This article reviews recent data on meningococcal disease and carriage in the Philippines. It aims to provide information on the epidemiology of meningococcal disease, its carriage, data on prevention, and the impact of vaccination on disease and carriage. The World Health Organization considers the Philippines as having low endemicity for meningococcal disease. However, current data underestimates the true burden in the country due to many factors. In recent years, data from the Philippines show a high case-fatality rate since only the septicemic form is being reported. Studies on asymptomatic meningococcal carriage rates are sparse, with one study by Gonzales, et al. investigating the prevalence of meningococcal nasopharyngeal carriage in Filipinos aged 5-24 years old living in an urban setting. The study showed that the overall prevalence of carriage was 3.7% and was highest (9%) among the 10-14 age group. Serogroup B was the most common isolate. Effective meningococcal vaccines are available. Although not included in the National Immunization Program, medical societies recommend giving vaccines to individuals at high risk of infection. Data on local epidemiology accounting for the disease and asymptomatic carriage are important to strengthen future programs on immunization and prevention of meningococcal disease.
Meningococcal Infections ; Meningococcal Vaccines

Introduction: Meningococcal disease is caused by Neisseria meningitidis that can present as fever or respiratory infection developing into a fulminant course. In February 2005, WHO experts confirmed that the Cordillera Administrative Region of the Philippines experienced an outbreak of Serogroup A Meningococcal Disease where there was an unusually large proportion of meningococcemia cases. Objectives: This study aims to describe the clinical profile of pediatric patients discharged from a tertiary hospital with a diagnosis of meningococcal disease and to identify the etiologic agent. Methodology: This is a retrospective descriptive study involving chart review of patients 0-18 years of age discharged from October 2004 to October 2006 with a diagnosis of either meningococcemia, meningococcal meningitis or both. Results: There were 217 discharges with this diagnosis. Of these, 100 (46.08%) belonged to the 0-18 years of age, 47% of who were male, 64% were Baguio residents, 28% were 0-1 year old, 19% were between 2-5 years old and 26% were 15-18 years old. 100% had a history of fever and 90% had rashes. 51% had a discharge diagnosis of Meningococcemia. 32% died due to septic shock, DIC. The etiologic agent was identified as Neisseria meningitidis. Conclusion: Of the study population, 53% were female. Children 0-5 years of age were most affected (47%). 100% had a history of fever. 32% died of septic shock. 62% were confirmed by laboratory. The culprit of this epidemic was a hypervirulent strain of Neisseria meningitidis Serogroup A Subtype A 1.9 sensitive to Penicillin.
Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; MENINGOCOCCAL INFECTIONS ; NEISSERIA MENINGITIDIS ; MENINGITIS, MENINGOCOCCAL

The complement system is composed of more than 25 different proteins and is usually divided into classical and alternative pathways. Complement component 7(C7) is one of the five terminal complement proteins that, upon activation of either the classical or the alternative pathway, interacts sequentially to form a large protein-protein complex, called membrane attack complex(MAC). Assembly of the MAC on target cells results in the formation of transmembrane pores that can lead to the killing of the cells. C7 deficiency is an autosomal recessive disorder that is mostly reported in Caucasians. The gene for C7 has been assigned to chromosome 5p13. To date, 15 different molecular defects leading to total or subtotal C7 deficient defects have been reported. C7 deficiency is associated frequently with recurrently bacterial infections, especially meningitis caused by Neisseria meningitidis. We report a case of a hereditary C7 deficiency associated with meningococcal meningitis.
Bacterial Infections ; Complement C7 ; Complement System Proteins ; Homicide ; Membranes ; Meningitis ; Meningitis, Meningococcal* ; Neisseria meningitidis

