MENINGOCOCCAL MENINGITIS (MCM) AT NEW

DELHI & INDIA

Dr. A. K. AVASARALA MBBS, M.D.PROFESSOR & HEADDEPT OF COMMUNITY MEDICINE & EPIDEMIOLOGYPRATHIMA INSTITUTE OF MEDICAL SCIENCES, KARIMNAGAR, A.P.INDIA: +91505417avasarala@yahoo.com

PART- III

DISCUSSION

DELHI PROBLEM-11. 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

.

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.

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?

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.

SPORADIC EPIDEMIC NATURE

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

FULMINANT NATURE OF MCM

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

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

CHANGING TREND

• PRIMARILY A DISEASE OF INFANTS AND CHILDREN (1966) NOW AFFECTING YOUNG ADULTS

• CERTAIN POPULATIONS - ARE MORE SUCEPTIBLE. WHY?

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

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