The Experts below are selected from a list of 13974 Experts worldwide ranked by ideXlab platform

C A Hart - One of the best experts on this subject based on the ideXlab platform.

  • Meningococcal Disease and its management in children
    BMJ (Clinical research ed.), 2006
    Co-Authors: C A Hart, A P J Thomson
    Abstract:

    Meningococcal Disease produces a considerable global burden of Disease. In this clinical review we focus mainly on Meningococcal Disease in the United Kingdom, but we also acknowledge the wider issues across the world. Meningococcal Disease, which may present clinically as septicaemia, as meningitis, or with a mixed picture, is caused by infection with Neisseria meningitidis or meningococcus. Recent advances include greater knowledge about the pathogenesis of Meningococcal Disease, work to facilitate its early diagnosis, and some evidence of improved outcomes after Meningococcal Disease. Despite these advances, valid evidence from large controlled studies is scarce, so most recommendations are based on consensus or tradition rather than on firm scientific evidence. Description of the Disease only as “meningitis” is inaccurate and misleading to patients and professionals. Septicaemia is the more dangerous clinical syndrome,1 which needs urgent treatment; meningitis also needs rapid treatment but is more likely to lead to neurodevelopmental sequelae. In the meningitis belt of sub-Saharan Africa, Meningococcal Disease presents predominantly as meningitis alone.2 ### What causes it The meningococcus is solely a human pathogen, and up to 50% of the population may carry meningococci in the nasopharynx.3 w1 Factors that lead to invasion and production of Disease include complex inter-relationships of genetic predisposition, host status, environmental conditions, and virulence of the organism.4 w2 ### Literature searches We searched Medline in May 2006 (PubMed, since 1966, except where stated) with the terms meningococcus, Meningococcal infection, Meningococcal Disease, Meningococcal Disease and predisposition (English, reviews, past 5 years), Meningococcal Disease and carriage (English, reviews, past 5 years), Meningococcal Disease and symptoms, Meningococcal Disease and signs, Meningococcal Disease and treatment, Meningococcal Disease and outcome, and Meningococcal Disease and prevention. We also did a Google search, which found about 2.5 million references on Meningococcal Disease ### Summary points Meningococcal Disease is the most common infectious cause of death in childhood in …

  • Mortality in severe Meningococcal Disease
    Archives of disease in childhood, 2001
    Co-Authors: Kentigern Thorburn, A P J Thomson, Paul Baines, C A Hart
    Abstract:

    AIM To evaluate mortality of critically ill children admitted with Meningococcal Disease. METHODS Prospective study of all children admitted to a regional paediatric intensive care unit (PICU) between January 1995 and March 1998 with Meningococcal Disease. Outcome measures were actual overall mortality, predicted mortality (by PRISM), and standardised mortality ratio. RESULTS A total of 123 children were admitted with Meningococcal Disease. There was an overall PICU mortality of 11 children (8.9%). The total mortality predicted by PRISM was 24.9. The standardised mortality ratio (SMR) was 0.44. Results were compared with those from four previously published Meningococcal PICU studies (USA, Australia, UK, Netherlands) in which PRISM scores were calculated. The overall PICU mortality and SMR were lower than those in the previously published studies. CONCLUSION Compared with older studies and calibrating for Disease severity, this study found a decrease in the mortality of critically ill children with Meningococcal Disease.

  • The Role of RANTES in Meningococcal Disease
    The Journal of Infectious Diseases, 2000
    Co-Authors: Enitan D. Carrol, K.j. Mobbs, A P J Thomson, C A Hart
    Abstract:

    The chemokine RANTES (regulated on activation, normal T cell expressed and secreted) is a potent regulator of leukocyte trafficking. RANTES preferentially attracts mature CD4 cells as well as macrophages and eosinophils, but not neutrophils. In total, 128 children with Meningococcal Disease were prospectively studied, and the role of RANTES in the pathophysiology of Meningococcal Disease was assessed. Plasma RANTES, interleukin (IL)‐8, IL6, IL-1 receptor agonist, and tumor necrosis factor‐a were measured at admission. Severity of Disease was stratified by the Glasgow Meningococcal septicemia prognostic score (GMSPS). RANTES levels correlated significantly with IL-8 levels, admission lactate levels, platelets, prothrombin time, and activated partial thromboplastin time. RANTES levels were lower in children with severe Disease ( ; ), in those with septic shock ( ), GMSPS > 8 P= .001 P ! .0005 and in nonsurvivors ( ; Mann-Whitney test). RANTES is a potential mediator in the P= .048 pathophysiology of Meningococcal Disease.

