engleski

Familial Epidemic of Meningococcal Disease

Two closely related boys from the same house hold (Home 1), aged two andthree, were affected with fulminant meningococcal sepsis known as Waterhouse-Friderichsen syndrome. Neisseriameningitidis serogorup B was isolated from their blood and cerebrospinal fluid. The two- year-old boydied one day after the onset of the disease. Epidemiological examination of contacts and pharyngeal swabswere performed in 14 persons from the household, all of them relatives of the affected children, as wellas in a number of other contacts. Chemoprophylaxis with cotrimoxazole was simultaneously administeredto all contacts. Family histories revealed that two contacts from the household where the patients didnot live (Home 2) were inadvertently omitted. Subsequent examinations, following a report of anothercontagious disease (salmonelosis), revealed that these two persons were Neisseria meningitidis carriers, together with another one in the same household. The carriers most probably caused the infection of athird, five-year-old boy, the deceased boy's brother (Home 1) who also developed fulminant meningococcalsepsis. The failure to take the appropriate prophylaxis led to a prolonged carrier state in the carrierfrom the second household. Repeated pharyngeal swab sampling revealed two more carriers from both householdsthat had previously been negative. Control of the epidemic was achieved after 5 weeks by repeated andcontrolled chemoprophylaxis with ciprofloxacin, and by repeated epidemiological examinations, disinfection, and daily health surveillance by the Sanitary Inspectorate. This extremely rare instance of a familialepidemic with three infected persons emphasizes the need for consistent chemoprophylaxis in meningococcaldisease contacts.

Carrier state ; chemoprophylaxis ; epidemic ; Neisseria meningitidis ; Waterhouse Friderichsen syndrome

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