IHR-Lecture 33 September 2, 2 !! " !!#$ ((e&tem@umdnj.edu) )age ! *+ !

Normal flora of: % carriers in population Virulent strains Pathogenesis Gram stain Niesseria meningiditis -as*phar.n/ 0-! $*st c*mm*n&. seen 1n !3-20 .ear *&ds 2 t*ta& but 0 c*ntr1bute m*st3 ", %, C, D, 4, &, 5, 22%, '()* men1ng1t1s, men1ng*c*ccem1a, 'aterh*use-6r1der1chsen s.ndr*me Gram negat17e, d1p&*c*ccus Diagnosis CSF and lood culture Gr*(s best *n ch*c*&ate agar (1th 08 9:2 -sma&& c*&*n1es, */1dase p*s1t17e Gr*(s :-L? *n ch*c*&ate agar (1th 08 9:2 -&arge, +&at, gre. c*&*n1es -sma&&, gra., -hem*&.t1c c*&*n1es -b1&e s*&ub&e, *pt*ch1n sens1t17e -use */ac1&&1n d1sc screen t* see 1+ the stra1n 1s pen1c1&&1n res1stant other 6ermentat1*n test3 g&uc*se and ma&t*se

Dr. Stephen Garrett (garrettst@umdnj.edu) %&ena 'e&t ,nc*rrected

Epidemiology !ransmission Resp1rat*r. secret1*ns, sp*rad1c cases "t ris# 9&*sed p*pu&at1*ns (d*rms, m1&1tar. " carr1er 8 r1ses t* ; -< )= 909< de+1c1enc.= .*ung ch1&dren Prophyla$is R1+amp1n, c1pr*+&*/ac1n t* carr1ers *r d1rect e/p*sure Prevention Vaccine >uadra7a&ent 7acc1ne aga1nst #, 9, ?, and '!30 (stra1n @ n*t 1mmun*gen1c) pr*tects aga1nst 0 8 *+ cases (because stra1n @ 1s resp*ns1b&e +*r 0 8) H1b 7acc1ne3 aga1nst stra1n @ *n&. " th1s has &*(ered t*ta& cases per .ear +r*m !2, t* 3 (and stra1n @ (ent +r*m caus1ng 2<8 t* 0 8 *+ cases) -)neum*7a/, p*&.7a&ent 7acc1ne (aga1nst a&& 23 stra1ns, used 1n atr1sB p*pu&at1*ns and +*r th*se C A0 .ears) -)re7nar, c*njugate 7acc1ne (aga1nst *n&. ; stra1ns, but can be used +*r ch1&dren D2 .ears)

+aemophilus influen,e

-as*phar.n/

$*st c*mm*n&. seen 1n ch1&dren up t* <-!2 .ears *&d

A t*ta& (#-6) but @ causes 2 8 *+ cases (be+*re 7acc1ne)

Sept1cem1a, men1ng1t1s, c*njunct171t1s, ep1g&*tt1s (cr*up), pneum*n1a, *t1t1s med1a

Gram negat17e, c*cc*-bac1&&us (dependent *n gr*(th c*nd1t1*ns)

Resp1rat*r. secret1*ns, sp*rad1c cases 1n ch1&dren

R1+amp1n +*r d1rect e/p*sure

Streptococcus pneumonia

-as*phar.n/

0-; (m*re carr1ers dur1ng spr1ngt1me)

<0 t*ta&, 23 cause <08

L*bar pneum*n1a, *t1t1s med1a, men1ng1t1s

Gram p*s1t17e, &ancet shaped, d1p&*c*cc1

Resp1rat*r. secret1*n -*+ten ass*c1ated (1th head trauma

#sp&en1c, s1cB&e ce&& anem1a, de+ects 1n hum*ra& 1mmun1t., a&c*h*&1sm