Neisseria meningitidis: a neglected cause of infectious haemorrhagic fever in the amazon rainforest

Abstract

Neisseria meningitidis has not been seen as a significant cause of infectious haemorrhagic fever in the Amazon inlands; most reported cases are from the city of Manaus, the capital of the State of Amazonas. This picture is sustained by the lack of reliable microbiology laboratories, the perception of the health care workers, and the difficult to reach medical assistance; thus the number of confirmed cases is even lower with no reference of the strains phenotype. We report here the investigation of a case of suspected meningococcemia and his close contacts in a rural community in the Coari Lake, up the Amazon River.

Epidemiology of infectious meningitis in the State of Amazonas, Brazil

“…However, the occurrence of cases in the remote areas of the state has been reported, with a differential diagnosis of hemorrhagic fever in the Amazon forest, where it can be mistaken for diseases caused by viruses or other agents (19) . In Brazil, in the 1970s and 1980s, epidemics were recorded in various cities that were caused most commonly by serogroups A and C followed by serogroup B (20) .…”

Neisseria meningitidis disease-associated clones in Amazonas State, Brazil

“…As in other parts of Brazil, the predominant strains were serogroup C [2]. Although N. meningitidis remains susceptible to first-line antibiotics, the management of patients is a challenge in Amazonas, where the mobility of people in the region is made almost exclusively by river [28]. Therefore, the best control measure is vaccination.…”

Cost-Effectiveness Analysis of a Universal Infant Immunization Program with Meningococcal C Conjugate Vaccine in Brazil

“…In São Paulo state, during the past 5 years, the proportion of meningococcal meningitis among BM cases increased in parallel with the increase in the proportion of cases with identification of the causative pathogen, supporting this correction strategy [38]. Nevertheless, it was not possible to propose a correction strategy for misdiagnosis and underreporting to SINAN, despite some evidence pointing to its importance [39].…”