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Regional Epidemiology and Surveillance Unit –
Bacterial & Other Viral Diseases
Meningococcal Disease Non-Neonatal Tetanus Influenza-like Illness
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Regional Epidemiology and Surveillance Unit –
Meningococcal Disease
DESCRIPTION
Meningococcal disease is caused by a bacterium known as
Neisseria meningitides (also called meningococci). Twelve
serogroups of N. meningitidis have been identified. The infection
is transmitted from person to person through droplets of
respiratory or throat secretions.
Close and prolonged contact (e.g. kissing, sneeing and coughing
on someone, living in close !uarters or dormitories (military
recruits, students), sharing eating or drinking utensils, etc.)
facilitate the spread of the disease.
The average incubation period is " days, ranging between # and $%
days
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Regional Epidemiology and Surveillance Unit –
Meningococcal Disease
IMPORTANCE OF SURVEILLANCE:
Meningococcal meningitis is the only form of meningitis to
cause epidemics. The case&fatality rate is between ' and $'.
The maority of cases occur in children *' years.
Meningococcal bivalent +, C and !uadrivalent +, C, , -$'vaccines are available/ immuniation of the entire population
should be considered to halt epidemics due to + and C
serogroup meningococci. 0mmuniation is also indicated for
people traveling to endemic areas.
1urveillance is needed to measure and detect epidemics andestablish the impact of both epidemic and non&epidemic
disease.
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Regional Epidemiology and Surveillance Unit –
Meningococcal Disease
Standard Case Definition/Classification:
Standard Case Definition/Classification:
Standard Case Definition/Classification:
Suspected case: + person with sudden onset of fever (23.'4C rectal or
23.%4C a5illary) and one or more of the following6
- neck stiffness
- altered consciousness
- other meningeal signs
- petechial or purpural rash
Note6 0n patients *$ year, suspect meningitis when fever is accompanied by
bulging fontanels
Probable case: + suspected case as defined above and6 Turbid C17 (with or
without positive 8ram stain) or ongoing epidemic and epidemiological link to
a confirmed case. Confirmed case: + suspected or probable case with laboratory confirmation.
Laorator! Confir"ation:
9ositive C17 antigen detection or culture. 9ositive blood culture
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Regional Epidemiology and Surveillance Unit –
N0n-Neonatal Tetanus
Descri,tion:
+n acute disease caused by an e5oto5in of the tetanus bacillus,Clostridium tetani, which grows anaerobically at the site of an inury.
The disease is characteried by painful muscular contractions,
primarily of the masseter and neck muscles, secondarily of trunk
muscles.
The first sign suggestive of tetanus in older children and adults isabdominal rigidity. 8eneralied spasms occur, fre!uently induced by
sensory stimuli/ typical features of the tetanic spasm are the position
of opisthotonus and the facial e5pression known as :risus
sardonicus.;
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Regional Epidemiology and Surveillance Unit –
N0n-Neonatal Tetanus
I",ortance of S#r.eillance:
0n developing countries, non&neonatal tetanus
continues to be an important cause of
preventable morbidity and mortality. Non&neonatal tetanus also takes a terrible toll,
especially in younger segments of the
population. 0t is estimated that in $>>% about
?% per cent of all non&neonatal tetanus cases
and deaths occurred among persons less than$' years of age.
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N0n-Neonatal Tetanus Standard Case Definition/Classification:
Suspected case: Not a,,licale
Probable case: Not a,,licale
Confirmed case: Ac#te onset of %!,ertonia and/or ,ainf#l "#sc#lar contractions ?#s#all!"#scles of t%e nec- and )a'@ and (enerali+ed "#scle s,as"s 'it%o#t a,,arent "edical ca#seas re,orted ! a %ealt% care ,rofessional*
Laborator Confirmation:
Laorator! confir"ation is of little %el, eca#se t%e or(anis" is rarel! reco.ered fro" t%esite of infection and #s#all! t%ere is no detectale antiod! res,onse*
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Influenza-like Illness Description:
An ac#te .iral disease of t%e res,irator! tract c%aracteri+ed ! fe.er& %eadac%e& "!al(ia&,rostration& cor!+a& sore t%roat and se.ere co#(%*
T%e inc#ation ,eriod is #s#all! 85 da!s and ,atient reco.er! is #s#all! 76= da!s*
Infl#en+a "a! e clinicall! indistin(#is%ale fro" disease ca#sed ! ot%er res,irator!.ir#ses& s#c% as co""on cold& cro#,& ronc%iolitis& .iral ,ne#"onia and #ndifferentiatedac#te res,irator! disease*
Disease trans"ission is t%ro#(% airorne s,read a"on( cro'ded ,o,#lations in encloseds,aces '%erein t%e infl#en+a .ir#s "a! ,ersist for %o#rs& ,artic#larl! in t%e cold and in lo'%#"idit!*
Trans"ission "a! also occ#r t%ro#(% direct contact* Ne' s#t!,es "a! e trans"itted(loall! 'it%in 56 "ont%s*
Se.ere illness and deat% d#rin( ann#al infl#en+a e,ide"ics occ#r ,ri"aril! a"on( t%e
elderl! and t%ose deilitated ! c%ronic cardiac& ,#l"onar!& renal or "etaolic disease&ane"ia or i""#nos#,,ression*
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Influenza-like Illness Importance of Surveillance:
S#r.eillance of infl#en+ali-e illness is .er! i",ortant eca#se of t%e ra,idit! 'it% '%ic%infl#en+a e,ide"ics de.elo,& its e$tensi.e "oridit! and t%e serio#sness of co",lications li-e.iral and acterial ,ne#"onias*
S#r.eillance of infl#en+a is essential for t%e earl! detection of ne' .ir#ses 'it% ne' s#rface,roteins t%at can ca#se ,ande"ics ran-in( as (loal %ealt% e"er(encies ?e*(* 8;8B& 8;>=&8;B@ 'it% "illions of deat%s ?c9< "illion in 8;8B@*
T%e earl! detection and c%aracteri+ation of t%ese .ir#ses allo's for ti"el! ann#al #,dates ofa .accine t%at can ,re.ent deat%s and alle.iate illness in .#lnerale (ro#,s of t%e ,o,#lation*
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Influenza-like Illness Standard Case Definition/Classification:
Suspected case: A ,erson 'it% s#dden onset of fe.er of 5BC and co#(% or sore t%roat in t%easence of ot%er dia(noses*
Probable case: Not a,,licale
Confirmed case: A s#s,ected case t%at is laorator!confir"ed ?#sed "ainl! ine,ide"iolo(ical in.esti(ation rat%er t%an s#r.eillance@*
Suspected !uman "vian Influen#a: A s#s,ect ILI case 'it% e$,os#re to s#dden ird deat%s$sudden bird deat%s in t&o or more %ouse%olds in a baran'a or deat% of at least () ofcommercial floc* increasin' t&ice dail for +,( consecutive das- OR confir"ed %#"an a.ianinfl#en+a case
Suspected Severe "cute Respirator Sndrome $S"RS- case: A s#s,ect ILI case 'it% e$,os#reto confir"ed SARS case*
Laborator Confirmation: Vir#s isolation or Pol!"erase C%ain Reaction ?PCR@ of nasal/oro,%ar!n(eal s'a or
trac%eal as,irate fro" t%e s#s,ected indi.id#al or direct detection of infl#en+a .iral anti(enor 9fold rise in antiod! titer et'een earl! and late ser#"*
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Thank You