Epidemic cerebrospinal meningitis

Overview of epidemic cerebrospinal meningitis (epidemic cerebrospinal meningit is) referred to ECM. By meningococcal of purulent meningitis. Clinical manifestations are fever, headache, vomiting, skin and mucous blockage, bruises and neck stiffness meningeal irritation. Of the disease in 1805 by the Swiss Vieusseaux description. 1887 Weichselbaum isolated from the cerebrospinal fluid from meningococcus. China in 1896, Li Tao in Wuchang official report. Etiology of meningococcal bacteria Neisseria is, gram-negative, kidney-shaped, multi-components, or four associates. Pathogen higher nutritional requirements, with blood or chocolate agar medium at 37 ° C, with 5 ~ 10% CO2, pH7.4 easy growth environment. After 16 to 18 hours of bacterial growth strong, the strongest antigen. Since bacteria containing the enzyme solution, if not promptly dissolved easily inoculated died. On the cold, dry sensitive below 35 ° C, heating to 50 ° C or general disinfectant to deal with it vulnerable to death. According to the folder from the membrane antigen polysaccharide different, hemagglutination test of the bacteria into A, B, C, D, X (1916), Y (1889), Z, W135 (319), 29E (1892), H, I, K and L13 blood group. In A, B, C group styles. Meningococcus bacteria - (meningocin) A group can be divided into four types, the Group C consists of six type; Group B is divided into 11-, B-2-pathogenic strongest. According to its lipopolysaccharide (CPS) will be divided into meningeal meningitis immunization eight - LPS, and pathogenicity relationship is not yet clear. For nearly 20 years, some European and American countries the prevalence of group A bacteria has been changed to Group B and Group C; China's flora is mainly pop group A, group B accounted for only a minority. But carriers to B, Group C-based, will become the next major epidemic Flora, to be closely observed. From the 1960s, the meningococcus right sulfamethoxazole resistance is becoming more popular, particularly in Group C and Group B is most serious. A group of resistance depending on the countries, regions and different, but also increasing trend. My separation of the most prevalent strains are more sensitive to sulfa, the sulfa drugs to treat the disease one of the main drug. Epidemiology (1) is the source of HIV infection and patients. Patient from the beginning of the end of latency to onset within 10 days is contagious. Pathogens exist in the patients or carriers of nasopharyngeal secretions, spread through respiratory droplets. During the epidemic, with an incidence duo who accounted for more than 2 ~ 4%, but the crowd nasopharyngeal carriage rate often significantly higher, sometimes as high as 50%, and the crowd carrier rate of over 20% when it suggests that the epidemic may occur, So carriers as a source of infection more meaningful. (2) transmission of pathogens through coughing, sneezing, speaking directly by droplets from the air spread In vitro and in the life of the extremely weak, the day-to-day supplies through indirect spread of the rare opportunities. Close contact, like sleep, the embrace of breastfeeding, such as kissing on the following two-year-old infant transmission of the disease is important. (3) the susceptibility of any age can develop the disease, from 2 ~ 3 months, 6 months to 2 years old the highest incidence rates, After age growth is gradually declining. Neonatal a bactericidal antibodies from the mother so rare incidence. Carriers and patients infected with the blood of bactericidal antibody IgG, IgM, IgA increased, In addition to the antibody with a group pathogens sterilization, different groups of meningococcal have bactericidal effect, This is because the bacteria in the group together with the outer membrane protein antigen. Subclinical infection through access to the group-specific antibody titers lower, can only protect the body from disease, not prevent re-infection. (4) the incidence of epidemic, a former starting November 21,1996 3, reached a peak in April and May started to decline. Other season a few sporadic cases occurred. As the crowd weakened immunity and susceptibility to the accumulation of the past, usually every three-five years in a small fashion. 8 ~ 10 emerged a pandemic. Epidemic factors and indoor activities, air circulation, lack of sunlight, overcrowding, suffering from respiratory tract infection, and so on. Small and medium-sized cities in two - or four-year-old five-nine-year-old the highest incidence rates, and the incidence rate roughly equal. Incidence scattered cities. Once the remote mountain source of infection intervention, which often caused point outbreak, 15 persons over the age of onset total incidence of 50%. A two or more persons incidence also styles. Dominant infection and subclinical infection in the ratio of 1 : 1000-5000.