Ziad A. Memish - One of the best experts on this subject based on the ideXlab platform.

  • Invasive Meningococcal Disease and travel.
    Journal of infection and public health, 2010
    Co-Authors: Ziad A. Memish, Anette Goubeaud, Michael Bröker, Claudius Malerczyk, Atef M. Shibl
    Abstract:

    Summary The epidemiology of invasive Meningococcal Disease varies geographically and in time and the risk of acquiring the Disease varies regionally, as well as with living conditions and behavior. An area, in which Meningococcal Disease outbreaks have frequently occurred, is the “African meningitis belt”, where epidemics of Meningococcal Disease with a peak incidence as high as 100–800/100,000 population/year have been reported. Another risk factor is mass gatherings including the Islamic pilgrimage to Makkah (Mecca), where outbreaks of Meningococcal Disease have repeatedly occurred. The latest outbreaks occurred during the Hajj pilgrimages of 2000 and 2001, when a shift from serogroup A Disease to serogroup W135 occurred. Vaccination against serogroups A, C, W-135 and Y with novel conjugate vaccines may help protect individuals and reduce the spread of bacterial carriage and Disease. Individuals who should be vaccinated include travelers to epidemic or hyperendemic areas (as identified by international health authorities), travelers for Umra or Hajj (Hajj pilgrims), travelers to high risk countries or regions (African meningitis belt) during the dry season or countries in sub-Saharan Africa outside the meningitis belt (where outbreak of meningitis has been reported in the preceding 2–3 years), military recruits or deployed military personnel, immunocompromized travelers and high school and college students. This review presents the global epidemiology of Meningococcal Disease, and discusses prophylaxis options including Meningococcal ACWY vaccines.

  • Meningococcal Disease and travel.
    International journal of antimicrobial agents, 2003
    Co-Authors: Annelies Wilder-smith, Ziad A. Memish
    Abstract:

    Meningococcal Disease continues to be a worldwide problem. This review examines the impact Meningococcal Disease has on international travel and vice versa the impact international travel has on the intercontinental spread of meningococci. The risk of Meningococcal Disease to the endemic population differs from that of travellers. The best documented risk of Meningococcal Disease among travellers has been in Hajj pilgrims for Mecca and Madina in Saudi Arabia. In response to the recent Hajj associated outbreak of W135 Meningococcal Disease, quadrivalent Meningococcal vaccine (against serogroups A/C/Y/W135) became a visa requirement. In view of increasing worldwide reports of Y and W135 Meningococcal Disease, there should be a switch in recommendation from the bivalent (against A& C) to the quadrivalent vaccine for all travellers.

  • Meningococcal Disease and Travel
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2001
    Co-Authors: Ziad A. Memish
    Abstract:

    Invasive Meningococcal Disease, in both endemic and epidemic forms, is the cause of significant morbidity and mortality worldwide. Despite all advances in therapy, the fatality rate of Meningococcal meningitis remains unacceptably high, between 5% and 10%, and a similar proportion suffers long-term neurological sequalae. Prevention of this rapidly fatal Disease is of paramount importance. The use of the available internationally licensed Meningococcal vaccines would be indicated for individuals with medical conditions that increase the risk of the Disease and for travelers to high-risk countries. In the last 2 years, there has been a shift in the epidemic pattern of Meningococcal Disease during the Hajj (pilgrimage) season, with predominance of Neisseria meningitidis serogroup W135. Recent changes have been made in the policy issued by the Saudi Ministry of Health (Riyadh, Saudi Arabia), which requires visitors from all over the world arriving for purposes of umra and Hajj to show evidence of vaccination against meningitis with the quadrivalent Meningococcal vaccine.

