İlk 24 Saat | Meningokok Menenjiti

Meningokok Menenjiti Nedir?

Erken tanı ve uygun tedavi ile bile vakaların ~%15'i ilk semptomlar sonrası 24 ila 48 saat içinde sıklıkla ölümle sonuçlanmaktadır.^2,6

Erken belirtileri gribe benzeyebilir ve yanlış teşhis konulabilir,¹⁸ bu nedenle ilk ortaya çıkan belirtilere dikkat edilmelidir:¹⁶

5 yaşın altındaki çocuklar: ateş¹⁶

5 yaşından büyük çocuklar: baş ağrısı¹⁶

Tüm yaş grupları: iştahsızlık, bulantı, kusma ve üst solunum yolu semptomları (boğaz ağrısı ve nezle).¹⁶

Bu erken belirtiler çocuklarda ortalama 7-12 saat sürmektedir.

Bundan sonra, ense sertliği, ışığa karşı hassasiyet ve şişkin bıngıldak dahil meningokok menenjitine özgü semptomlar başlar. Bu semptomların ortalama başlangıç süresi, hastalığın başlangıcından itibaren yaklaşık 12 ila 15 saattir. Son belirtiler (bilinç kaybı, deliryum veya nöbet gibi) 1 yaşından küçük bebeklerde ortalama 15 saat, daha büyük çocuklarda ise 24 saat civarında görülür.¹⁶

Kişiler arası temas, meningokok menenjitinin bulaşmasına neden olabilir ve bebeğinizin bir oyuncağı paylaşması ile kolayca gerçekleşebilir.^1,20

Meningokok Menenjiti Nedir?

Meningokok menenjiti insandan insana şu şekilde yayılabilir:^1,2,20

Meningokok Menenjiti Bulaşma Yolları^1,2,20

Enfekte insanlarla uzun süreli temas.²⁰

Yiyecek veya içecek, su şişesi, diş fırçası, oyuncak, ağız koruyucusu ve müzik aleti gibi şeylerin paylaşımıyla tükürükle mikropların yayılması.¹

Hapşırma, yakın konuşma veya öpüşmeden kaynaklanan damlacıklar.²

N. meningitidis bakterileri kişiler arası yakın veya uzun süreli temas yoluyla bulaşabilir.²⁰ Genellikle vücudun savunmasını işgal eder ve kan dolaşımı yoluyla beyne yayılır, bu durum sadece 24-48 saat içinde ölüme yol açabilir.^2,6

Her on kişiden biri semptom göstermeden veya hastalanmadan meningokok taşıyıcısı olabilir.²⁰

