Meningococcal infections

Abstract

The meningococcal diseases1 represent a spectrum of illness caused by Neisseria meningitidis (Table 1). Although sporadic endemic cases occur throughout the world, massive, devastating epidemics tend to reflect conditions of crowding, mobilization, and enclosed institutional populations. In recent years outbreaks have also been associated with large religious gatherings, especially the Hajj. Such outbreaks tend to be extraordinarily disruptive, especially because of the fear and fright that they induce in the affected populations. Among civilians, children are most often attacked, with mortality rates of 80-90% having been noted in some epidemics that occurred before effective therapeutic agents became available. In the past the disease was also known as cerebral spinal fever and epidemic cerebral spinal meningitis, as well as by other names. Mobilization for war, with the induction of many young men into crowded military camps, has generally been accompanied by outbreaks. Also, in recent years there has been awareness of outbreaks as well as frequent sporadic meningococcal infections among college freshmen, who also represent a mix from many diverse origins, in dormitories and other sometimes crowded living quarters on many campuses. Generalized outbreaks among the military do not arise de novo, but may reflect what is occurring in the associated civilian populations. The development of meningococcal capsular polysaccharide vaccines, and more recently conjugate meningococcal vaccines, has had a significant effect on prevention of military epidemics of meningococcal epidemics, and now its impact on civilian disease is, becoming, realized. © Springer Science+Business Media, LLC 2009.