MENINGOCOCCAL MENINGITIS (MCM) AT NEW DELHI

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MENINGOCOCCAL MENINGITIS (MCM) AT NEW DELHI
INDIA
Dr. A. K. AVASARALA MBBS, M.D. PROFESSOR
HEAD DEPT OF COMMUNITY MEDICINE
EPIDEMIOLOGY PRATHIMA INSTITUTE OF MEDICAL
SCIENCES, KARIMNAGAR, A.P. INDIA
91505417 avasarala_at_yahoo.com
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• PART- III
  
• DISCUSSION

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DELHI PROBLEM-1

• IS DELHI BECOMING
• HOMETOWN FOR MCM?
• DELHI IS PRESENTLY
• EXPERIENCING THE EIGTH
• OUTBREAK OF MCM
• COMMENCING FROM 1966
• EPIDEMICS OCCURRED AT
• DELHI IN SIX CONSECUTIVE
• YEARS FROM 1983 TO 1988
• .

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DELHI PROBLEM - 2

• WHY IS IT SO?
• PROBABLY , THE AGENT IS ABLE TO SURVIVE IN
  NASOPHARYNGEAL CARRIERS IN OVERCROWDED POPULATION
  OF DELHI.
• PROBABLY, HIGH OR OPTIMUM NASOPHARYNGEAL CARRIER
  STATE IS CONSTANTLY MAINTAINED PRESENT IN DELHI
  POPULATION.

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EPIDEMIOLOGICAL STUDY?

• HOW THE AGENT (MENINGOCOCCI ) IS THRIVING AT
  DELHI ? (AGENT FACTORS)
• WHAT ARE THE HOST FACTORS MAKING DELHI
  POPULATION MORE SUSCEPTIBLE TO MCM?
• HOW DELHI ENVIRONMENT IS FAVOURABLE (ENVIRONMENT
  FACTORS) TO MENINGOCOCCI?

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DIFFICULT TO PREDICT

• MCM EPIDEMIC IS DIFFICULT TO PREDICT
• BUT INDICATORS AVAILABLE
• INCREASED LABORATORY CONFIRMED CASES - THIS WAS
  OBSERVED IN 1966 DELHI EPIDEMIC
• CHANGE IN SEROGROUPING OF CASES
• No change in serogroup.
• CHANGE IN AGE GROUP ( MORE IN HIGHER AGE GROUPS)
• Delhi epidemic 1966 predominantly affected
  infants, while the present epidemic affected
  mainly 15-29 years, young adults.

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SPORADIC EPIDEMIC NATURE

• MOST OFTEN MCM EPIDEMIC COMMENCES WITH A FEW
  SPORADIC CASES EVERY YEAR AND THEN BLOWS UP INTO
  AN EPIDEMIC.

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FULMINANT NATURE OF MCM

• HIGH MORTALITYAS THE DISEASE IS OFTEN FATAL,
  PARTICULARLY IN CHILDREN AND YOUNG ADULTS, IT
  CREATES SCARE AMONG THE POPULATION

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NASOPHRYNGEAL CARRIER STATE

• THIS FACTOR IS OF PARAMOUNT IMPORTANCE BECAUSE
• HIGH CARRIER RATE IS OFTEN RELATED TO THE
  EPIDEMICITY
• VACCINE CAN PREVENT NEITHER THE CARRIER STATE
  NOR THE EPIDEMIC

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• CHANGING TREND
• PRIMARILY A DISEASE OF INFANTS AND CHILDREN
  (1966) NOW AFFECTING YOUNG ADULTS
• CERTAIN POPULATIONS - ARE MORE SUCEPTIBLE.
  WHY?

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SUMMARY

• INDIA AND MORE SO DELHI NEEDS
• MORE CONSTANT EFFECTIVE SURVILLANCE AND HEALTH
  ACTION FOR CONTROLLING MCM
• A VACCIVNE EFFECTIVE AGAINST NASOPHARYNGEAL
  CARRIERS
• COMMUNITY SENSITIZATION AND ACTIVE PARTICIPATION
  TO CONTROL MCM

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REFERENCES

• UPDATES ON MENINGOCOCCAL MENINGITIS,
  COMMUNICABLE DISEASES DEPARTMENT, WHO, REGIONAL
  OFFICE FOR SOUTH EAST ASIA
• COMMUNICABLE DISEASE BULLETIN - REPORT BY DR.
  (MRS.) S. SEHGAL, DIRECTOR, NATIONAL INSTITUTE OF
  COMMUNICABLE DISEASES, NEW DELHI