Meningococcal disease fact

• The vaccine for those who are performing Hajj and Umrah contains vaccines against Meningococcus serogroup A, C, Y and W135. 
• For paediatric patients, the vaccine is against serogroup A. hence, we see the decline in this infection in paeds populations.
• If you want to go to Africa / Middle east, the vaccine must at least contains against serogroup A and C.
• Why don't we have vaccination against serogroup B? because it lacks the immunogenic polysachharide capsule that vaccines can act on. 
• In teenagers : most prevalent Serogroup C. In infant : Serogroup B
• Meningococcus (Neiserria Meningitides) spreads via nasopharynx secretions. Hence, risk factors include immunocompromised and overcrowding places. 
• Presentations can either be, septicemia, meningitis or focal lesion (septic arthritis, pericarditis or conjunctivitis)
• rash can be petechiae or purpura (non-blanching). 
• Meningococcal septicemia is not known to have neck stiffness, bulging fontanelle. abdominal symptoms, photophobia and the tests (kernig's, burudzski) are negative. This is the otherwise in meningitis.
• Kernig's sign (pain elicited with passive extension of the leg in a supine patient lying with their thigh flexed on their abdomen and their knee flexed)
• Burudzski's sign (passive flexion of the neck in a supine patient results in spontaneous flexion of the hips and knees)
• In meningococcal septicemia, IV/IM Benzylpenicillin must be given immediately. In meningitis, it is not urgent since the progress is slow.
• complication : distal amputations, lossof hearing, cranial nerve palsies, scars due to skin necrosis, cerebral atrophy, hydrocephalus, mental retardation can occur.  

source of BMJ Learning Module