TAILIEUCHUNG - Meningococcal Disease

In 1887, Anton Weichselbaum, a Viennese doctor, was the first to report the isolation of meningococci from patients with meningitis (1). Shortly after, came the first description of lumbar puncture in living patients (2), leading to the isolation of meningococci from acute cases of meningitis. Three years later, Kiefer grew meningococci from the nasopharynx of cases of meningococcal disease, and from their contacts (3), a finding of immense significance in advancing understanding of the epidemiology and pathogenesis of the disease. Early serological typing systems demonstrated that there were important differences between meningococci in terms of their virulence. | M E T H O D S I N M O L E C U L A R M E D I C I N ETM Meningococcal Disease Methods and Protocols Edited by Andrew J. Pollard MD PhD Martin C. J. Maiden PhD . V I fl J L Humana Press 1__ Microbiology and Laboratory Diagnosis Keith Cartwright 1. Introduction . Historical Background In 1887 Anton Weichselbaum a Viennese doctor was the first to report the isolation of meningococci from patients with meningitis 1 . Shortly after came the first description of lumbar puncture in living patients 2 leading to the isolation of meningococci from acute cases of meningitis. Three years later Kiefer grew meningococci from the nasopharynx of cases of meningococcal disease and from their contacts 3 a finding of immense significance in advancing understanding of the epidemiology and pathogenesis of the disease. Early serological typing systems demonstrated that there were important differences between meningococci in terms of their virulence 4 . . Meningococcal Carriage and Disease It is believed that meningococci only occur in humans. They have never been isolated from other animals possibly owing to their inability to acquire iron from any other than human sources transferrin and lactoferrin . Their fastidious nature makes it most unlikely that there are any important environmental reservoirs. Meningococci form part of the normal commensal flora and can be isolated from the nasopharynx of approx 10 of individuals overall. Nasopharyngeal carriage is age-dependent peaking in late teenage and early adulthood at 20-30 or more but with low prevalence in the young and in the elderly. It is not clear whether acquisition of a new meningococcus in the nasopharynx results in respiratory illness. Meningococci may also be isolated from the urethra and from the rectum from time to time and appear to be capable of causing urethritis. From Methods in Molecular Medicine vol. 67 Meningococcal Disease Methods and Protocols .

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