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Meningococcal disease is an immediately notifiable condition in Oklahoma, meaning cases must be reported to the state health department immediately upon suspicion or diagnosis. A suspected or confirmed case of meningococcal invasive disease triggers an investigation by personnel at the state and county health departments. Although the likelihood of secondary cases is extremely low, the severity of the disease warrants quick public health action to prevent disease.
Meningococcal disease is a potentially severe or fatal disease caused by the bacteria Neisseria meningitidis. Fortunately, the disease is uncommon and not all people who become infected with the bacteria develop illness. If you become infected, this means that you carry the bacteria in your nose or throat. At any one time, approximately 10% to 15% of the population will carry the bacteria but never experience any illness; less than 1% of infected people will ever develop symptoms.
Neisseria meningitidis can be passed from person to person by direct contact with nose and throat secretions through coughing, kissing, or sharing items such as drinking and eating utensils. The time from exposure to symptom onset (incubation period) ranges from 2 to 10 days, but usually occur with 3 to 4 days after exposure. Illness may present as pneumonia, septicemia, or meningitis. Septicemia is an infection of the blood with symptoms of fever, nausea, vomiting, and a rash. Meningitis is the inflammation of the protective membranes covering the central nervous system. Symptoms of meningococcal meningitis include fever, headache, nausea, vomiting, stiff neck, and a petechial rash. About 10% to 20% of people that develop disease will have long-term effects such as mental retardation, limb loss, or hearing loss. If untreated, approximately 15% of people with the disease will die. If you experience symptoms of meningococcal disease, contact your healthcare provider immediately.
Antibiotics such as penicillin or ceftriaxone are the appropriate treatment for meningococcal disease. Most people who receive appropriate treatment will survive the disease. A vaccine is available that prevents infection from four of the five primary serogroups of Neisseria meningitidis, and is recommended for those persons at higher risk of developing disease. These people include freshman living in dormitories, persons with immunocompromising conditions, people without a spleen, and people traveling to parts of the world where meningococcal disease is more common (such as certain parts of Africa). Oklahoma is one of the few states with a mandated vaccination law requiring public or private post-secondary educational institutions to provide information on the risks associated with meningococcal disease and the risks and benefits of vaccination to students who plan to reside in on-campus housing.
Close contacts to a case of meningococcal disease are recommended to receive antibiotics to prevent them from getting the disease. This is because close contacts are at much higher risk of developing disease than the general population. Close contacts include household members, close friends that spend a lot of time with the ill person, health care personnel with unprotected droplet exposure to a case, and persons that have had direct exposure to the ill patient’s nasal or oral secretions seven days prior to becoming ill. A public health nurse will work with the family of the ill person to identify all family, friends, and contacts that need antibiotics. Casual contacts, including classmates and co-workers, are not at increased risk of disease and do not need prophylaxis with antibiotics.
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