It was a celebration----three days of dancing to give thanks to God for the spri

Question

It was a celebration----three days of dancing to give thanks to God for the spring harvest. Saihun was enjoying watching young girls and men attired with silver and gold ornaments. Saihun lived near other members of her clan, a large extended family within the Khasi tribe of the East Khasi Hills of Meghalaya—a state in northeast India that bordered Bangladesh. Although the celebration day was hot and humid, it had not rained--- a real blessing. The East Hills and surrounding areas were part of a subtropical rain forest. The abundant rain helped Saihun’s family to eke out a living growing rice.

Although Saihun was enjoying the night’s celebration, she was worried about her father, who was in bed with fever and headache. Normally she wouldn’t be so concerned except for the news of meningitis outbreak moving through the area. The outbreak, which began in Bangladesh, had moved into northeastern India. The latest news stated that more than 2,500 people had taken ill with over 230 deaths in just the past month, which most of the cases occurring among the 140,000 people who lived in the poor tribal-dominated areas of Meghalaya.

1.       What pathogens can cause meningitis?

2.       Which pathogen is most often associated with epidemics in the Meningitis belt

3.       Name and describe the causative agent of meningococcal meningitis

4.       What is the incidence rate of the disease

5.       What lab tests would have to be used to determine if her father had meningococcal meningitis?

The next morning when Saihun checked on her father, his headache was intense. He was vomiting, was very sensitive to light and had a stiff neck. Saihun also noticed an irregular rash on his trunk and legs.

6.       How is this pathogen spread from person to person

7.       What characteristic of the pathogen enable it to infect and damage the CNS?

8.       What characteristics of the pathogen cause the rash that was observed?

Her family did not have the resources to get her father to a hospital but did get the necessary antibiotics from a local clinic

9.       What antibiotics are typically given to treat this type of infection

10.   What is the mechanism of action of the drug

Explanation / Answer

1. Pathogens which cause meningitis are Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenza, Listeria monocytogenes, E.coli, Group B streptococci

2. Neisseria meningitidis prevalanceis more in epidemics

3. Neisseria meningitidis is the causative agent for Meningococcal meningitidis

It is a Gram negative proteobacterium, diplococci, it is the only organism responsible for meningitis epidemically. It infects the host cells by sticking to the cells with the help of Pili and surface proteins like Opa and Opc.

4. According to 2015 CDC report, incidence rate of of 0.18 cases per 100,000 persons is recorded.

meningococcal disease can be seen in any age group, but rates of disease are highest in children younger than 1 year, followed by adolescents between 16 to 23 years have the highest rates of meningococcal disease.

5. Blood and Cerebrospinal fluid samples to be collected for diagnosing the infection.

If the infection is seen in the samples, the we can go for culturing of samples to identify the specific bacteria.

6. Humans are the only hosts for this infection and it spreads through exchange of respiratory and throat secretions by Coughing, sneezing, Kissing etc.

7. Gram negativebacteria having polysaccharide capsule makes resistant to phagocytosis and enables bacteria to attack meninges.

8. Lipid A content of the bacteria is responsible for the rashes

9. Third-generation cephalosporin (ceftriaxone or cefotaxime) is the drug of choice for the treatment of meningococcal meningitis and septicemia.

10. Cephalosporins are Beta lactam antibiotics similar to penicillins.

Mechanism action is inhibiting the cellwall sysnthesis in both gram negative and gram positive bacteria by binding to penicillin binding proteins (transpeptidases, endopeptidases, and carboxypeptidases)

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