Canadian Pediatric Society. Meningococcal Vaccine. Paediatr Child Health 2005;10(2).
World Health Organization. Meningococcal meningitis.2018. Available from: https://www.who.int/news-room/fact-sheets/detail/meningococcal -meningitis . Accessed 25 February 2021.
Centers for Disease Control and Prevention (CDC). Meningitis: About Bacterial Meningitis Infection, 2019. CDC website. https://www.cdc.gov/meningitis/bacterial.html. Accessed 25 February 2021.
Centers for Disease Control and Prevention (CDC). Meningitis: Viral, 2019. CDC website. https://www.cdc.gov/meningitis/viral.html. Accessed 25 February 2021.
Centers for Disease Control and Prevention (CDC). Meningitis. CDC website. https://www.cdc.gov/meningitis/index.html. Accessed 25 February 2021.
World Health Organization. Weekly Epidemiological Record. 2011; 86: 521-54.
Zunt J, Kassebaum N, Blake N, Glennie L, Wright C, Nichols E et al. Global, regional, and national burden of meningitis, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology. 2018; 17(12): 1061-1082.
NHS. Meningitis Causes. 2019. Available from: https://www.nhs.uk/conditions/meningitis/causes/. Accessed 25 February 2021.
Purmohamad, A, Abasi E, Azimi T et al. Global estimate of Neisseria meningitidis serogroups proportion in invasive meningococcal disease: A systematic review and meta-analysis.Microb Pathog 2019 134:103571.
Viner R, Booy R, Johnson H, Edmunds W, Hudson L, Bedford H et al. Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC): a case-control study. The Lancet Neurology. 2012; 11(9):774-78.
Bettinger J, Scheifele D, Le Saux N, Halperin S, Vaudry W, Tsang R. The Disease Burden of Invasive Meningococcal Serogroup B Disease in Canada. The Pediatric Infectious Disease Journal. 2013;32(1):e20-e25.
Centers for Disease Control and Prevention. Meningococcal Surveillance 2019. Available from: https://www.cdc.gov/meningococcal/surveillance/index.html. Accessed 25 February 2021.
Bundy L, Noor A. Neonatal Meningitis. Ncbi.nlm.nih.gov. 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532264/ . Accessed 25 February 2021.
National Institutes of Health. Medline Plus. Meningococcal meningitis. https://medlineplus.gov/ency/article/000608.htm. Accessed 25 February 2021.
National Health Service (NHS). Meningitis: symptoms, 2019. NHS website. https://www.nhs.uk/conditions/meningitis/symptoms/. Accessed 25 February 2021.
Thompson M, Ninis N, Perera R, Mayon-White R, Phillips C, Bailey L et al. Clinical recognition of meningococcal disease in children and adolescents. The Lancet. 2006; 367(9508):397-4.
Villena R, Safadi M, Valenzuela M et al. Global epidemiology of serogroup B meningococcal disease and opportunities for prevention with novel recombinant protein vaccines. Human Vaccines & Immunotherapeutics 2018;14(5): 1042–1057.
Centers for Disease Control and Prevention . Meningococcal Signs and Symptoms. 2017. Available from: https://www.cdc.gov/meningococcal/about/symptoms.html. Accessed 25 February 2021.
NHS. Overview Meningitis. 2019. Available from: https://www.nhs.uk/conditions/meningitis/symptoms/ . Accessed 25 February 2021.
Centers for Disease Control and Prevention (CDC).Meningococcal: Causes and Transmission, 2019. CDC website. https://www.cdc.gov/meningococcal/about/causes- transmission. html. Accessed 25 February 2021.
ECDC. Surveillance Atlas of Infectious Diseases. 2018. Available from: https://atlas.ecdc.europa. eu/public/index.aspx. Accessed 25 February 2021.
National Organization for Rare Disorders (NORD). Meningococcal Meningitis, 2020. NORD website. https://rarediseases.org/rare-diseases/ meningococcalmeningitis/Accessed 25 February 2021.
Christensen H, May M, Bowen L, Hickman M, Trotter C. Meningococcal carriage by age: a systematic review and meta-analysis. The Lancet Infectious Diseases. 2010; 10(12): 853-861.
Memish Z, Goubeaud A, Bröker M, Malerczyk C, Shibl A. Invasive meningococcal disease and travel. Journal of Infection and Public Health. 2010; 3(4): 143-151.
Steffen R. The Risk of Meningococcal Disease in Travelers and Current Recommendations for Prevention. Journal of Travel Medicine.2010;17(suppl 1):9-17.
Choi C. Bacterial Meningitis in Aging Adults. Clinical Infectious Diseases. Clinical Infectious Diseases. 2001;33(8): 1380–1385.
For Every Child, Every Right: The Convention on the Rights of the Child at a crossroads. New York: United Nations Children’s Fund (UNICEF), 2019.
NHS. Why vaccination is safe and important. https://www.nhs.uk/conditions/vaccinations/why-vaccination-is-safe-and-important/. Accessed 25 February 2021.
Nigeria Centre for Disease Control (NCDC). World Meningitis Day 2019 - Life After Meningitis, 2019. NCDC website. https://ncdc.gov.ng/news/177/world-meningitis-day---2019-life-after-meningitis#: ~:text=Globally2%C20%Meningitis20%aects20%about202.8%,are20%currently20%aected20% in20%Nigeria. Accessed 25 February 2021.
Ceyhan M. et al. (2014) Meningitidis caused by Neisseria Meningitidis, Hemophilus Influenza Type B and Streptococcus Pneumoniae during 2005-2012 in Turkey. Human Vaccines & Immunotherapeautics, 10:9, 2706-2712.
Gökçay G., Beyazova U. (Ed) İlk Beş Yaşta Çocuk Sağlığı İzlemi. Sosyal Pediatri Yayınları