Management of a Neisseria meningitidis case: factors that guarantee the effectiveness of supporting Public Health actions
Keywords:
Chemoprophylaxis; Surveillance; Vaccinations; Neisseria meningitidis; Public HealthAbstract
Among invasive bacterial diseases, meningococcal meningitis is a serious and contagious disease caused by Neisseria meningitidis. The disease has a high lethality grade and could have long-term sequelae. This paper describes a case of meningitis that occurred in the territory under the jurisdiction of Local Health Authority ULSS 1 Dolomiti and the related management methods. The activities described concern rapid alerts, an epidemiological investigation, the administration of chemoprophylaxis and offering vaccinations, implemented according to the current Public Health protocol through different healthcare workers. This case report aims to support the management of possible similar cases, underlining the conditions that favoured the application of the envisaged measures, including an on-call ready availability service; the presence of population vaccination centres located in the area investigated; and a network sensitive to early warnings and collaboration within and between Local Health Authorities.
References
1. Yazdankhah SP, Caugant DA. Neisseria meningitidis: an overview of the carriage state. J Med Microbiol. 2004 Sep;53(Pt 9):821-832. doi: 10.1099/jmm.0.45529-0.
2. Hill DJ, Griffiths NJ, Borodina E, Virji M. Cellular and molecular biology of Neisseria meningitidis colonization and invasive disease. Clin Sci (Lond). 2010 Feb 9;118(9):54764. doi: 10.1042/CS20090513.
3. Read RC. Neisseria meningitidis; clones, carriage, and disease. Clin Microbiol Infect. 2014 May;20(5):391-5. doi: 10.1111/1469-0691.12647.
4. Caugant DA, Maiden MC. Meningococcal carriage and disease--population biology and evolution. Vaccine. 2009 Jun 24;27 Suppl 2(4):B64-70. doi: 10.1016/j. vaccine.2009.04.061. Epub 2009 May 21.
5. Centers for Disease Prevention and Control (CDC). Meningococcal disease. Available from: https://www.cdc.gov/ vaccines/pubs/pinkbook/mening.html [Last accessed: 2023 Dec 14]).
6. van Deuren M, Brandtzaeg P, van der Meer JW. Update on meningococcal disease with emphasis on pathogenesis and clinical management. Clin Microbiol Rev. 2000 Jan;13(1):144-66, table of contents. doi: 10.1128/ CMR.13.1.144.
7. Chang Q, Tzeng YL, Stephens DS. Meningococcal disease: changes in epidemiology and prevention. Clin Epidemiol. 2012;4:237-45. doi: 10.2147/CLEP.S28410.
8. Stephens DS. Biology and pathogenesis of the evolutionarily successful, obligate human bacterium Neisseria meningitidis. Vaccine. 2009 Jun 24;27(Suppl 2):B71-7. doi: 10.1016/j.vaccine.2009.04.070.
9. Ministero della Salute. Prevenzione e controllo delle malattie batteriche invasive prevenibili con vaccinazione. Available from: https://www.trovanorme.salute.gov.it/norme/rende rNormsanPdf?anno=2017&codLeg=59229&parte=1%20
&serie=null [Last accessed: 2023 Dec 14].
10. Presa J, Serra L, Weil-Olivier C, York L. Preventing invasive meningococcal disease in early infancy. Hum Vaccin Immunother. 2022 Nov 30;18(5):1979846. doi: 10.1080/21645515.2021.1979846.
11. Resolution of the Veneto Regional Council n. 411 of 26 February 2008. Vaccination calendar - changes and additions.
12. Russo F, Pozza F, Napoletano G, Zanella F, Baldovin T, Lazzari R, et al. Experience of vaccination against invasive bacterial diseases in Veneto region (north east Italy). J Prev
Med Hyg.2012 Jun;53(2):113-5. 10.15167/2421-4248/ jpmh2012.53.2.328.
13. Resolution of the Veneto Regional Council n. 1564 of 26 August 2014. Approval of the new “Vaccination Calendar” of Veneto Region. Partial modification of the D.G.R. n. 411 of 26 February 2008, approval of document “Offer of vaccinations for subjects at risk”, approval of “Training program for healthcare workers”, approval of document “Communication plan to support vaccine-preventable infectious diseases”.
14. Resolution of the Veneto Regional Council n. 990 of 11
August 2023. Transposition of the Agreement of the StateRegions Conference on the document containing “National vaccination prevention plan (PNPV) 2023-2025” and on the document containing “National vaccination calendar” (Rep. Acts n. 193/CSR of 02/08/2023) and strengthening of vaccination prevention strategies with simultaneous updating of the offer of the Veneto Region.
15. Tascini C, Iantomasi R, Sbrana F, Carrieri C, D’Angela D, Cocchio S, et al. MAGLIO study: epidemiological analysis on invasive meningococcal disease in Italy: focus on hospitalization from 2015 to 2019. Intern Emerg Med. 2023 Oct;18(7):1961-1969. doi: 10.1007/s11739-023-03377-7. Epub 2023 Aug 1.
16. Baldovin T, Lazzari R, Cocchio S, Furlan P, Bertoncello C, Saia M, et al. Invasive meningococcal disease in the Veneto region of Italy: a capture-recapture analysis for assessing the effectiveness of an integrated surveillance system. BMJ Open. 2017 May 2;7(4):e012478. doi: 10.1136/bmjopen2016-012478. Epub 2023 Aug 1.
17. Italian National Institute of Health. Invasive bacterial diseases (sepsis and meningitis). Available from: https://www.
epicentro.iss.it/meningite/ [Last accessed: 2023 Dec 15].
18. Russo F, Zanella F, Ferraresso A, Piccolo R, Ledri R, Pellizzari B, et al. Infectious diseases: plan for preparedness and response to public health emergencies at the national level - From surveillance to emergency control.” Veneto Region”.
19. Red Book® new Italian edition: guided exploration of the Report of the Committee on Infectious Diseases 2021-2024. Red Book. Italian Edition. American Academy of Pediatrics and Pacini Editore Medicina; 2022.
20. Marcotrigiano V, Pattavina F, Blangiardi L, Salerno G, Dalena A, Del Bianco F, et al. The Preventive Health Professions in Italy: The Efficient Use of Resources, Skills and Best Practice during the Pandemic. Healthcare (Basel). 2022 Sep 28;10(10):1906. doi: 10.3390/healthcare10101906.
21. Cinquetti S, De Polo A, Marcotrigiano V, Battistin M, Bino E, De Mattia G, et al. Lessons Learned from the COVID-19 Vaccination Campaigns in Veneto Region: Population Vaccination Centers as Support for the Traditional Outpatient Model. Vaccines (Basel). 2023 Nov 7;11(11):1695. doi:
10.3390/vaccines11111695.
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Copyright (c) 2025 Anna Voltolini, Vincenzo Marcotrigiano, Serena Cian, Nahuel Fiorito, Alfonsina Sollano, Ilaria Dall'O, Vincenzo Baldo, Sandro Cinquetti (Author)

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