Heilsa - Sjúkrakassagrunnurin
Susceptibility and Outcome in Invasive Meningococcal Disease n a Gentically Homogenous Population (MeFcocc Study)
Landssjúkrahúsið og Syddansk Universitet
Shahin Gaini, Mattjijs C. Brouwer, Court Pedersen, Søren Hansen, Svein-Ole Mikalsen, Guðrið Andorsdóttir, Amanda Vang, Bjarni á Steig, Marija Todorovic Marcovic, Høgni Debes Joensen
Stuðul úr Granskingargrunninum:
Bacterial meningitis is a very serious condition in any human. It can affect individuals of all ages, but especially small children are at risk. Amongst parents with small children, meningococcal meningitis is one of the most feared diseases as it has a relatively high mortality, a high degree of both long-term and short-term sequelae and because no effective vaccine is yet known to exist against the most common bacterial subgroup in our region, the Neisseria meningitis, type B.
The disease presents typically with the meningeal sign of neck stiffness with fever, headache, or sensitivity to light, and in severe cases with other neurologic signs such as convulsions or coma. In other cases, symptoms of septicaemia is the main and most severe clinical picture. In treating the disease, it is paramount to start treatment with intravenous antibiotics as soon as possible and attend hospital facilities immediately after. Often, the use of intensive care is necessary as well.
In the Faroes, an epidemic of meningococcal meningitis hit the islands in the 1970s through the 1980s. Most of the patients were small children with very severe infections and many died. To this day, no similar epidemic with such high numbers of cases of meningococcal meningitis has been seen elsewhere. No apparent explanation was found, but the numbers of new cases declined slowly after changing the antibiotic prophylaxis given to near contacts. Some cases of recurrent infections were seen as well as indices of high familial occurrence that could indicate a genetic disposition to the disease.
It is known from other studies that there are several defects of the immune system that are related to an increased susceptibility to meningococcal infections. Also, defects have been found, that are related to the severity of the disease.
As the Faroes have a population with a high genetic homogeneity, several approaches to research in this area are possible. We have planned three substudies with the cohort of individuals with previous invasive meningococcal infection in the above-mentioned period. They will be examined clinically for sequelae, primarily neurological (including hearing, vision, cognitive and psychological testing and MRI). Blood samples will be taken for analysis of immune functions — functional assays of complement function - and for genetic polymorphisms of defects of the immune system — also with focus on the complement system.
In conclusion, the main objective of these studies is to examine whether these individuals are especially at risk for meningococcoal infections and its long-term effects. The results could then, if applicable, be used as an increased awareness of future epidemics in the Faroese population and change the vaccine strategies of the population. Also, and equally important, the results would provide new insights into the disease of meningococcal meningitis in general, adding new knowledge to the international scientific literature.