Meningococcaemia: current concepts in prophylaxis
| Autor: | A.P. Ball |
|---|---|
| Rok vydání: | 1980 |
| Předmět: |
Microbiology (medical)
Risk Nasopharyngeal carriage Attack rate Population Minocycline Neisseria meningitidis Meningococcal disease Nasopharynx Medicine Humans education education.field_of_study Sulfonamides business.industry Vaccination medicine.disease Clinical disease Lower incidence Meningococcal Infections Infectious Diseases Carriage Bacterial Vaccines Carrier State Rifampin business Demography |
| Zdroj: | The Journal of infection. 2(4) |
| ISSN: | 0163-4453 |
| Popis: | Nasopharyngeal carriage of virulent meningococci is common in the community rising from 2-4-5.4 per cent in children (Gold, Goldschneider, Lepow, Draper and Randolph, 1978; Marks, Frasch and Shapera, 1979) to 21 per cent in mixed populations (Fraser, Bailey, Abbott, Gill and Walker, 1973). In young military recruits in overcrowded barracks carriage rates may rise from 30 per cent to 70 per cent within a few months (Fraser, Bailey, Abbott, Gill and Walker, 1973) and acquisition rates of 60 per cent over a period of three months have been reported in similar student populations (Melton, Edwards and Devine, 1977). The attack rate of disease amongst contacts of sporadic cases is small in comparison. The Meningococcal Disease Surveillance Group (1976a,b) have reported secondary attack rates in family contacts of 0.22-0.42 per cent. In epidemics casual contacts are at no greater risk than the general population, but the risk to close family contacts has varied from 1.6-5.9 per cent (Munford, Taunay, De Morais, Fraser and Feldman, 1974; Kaiser, Hennekens, Saslaw, Hayes and Bennett, 1974). The paradox of the difference between the incidence of acquisition and carriage, and the much lower incidence of clinical disease is beginning to be explained. Protection is partly the result of natural immunity acquired through carriage of low virulence strains, but may also result from childhood carriage of the closely related, but weakly pathogenic, Neisseria lactamica. Acquisition of this organism (by up to 20 per cent of infants) results in the development of IgG antibody active against group A, B and/or C meningococci in two-thirds, bactericidal titres being present in 40 per cent (Gold, Goldschneider, Lepow, Draper and Randolph, 1978). Conversely, various immune defects including classical agammaglobulinaemia, familial IgM deficiency (Hobbs, Milner and Watt, 1967), failure of antibody synthesis (Whittle, Oduloju, Evans-Jones and Greenwood, 1976) and complement component deficiencies (Lambert, Thompson, Jones and Fleck, 1979; Haeney, Ball and Thompson, 1979) have been shown to predispose to meningococcal disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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