Prevalence and Symptoms of Neisseria Meningitidis Nm

Neisseria Meningitidis (Nm)

Background

It would be prudent to note, from the onset, that this particular pathogen happens to be exclusively human. In the words of Seib and Peak (2019) “Neisseria meningitidis is a leading worldwide cause of sepsis and meningitis, with the highest increase in infants, young children, and adolescents resulting in significant morbidity and mortality” (p. 87). Nm, according to Rouphael and Stephens (2012), was first identified in 1887 by a Viennese pathologist by the name Anton Weichselbaum. Rouphael and Stephens (2012) also make an observation to the effect that over time, Nm has been able to evolve multiple mechanisms. This, according to the authors, makes it possible for the pathogen to effectively colonize a person’s respiratory tract via the relevant adaptations. This text concerns itself with not only the description and prevalence of Nm, but also its transmission, infection symptoms, as well as prevention efforts.

Discussion

Description and Prevalence

Meningitis could be caused by a wide range of organisms. These could be inclusive of, but they are not limited to viruses, fungi, as well as bacteria. It therefore follows that Nm is one of the causes of meningitis (specifically bacterial meningitis). However, in addition to meningitis, Nm has been linked to a number of other ailments including; pneumonia and sepsis - and in some instances epiglottitis, endophthalmitis and myocarditis (World Health Organization – WHO, 2018). In essence, - and could be conceptualized as a potentially fatal meninges infection – with its most significant impact being on the affected individual’s brain membrane. The disease has been referenced as being fatal in the above statement owing to the fact that if left untreated, it has a fatality rate of more than 50% (WHO, 2018). Previous studies have identified a total of 12 Nm types. Half of these could trigger epidemics and diseases. At present, Type Y, Type X, Type W, Type C, Type B, and Type A have been associated with epidemics and disease (Centers for Disease Control and Prevention – CDC, 2019). As CDC (2019) further observes, in the United States, the most common Nm types are Y, C, and B. In essence, these are the Nm types that trigger the highest number of illnesses in the country. It is also important to note that as WHO (2018) points out, there are a wide range of situations/scenarios in which Nm has been observed. The said situations range from huge epidemics to small clusters and sporadic cases. WHO is also categorical that although persons from all ages could be affected by Nm, those who appear to be most impacted are young persons, preschool children, as well as babies.

The highest Nm infection rates in the world appear to be largely concentrated in what the Disease Control and Prevention – CDC ((2020) refers to as the sub-Saharan Africa “meningitis belt.” More specifically, infection rates in this particular region appear to be highest from the month of December through to June, i.e. during the dry season. It therefore follows that persons from other parts of the world should avoid travelling to this particular region during this period of the year – except for essential travel. This is particularly the case owing to the fact that as the CDC (2020) observes, “travelers who spend a lot of time with local populations in the meningitis belt, especially during outbreaks of meningococcal disease, are more likely to get this disease.”

Transmission

As has been pointed out elsewhere in this text, Nm happens to be an exclusively human pathogen. Towards this end, it follows that there is no animal reservoir for Nm – and, thus, only humans can be infected with the same. Transmission from one person to another could occur in a number of formats. According to the CDC (2019), the primary path to transmission happens to be via carrier throat or respiratory secretions. Thus, its transmission medium happens to be aerosols. In as far as the actual transmission formats are concerned, WHO (2018) is categorical that “smoking, close and prolonged contact – such as kissing, sneezing or coughing on someone, or living in close quarters with a carrier – facilitates the spread of” Nm.” Towards this end, huge gatherings of persons have been fingered as a prominent transmission route. It would also be prudent to note that as WHO further observes, past studies have indicated that most persons happen to be carriers of this particular pathogen. As a matter of fact, according to the CDC (2019), it is estimated that in every 10 persons, 1 person carries the pathogen in his or her throat. In some instances, specifically in regions with a high disease burden, Nm could be present in 3 out of 10 persons without any presenting symptoms (Tommassen and Arenas, 2017). At some point, or in some instances, the defense systems of the body are overwhelmed by Nm – in which case it spreads to the brain of the person via the bloodstream.

Symptoms of Infection

Infection with Nm has been associated with a number of symptoms. It should be noted that there are no standard symptoms for infection with Nm. This is more so the case given that symptoms could widely vary on the basis of the specific illness caused. However, some of the more common symptoms that could be brought about by Nm infection, according to the CDC (2020), are inclusive of stiff neck, headache, as well as sudden fever. Some of the other key symptoms that have been identified by the CDC (2020) are; “nausea, vomiting, increased sensitivity to light, and confusion.” As CDC further observes, infants as well as children with an Nm infection could present with certain other symptoms that may not necessarily be common among adults. Some of the said symptoms are inclusive of poor reflexes, vomiting, and inactivity (CDC, 2020). CDC also makes the observation to the effect that if not addressed as quickly as possible, an Nm infection could result in death within a few hours.

Prevention

According to Seib and Peak (2019), in the period preceding the development of antibiotics and serum therapy, Nm infection was always almost fatal. Indeed, 7 to 8 cases, out of every 10 cases of NM infection used to be fatal. Although a lot of ground has been covered today in terms of prevention and treatment, NM infection is still associated with a high mortality rate. There are a number of strategies that individuals could embrace in an attempt to prevent an NM infection. The CDC (2020) makes an observation to the effect that the most effective prevention route happens to be via a meningococcal vaccine. At present, particularly in the US, persons have a choice of two vaccines; i.e. the Serogroup B meningococcal (MenB) vaccine and the Meningococcal ACWY (MenACWY) vaccine (CDC, 2020).

Apart from vaccines, Nm infection could also be prevented via what is referred to as chemoprophylaxis (WHO, 2018). The antibiotic that is often used in this case is ciprofloxacin (WHO, 2018). However, when this is unavailable, the best alternative happens to be ceftriaxone (WHO, 2018). More specifically, as the World Health Organization points out, “antibiotic prophylaxis for close contacts, when given promptly, decreases the risk of transmission.” As a matter of fact, this prevention route is routinely deployed for persons who happen to be having close contact in household settings. However, according to WHO, within the African meningitis belt, antibiotic prophylaxis is only deemed appropriate in scenarios that are non-epidemic.