NAME: Neisseria meningitidis
SYNONYM OR CROSS REFERENCE: Meningococcal meningitis, Meningococcal infection, cerebrospinal fever, meningococcemia
CHARACTERISTICS: Gram negative diplococci, intra or extra-cellular; multiple serogroups - 13 recognized groups (Groups A, B, C, X, Y, Z and W135 are frequently occurring); infection of the CSF
PATHOGENICITY: Acute disease characterized by sudden onset with fever, intense headache, nausea and often vomiting, stiff neck, and frequently a petechial rash with pink macules; delirium and coma; early diagnosis and modern therapy have reduced case fatality rate from 50% to less than 10%; may be asymptomatic or with only local symptoms, 10% of patients who recover have permanent neurologic disability, limb loss, and hearing loss; invasive with septicemia or meningitis; death rate is high in fulminating meningococcemia; infection usually causes sub-clinical mucosal infections; carrier prevalence of 25% or greater may exist without cases of meningitis
EPIDEMIOLOGY: Worldwide; sporadic cases in both urban and rural areas; greatest incidence in winter and spring; epidemic waves at irregular intervals; primarily a disease of very small children; occurs commonly in children and young adults, in males more than females; more commonly in newly aggregated adults under crowded living conditions; high incidence in sub-Sahara; Group A, B, C mainly responsible; largest epidemic in 1996 reported in West Africa
HOST RANGE: Humans
INFECTIOUS DOSE: Not known
MODE OF TRANSMISSION: By direct contact, including droplets and discharges from nose and throat of infected persons, more often carriers than cases; invasion sufficient to cause systemic disease is comparatively rare; carrier prevalence of 25%; indirect contact not significant
INCUBATION PERIOD: From 2-10 days, commonly 3-4 days
COMMUNICABILITY: Communicable until meningococci are no longer present in discharges; meningococci usually disappear within 24 hours of institution on sulfonamide treatment; penicillin will usually only suppress the organisms but they are not eradicated with this drug
RESERVOIR: Humans
ZOONOSIS: None
VECTORS: None
DRUG SUSCEPTIBILITY: Prophylactic antibiotic of choice is rifampin; ceftraixone, ciprofloxacin are reported to be effective; susceptible to penicillin
DRUG RESISTANCE: Resistance to penicillin, sulfonamides and chloramphenicol have been reported
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to many disinfectants - 1% sodium hypochlorite, 70% ethanol, iodines, glutaraldehyde, formaldehyde
PHYSICAL INACTIVATION: Susceptible to temperature changes and desiccation; inactivated by moist heat (121° C for at least 15 min) and dry heat (160-170° C for at least 1 hour)
SURVIVAL OUTSIDE HOST: Does not survive well in environment
SURVEILLANCE: Close surveillance for early signs of illness, especially fever; demonstration of organisms in CSF; serological studies
FIRST AID/TREATMENT: Initiate antibiotic treatment immediately when the presumptive clinical diagnosis is made
IMMUNIZATION: Personnel working with high concentrations or large quantities of organisms should be immunized with the tetravalent polysaccharide vaccine (A, C, Y, and W-135); a bivalent vaccine (A and C)
PROPHYLAXIS: Rifampin for close contacts or if have intimate exposure to nasopharyngeal secretions; sulfonamides may be used if less than 5% of strains from cases are resistant
LABORATORY-ACQUIRED INFECTIONS: Demonstrated hazard to laboratory workers; 8 reported cases up to 1974 (Pike, R.M.; Ann Rev Microbiol., 1979; 33:41-46); 2 fatal cases in clinical labs in 1988 (MMWR 1991; 40:46-47); 2 fatal case in 1991 (unpublished)
SOURCES/SPECIMENS: Pharyngeal exudates, cerebrospinal fluid, blood, saliva
PRIMARY HAZARDS: Parenteral inoculation; droplet or aerosol exposure of mucous membranes; infectious aerosols and ingestion
SPECIAL HAZARDS: None
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment equipment and facilities for all activities utilizing known or potentially infectious body fluids and tissues; additional containment (biosafety level 3) for activities with high potential for aerosol production or activities involving production quantities or concentrations of infectious cultures
PROTECTIVE CLOTHING: Laboratory coat; gloves when working with infectious materials; gloves and gowns with ties in back and tight wrists when working in biosafety cabinet
OTHER PRECAUTIONS: Certified biological safety cabinets should be used when mechanical manipulations that have aerosol potential are performed
SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with paper towel and then 1% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient contact time (30 min) before clean up
DISPOSAL: Decontaminate before disposal; steam sterilization, chemical disinfection, incineration
STORAGE: In sealed containers that are appropriately labelled
Date prepared: March, 2001
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright ©
Health Canada, 2001