Saturday, January 17, 2015

Week 2: Epidemiology

Since Meningococcal Meningitis can strike rapidly, and unexpectedly in healthy individuals, disease surveillance systems have been put into place to monitor its variance.  The bacterium does not only cause meningitis.  In fact, the cases of people who contract the bacterium, meningitis only occurs in about 47% (CDC, 2012).  This data has been displayed in the graph below.  To better understand this epidemiological data, I will be showing you the epidemiology of Meningococcal disease itself, rather than the symptom of meningitis.  Disease surveillance is much higher for the disease, rather than it’s characteristics.  The rate of this disease has been declining in the United States over the last 20 years.  This is mainly in response to a new vaccination.  From 2005-2001, there were an estimated 800-1,200 cases of meningococcal disease that occurred annually in the United States (Baker, 2013).  This means that there were only about 0.3 cases per 100,000 individuals.  Since the vaccine was recommended in 2005, incidence had declined by 64%, which is reflected in those rates (Baker, 2013).




 http://www.cdc.gov/vaccines/pubs/pinkbook/mening.html

Who:
Age groups that are at the highest risk are those under the age of 1, and then a peak begins again around the age of 16-21 (CDC, 2014).  Infants have a more difficult time fighting off infections like this one.  This is the same case for elderly adults.  The adolescent and young adult ages are at risk due to how this disease is transmitted.  Transmission occurs from person to person through close respiratory secretions or saliva.  It is around this age that individuals are likely to kiss others, share eating utensils, and share drinks.  5-10% of adults are carriers of the bacterium (Cohn, MacNeil, 2014).  This means they have the bacteria yet do not display any symptoms.  This is critical to understand because transmission can occur without knowing it.    



 http://www.cdc.gov/meningococcal/surveillance/index.html

Where:
Almost all cases of Meningococcal  disease and the corresponding meningitis are sporadic, meaning they occur on their own without warning.  However sometimes, outbreaks can occur in small communities, schools, colleges, prisons, military corridors, and other small populations.  An outbreak is defined as multiple cases in a community of institution over a short duration of time.  These outbreaks occur due to the simple transmission of disease from living, or working, in tight quarters (Baker, 2013).  This bacterium is not only limited to the US, but is found worldwide.  Specific areas of Africa have a high incidence of Meningococcal  disease.  The area is know as the Belt of Africa and can be seen in the picture below.  In epidemic regions, incidence rates can be up to 1,000 cases per 100,000 persons (Cohn, MacNeil, 2013).  Knowing where disease rates are high is important information to travelers that can receive vaccines for preventable disease. 




 http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/meningococcal-disease

When:
The rise in cases seems to correspond in time with that of typical flu season, around December or January of each year (CDC, 2014). The immune system is inherently low at this time, so it is easy for bacteria to swoop in and cause disease. 

Morbidity and Mortality:
Although our rates of Meningococcal disease are at a historical low, the case fatality ratio remains at 10-15%.  This means that out of all the individuals in the United States that are contracted with the disease, 10-15% of them will die.  Out of those that survive, 11-19% have long term disabilities.  These disabilities often include neurological disability, limb or finger loss, and hearing loss (Baker, 2013). 


BIBLIOGRAPHY

Baker, C., Briere, E., Clark, T., Cohn, A., MacNiel, J., Meissner, H., Messonnier, N., Ortega, I. (2013, Mar 22).  Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm

Cohn, A., MacNeil, J., (2014, April 1) Meningococcal Disease: Manual for the Surveillance of Vaccine Preventable Diseases. Retrieved from http://www.cdc.gov/vaccines/pubs/surv-manual/chpt08-mening.html

Cohn, A., MacNeil, J., (2013, August 1) Infectious Disease Related to Travel. Retrieved from                                                   http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/meningococcal-disease

Centers for Disease Control and Prevention. (2012, May 7). Meningococcal Disease. Retrieved from                                     http://www.cdc.gov/vaccines/pubs/pinkbook/mening.html


Centers for Disease Control and Prevention. (2014, April 1) Surveillance.  Retrieved from                                                       http://www.cdc.gov/meningococcal/surveillance/index.html

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