Meningococcal Disease in Meningococcal Disease in New ZealandNew Zealand

(Johnson, 1999)

IntroductionIntroduction

Meningococcal

Significant morbidity and mortality for

Northland population

South Auckland

(Mosby's, 1998)

To Understand this DiseaseTo Understand this Disease

Viral (aseptic) Benign condition Viral infection Mumps, glandular

fever, herpes Not fatal Common in young

children

Bacterial (septic) Bacterial carrier Haemophilus

influenza (hib) Neisseria Meningitis North Island (Sero

group B) South Island (Sero

group C)

(Delrosa, 1998)

Recognizing the Signs & Recognizing the Signs & SymptomsSymptoms

In Babies Fever, possibility with cold hands

and feet Refusing feeds, vomiting High pitch moaning, whimpering

cry Fretful, dislikes being handled Blank, staring expression Pale, blotchy complexion Tense or bulging fontanel Maybe floppy Neck retraction with an arched

back

In Children and Adults High temperature, fever possibilty

with cold hands and feet.

Vomiting

Violent, severe headache

Joint/muscle/ stomach pains

Drowsiness, confusion

Neck stiffness

Dislike of bright lights

Altered consciousness

Deterioarting condition

(Northland Health, 2000) & (Delrosa, 1999)

PreventionPrevention

Notifiable Disease

Identified-Close contacts

Antibiotics (Rifampicin, Ceftriaxone)

(Northland Health, 2002)

StatisticsStatisticsIncrease of meningitis casesIncrease of meningitis cases

Country % per 100,000 New Zealand 17.4 Australia 2.5 Canada 0.7 U.S. 1.0 England & Wales 5.0 Scotland 6.2

(Northland Health, 2002)

Statistics cont…Statistics cont…- - sero group B frequent in upper North Islandsero group B frequent in upper North Island

- sero group C frequent in Southland- sero group C frequent in Southland

Hotspots in Northland

% per 100,000

Whangarei 33.9

Whangaroa 32.1

Hokianga 31.1

(Northland Health, 2002) (Ministry of Health, 2000)

Statistics cont...Statistics cont...

Seasonal disease

Northlands’ relatively low case fatality rate

South Auckland- 2/10 people are carriers

(Spark, 2000) (Eberhart-Phillips, 2000)

Social & Cultural Social & Cultural DeterminantsDeterminants

Trickle down effect

Contributing factors

Deprivation index

(Housing new Zealand, 2000) (Sutton, 2000) (Nursing Council,

2000)

Current & Future InterventionsCurrent & Future Interventions

Healthy Housingallieviate overcrowding reduce disease risk

Education reduce the spread of infection among

carriers

“Don’t share spit”

(Nursing Council, 2001) (Sheddan, 2002) (Collett & Brooker, 2002)

Current and future Current and future interventionsinterventions

Nurse practitioners prescribing will save lives, prevent secondary

cases further education

Vaccine New Zealand Government-Meningococcal B

vaccine

ConclusionConclusion

Evidence of current health issues

Relevant social and cultural factors

Strategies and initiatives

Early recognition and treatment