China ; Humans ; Meningococcal Infections ; Serogroup

Meningococcal infections can be associated with abnormalities of the complement system, which contains 5 terminal complement proteins. Furthermore, deficiencies in 1 of these 5, complement component 7 (C7), leads to the loss of complement lytic function, and affected patients show increased susceptibility to recurrent meningococcal meningitis and systemic Neisseria gonorrhoeae infection. In September 2003, an 11-year-old female patient presented at our outpatient department with high fever, lower leg pain, headache, and petechiaes. She rapidly progressed to coma but later achieved full recovery due to prompt treatment. Her final diagnosis was meningococcal sepsis and arthritis. Her elder brother also had a similar bacterial meningoencephalitis history, which encouraged us to perform analyses for complement component and gene mutations. Resultantly, both the brother and sister were found to have the same mutation in the C7 gene. Subsequently, vaccinations of the meningococcal vaccine meningococcal vaccine (Menomune(R)) were administered. However, in September 2006, the brother expired due to acute micrococcus meningoencephalitis. At present, the 16-year-old female patient is healthy. Here, we report a Korean family with a hereditary C7 deficiency with susceptibility to meningococcal infections due to C7 gene mutation.
Adolescent ; Arthritis ; Child ; Coma ; Complement C7 ; Complement System Proteins ; Female ; Fever ; Headache ; Humans ; Immunologic Deficiency Syndromes ; Leg ; Meningitis, Meningococcal ; Meningococcal Infections ; Meningococcal Vaccines ; Meningoencephalitis ; Micrococcus ; Neisseria gonorrhoeae ; Outpatients ; Sepsis ; Siblings ; Vaccination

Sepsis and meningitis caused by Neisseria meningitidis are rare in neonates, but neonatal sepsis and meningitis are associated with a high rate of mortality. Meningococcal disease is commonly reported in older children and adolescents and is known to be more prevalent in community settings. In this study, a 16-day-old neonate was diagnosed with serogroup B meningococcal sepsis and meningitis. The baby was treated with antibiotics at the early stages of the infection and was discharged in good condition without any complications. This case report can serve to raise awareness of the incidence and importance of meningococcal infection in neonates, especially serogroup B.
Adolescent ; Anti-Bacterial Agents ; Child ; Humans ; Incidence ; Infant, Newborn ; Meningitis ; Meningococcal Infections ; Mortality ; Neisseria meningitidis ; Neisseria ; Sepsis ; Serogroup

China ; epidemiology ; Humans ; Meningococcal Infections ; epidemiology

China ; Humans ; Meningococcal Infections ; prevention & control ; Meningococcal Vaccines ; classification ; therapeutic use ; Practice Guidelines as Topic

Meningococcal infection is a life threatening disease that leaves serious sequelae in spite of appropriate treatment, thus vaccination for high risk groups are important for the prevention of meningococcal diseases. However, the vaccine for Neisseria meningitidis has not been available in Korea until we introduced bivalent (serogroup A and C) polysaccharide vaccine for the first time for relief works in our university hospital. The vaccine was administered from January 2005 to March 2007 to 317 persons. Of the groups administered, the largest group among them were 133 (133/317, 42%) students who planned to study abroad and needed the vaccination for secure entrance to school dormitories. This group was followed by health care workers, travellers to the regions of the world with high risks of meningococcal diseases, and splenectomised patients. To rationalize the domestic use of meningococcal vaccine, the availability of vaccines first needs to be simplified by introducing them to the domestic market; for this to be possible, the approval system for vaccines should be reformed and epidemiogical studies need to be carried out.
Delivery of Health Care ; Humans ; Korea ; Meningococcal Infections ; Meningococcal Vaccines ; Neisseria meningitidis ; Relief Work ; Vaccination* ; Vaccines

Meningococcal infection is a life threatening disease that leaves serious sequelae in spite of appropriate treatment, thus vaccination for high risk groups are important for the prevention of meningococcal diseases. However, the vaccine for Neisseria meningitidis has not been available in Korea until we introduced bivalent (serogroup A and C) polysaccharide vaccine for the first time for relief works in our university hospital. The vaccine was administered from January 2005 to March 2007 to 317 persons. Of the groups administered, the largest group among them were 133 (133/317, 42%) students who planned to study abroad and needed the vaccination for secure entrance to school dormitories. This group was followed by health care workers, travellers to the regions of the world with high risks of meningococcal diseases, and splenectomised patients. To rationalize the domestic use of meningococcal vaccine, the availability of vaccines first needs to be simplified by introducing them to the domestic market; for this to be possible, the approval system for vaccines should be reformed and epidemiogical studies need to be carried out.
Delivery of Health Care ; Humans ; Korea ; Meningococcal Infections ; Meningococcal Vaccines ; Neisseria meningitidis ; Relief Work ; Vaccination* ; Vaccines