dolor abdominal agudo como forma de presentación inicial de la enfermedad invasiva por meningococo serogrupo A / Abdominal acute pain as initial symptom of invasive meningococcus serogrup A illness

El dolor abdominal agudo como manifestación inicial de laenfermedad meningocócica es una entidad infrecuente y raramentedescrita en la bibliografía. Presentamos el caso de un lactante de 10 meses que consulta en el Servicio de Urgenciaspor un síndrome febril y dolor abdominal agudo, aislándose en el hemocultivo Neisseria meningitidis serogrupo A.

The abdominal acute pain as an initial symptom of meningococcemia is an infrequent entity rarely described in the literature. We present a 10 month-old infant with fever and acute abdominal pain, who was admitted in Emergency Care. Later, Neisseria meningitidis serogroup A was isolated from blood cultures.

Clinical profile of Group A meningococcal outbreak in Delhi.

We present a retrospective analysis of clinical profile of 100 children admitted to a Government hospital at Delhi between April 2005 and December 2006 with group A meningococcal infection. Maximum children presented in late winter and spring.Younger children were less affected (5% children < 1 year). Fever (86%), vomiting (64%) and rash (63%) were the most common presenting symptoms. All children presented within 5 days of onset of symptoms and 52% within 24 hours. 67 % children had meningococcal meningitis; 20% had meningococcemia; and 13% had both. Overall mortality was 17%. Altered sensorium and shock at presentation significantly increased the mortality. All culture positive cases had group A Neisseria meningitides. All meningococcal isolates were sensitive to penicillin/ampicillin, ciprofloxacin, ceftriaxone, chloramphenicol and erythromycin except, one each resistant to ampicillin and erythromycin.

Surveillance on pathogens of meningococcal meningitis in Beijing, 2005 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the pathogens of meningococcal meningitis (MM) in Beijing, 2005.</p><p><b>METHODS</b>Blood and cerebrospinal fluid specimens from MM patients were detected by polymerase chain reaction. Bacterial strains were analyzed by pulsed-field gel electrophoresis and multilocus sequence typing.</p><p><b>RESULTS</b>7 of the blood and 5 of cerebrospinal fluid specimens showed positive results. 105 of the Neisseria meningitides strains were isolated from the specimens of patients, close contacts and healthy carriers. Serogroup A and C Neisseria meningitides strains shared the same patterns of pulsed-fieldgel electrophoresis, respectively. The sequence type of serogroup A Neisseria meningitides belonged to ST7 while the sequence type of serogroup C Neisseria meningitides belonged to ST4821.</p><p><b>CONCLUSION</b>Patients suffered from meningococcal meningitis were caused by serogroup A (ST7) and C (ST4821) Neisseria meningitides in Beijing, 2005.</p>

Meningococcemia crónica en adultos: a propósito de un caso / Chronic meningococcemia in adults: case report and review of the literature

La presentación de la meningococcemia como cuadro crónico o recurrente es muy poco frecuente, y por esta misma razón, pocas veces es sospechado. Presentamos un caso de meningococcemia crónica recurrente en una paciente de 22 años de edad, con un cuadro clínico sugestivo, que luego se confirmó por desarrollo en hemocultivos del microorganismo. El objetivo de la presentación es recordar la existencia de esta forma clínica, que en nuestro caso, a pesar de los síntomas sugestivos, recién fue diagnosticada luego del quinto episodio

Anticorpos antipolissacarídeo de Neisseria meningitidis, grupos A e C, em vacinados e em pacientes com doença meningocócica previamente vacinados ou não / Anti-Neisseria meningitidis polysaccharide antibodies, groups A and C, in vaccinated and previously vaccinated or unvaccinated patients with meningococcal disease

A resposta ao estímulo antigênico e vacina polissacarídica antimeningocócica foi avaliada pela reação de hemaglutinação passiva em indivíduos de faixas etárias de 0 a maiores de 21 anos. A vacina polissacarídica A mostrou-se mais imunogênica do que a vacina polissacarídica C. Não foi encontrada reação cruzada entre o polissacarideo A e C. Na doença meningocócica, a reação mostrou-se específica para os dois grupos de meningococos, permitido diagnóstico correto de muitos casos em que falharam as outras provas diagnósticas. Em pacientes vacinados com a vacina antimeningocócica AC, que vieram a ter a doença, a reação de hemaglutinação passiva mostrou-se ineficaz como prova diagnóstica pois a maioria dos pacientes, quando apresentaram títulos hemaglutinantes, estes eram muitos baixos, sem conversão sorologicas ou, quando havia conversão, não foi possível averiguar se esta era devida à vacina ou à doença (AU).