P. Rohner - One of the best experts on this subject based on the ideXlab platform.

  • Epidemiology of Meningococcal Disease in Switzerland, 1999–2002
    European Journal of Clinical Microbiology and Infectious Diseases, 2004
    Co-Authors: H. Jaccard Ruedin, B. Ninet, E. Pagano, P. Rohner
    Abstract:

    In Switzerland, immunisation against serogroup C Meningococcal Disease is recommended for persons at increased risk but is not included in the national vaccination programme. The aim of this study was to present the nationwide surveillance data on invasive Meningococcal Disease collected from 1999 to 2002, emphasising the evolution in the absence of extended vaccination. The number of reported cases of Meningococcal Disease peaked at 178 cases in 2000 (incidence rate of 2.5/100,000 person-years), with 61% of all cases attributed to serogroup C meningococci (incidence rate, 1.5/100,000 person-years). Since 2001, a spontaneous decrease in the reported cases was observed, resulting in an overall incidence rate of 1.4/100,000 person-years in 2002 (serogroup C cases, 0.8/100,000 person-years). On the other hand, the case-fatality rate of serogroup C cases increased to 18% in 2002, leading to an increase in the overall case-fatality rate from 8% to 14% ( P >0.05). The small sample size reduces the interpretability of this observation. However, when the introduction of a generalised vaccination against serogroup C Meningococcal Disease is discussed, the fluctuations in the number of vaccine-preventable deaths should receive greater attention.

  • Epidemiology of Meningococcal Disease in Switzerland, 1999-2002.
    European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2004
    Co-Authors: H. Jaccard Ruedin, B. Ninet, E. Pagano, P. Rohner
    Abstract:

    In Switzerland, immunisation against serogroup C Meningococcal Disease is recommended for persons at increased risk but is not included in the national vaccination programme. The aim of this study was to present the nationwide surveillance data on invasive Meningococcal Disease collected from 1999 to 2002, emphasising the evolution in the absence of extended vaccination. The number of reported cases of Meningococcal Disease peaked at 178 cases in 2000 (incidence rate of 2.5/100,000 person-years), with 61% of all cases attributed to serogroup C meningococci (incidence rate, 1.5/100,000 person-years). Since 2001, a spontaneous decrease in the reported cases was observed, resulting in an overall incidence rate of 1.4/100,000 person-years in 2002 (serogroup C cases, 0.8/100,000 person-years). On the other hand, the case-fatality rate of serogroup C cases increased to 18% in 2002, leading to an increase in the overall case-fatality rate from 8% to 14% (P>0.05). The small sample size reduces the interpretability of this observation. However, when the introduction of a generalised vaccination against serogroup C Meningococcal Disease is discussed, the fluctuations in the number of vaccine-preventable deaths should receive greater attention.

Nathan Kuppermann - One of the best experts on this subject based on the ideXlab platform.

  • Treatment of Unsuspected Meningococcal Disease |[bull]| 390
    Pediatric Research, 1998
    Co-Authors: Vincent J. Wang, Richard Malley, Gary R. Fleisher, Stanley H. Inkelis, Nathan Kuppermann
    Abstract:

    Background: Children with Meningococcal Disease may present with fever alone, without clinical toxicity or specific signs, and may inadvertently be treated as outpatients because Meningococcal Disease is unsuspected. It is unknown whether outpatient antibiotic therapy prevents sequelae of unsuspected Meningococcal Disease (UMD).

W I C Sam - One of the best experts on this subject based on the ideXlab platform.

  • The role of lumbar puncture in Meningococcal Disease.
    Archives of disease in childhood, 2000
    Co-Authors: W I C Sam
    Abstract:

    Editor,—The numbers of cases of Meningococcal Disease diagnosed clinically and by polymerase chain reaction (PCR) have increased, while the numbers of culture confirmed cases and lumbar punctures are falling.1 2 This changing trend in case ascertainment was noted by Gill.3 Pollard et al seem to support this trend,4 preferring to avoid lumbar puncture in all patients with “clinically obvious” Meningococcal Disease because it “adds little useful …