国内多年来应用脑膜炎球菌A群多糖菌苗.PPT

Epidemic Cerebrospinal Meningitis Epidemic Cerebrospinal Meningitis Summarization: The main clinical manifestations: High fever Severe headache Frequent vomitting Petechiae Triad signs of meningeal irritation (stiff-neck rigidity, Kernig sign Brudzinski sign) CSF shows purulent changes Epidemic Cerebrospinal Meningitis Summarization: In severe cases septic shock and damage of the brain parenchyma may occur. With the highest morbidity in fulminant meningitis ETIOLOGY Neisseria meningitidis is a gram-negative diplococcus, commonly named the meningococcus. ETIOLOGY This kind of bacteria can be found only in humanbody. Meningococcus can be divided into 13 serogroups due to their specific polysaccharide antigen, include group A、B、C、D、X and so on. (90% is A,B,C) ETIOLOGY Endotoxin released by meningococcus is the most important cause of the disease Resistance: very weak The meningococcus are sensitive to dry, cold, heat and common antiseptics. Autolyze: specimen delivery EPIDEMIOLOGY Source of infection: fomes and patients The human nasopharynx is the only known reservoir of meningococcal infection. EPIDEMIOLOGY Route of transmition: respiratory tract transmition Meningococci are spread from person to person by airborne droplets of infected nasopharyngeal secretions. Indirect transmission is rare. Contact transmission is significant to babies below 2 years old. EPIDEMIOLOGY Susceptible groups: all people is susceptible From 6 months to 2 years is high-incidence A permanent post-infection immunity EPIDEMIOLOGY Epidemiologic character: The whole year especially winter spring( November~ May) All over the world 流行特征 1．流脑发病概况 2．聚集性病例 3．菌群分布和菌株分离情况 4 ．脑膜炎奈瑟菌（Nm）菌株耐药检测情况 1．流脑发病概况（历史回顾） 流脑最初在1805年发现于瑞士日内瓦，脑膜炎球菌是在1887年被确认的。 中国是流脑高发的国家之一，曾于上个世纪的1938年、1949年、1959年、1967年、1977年发生过5次流脑大规模流行。 1985年，全国广泛接种A群多糖菌苗后，发病率逐年降低，未再出现全国性大流行,近几年来发病率控制在0.2／10万左右的较低水平。 1．流脑发病概况（近年趋势） 1985 年 10/1