Meningitis

Generalities
Agent	There are several agents causing meningitis. 1) Main Bacteria: - Neisseria meningitidis (meningococcus): Gram negative diplococci. Main invasive serotypes are A, B, C, W135, X, and Y. - Haemophilus influenza: Gram negative cocco-bacilli. There are 6 serotypes from (a) to (f). The serotype (b) is responsible of invasive infection. - Streptococcus pneumonia (pneumococcus): Gram positive diplococci. There are more than 90 serotypes. - Leptospira: spirochetes, Leptospira interrogans (26 serogroups) - Listeria monocytogenes: Gram positive, rod-shapped - Other bacterial agents: Staphylococcus, enteric bacteria, group B streptococci, Mycobacterium tuberculosis… 2) Virus: - Mumps - Measles - West Nile virus: a Flavivirus - Enterovirus: including Coxsackieviruses A (2-4, 7, 9-10), Coxsackieviruses B (1-6), Echoviruses (2, 5-7, 9-11, 14, 18, 30), Enterovirus 71, Poliovirus (1-3) - Herpes Simplex virus (types 1 and 2): family Herpesviridae - Varicella-Zoster virus: Human (alpha) Herpesvirus 3 (varicella-zoster) from the group Herpesvirus - Adenovirus: Adenovirus, several types (1, 2, 3, 4, 5 and 7), genus Mastadenovirus, family Adenoviridae, - Lymphocytic choriomeningitis virus: an Arenavirus - Sandfly fever viruses: genus Phlebovirus, family Bunyaviridae. They include more than 60 antigenically distinct virus serotypes. Two main groups are identified: a) Sandfly fever group including the Naples serocomplex (Karimabad virus, Arabia virus, Massilia virus, Punique virus, Tehran virus, Toscana virus …) and Sicilian serocomplex; and b) Uukuniemi group -Other virus: arboviruses… 3) Parasites: - Candida albicans, cryptococcus…
Incubation period	varies with the agent
Period of transmissibility	varies with the agent
Reservoir	varies with the agent
Modes of transmission	varies with the agent
Clinical presentation	varies with the agent
Resources
Case definition	- MOPH circular no. 52 (2007): Meningitis - MOPH circular no. 63 (2007): Neisseria meningitidis - MOPH circular no. 54 (2007): Haemophilus influenzae b - MOPH circular no. 36 (2012): West Nile Virus
Forms	- Meningitis reporting form - Meningitis investigation form
Data	- Weekly report

ATC	Name	B/G	Ingredients	Form	Price
J07CA11	DIPHTHERIA, TETANUS,PERTUSSIS, HEPATITIS B AND HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINE	B	Diphteria Toxoid1 - ?25Lf (?30IU)/0.5ml, Tetanus toxoid1 - ?2.5Lf (?40IU)/0.5ml, Bordetella pertussis (Whole cell) - ?16OU (?4.0IU)/0.5ml, HBs Antigen (r DNA)1 - ?10mcg/0.5ml, H. Influenza type b, purified capsular polysaccharide2 - 10mcg/0.5ml, 1 adsorbed on aluminium phosphate, Al+++ - ?1.25mg , 2 conjugated to tetanos toxoid carrier protein -	Injectable suspension	1,515,854 L.L
R03AK07	BUFOMIX EASYHALER	G	Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation	Metered dose inhaler	2,365,163 L.L
B05D	PERITONEAL DIALYSIS SOLUTION WITH 4 1/4% DEXTROSE	G	Sodium lactate - 0.392g%, Calcium chloride, 2H2O - 0.0257g%, Magnesium chloride, 6H2O - 0.0153g%, Sodium chloride - 0.567g%, Dextrose, H2O - 4.25g%	Injectable solution	498,744 L.L
R03AK07	BUFOMIX EASYHALER	G	Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation	Metered dose inhaler	1,182,581 L.L
B05D	PERITONEAL DIALYSIS SOLUTION WITH 1 1/2% DEXTROSE	G	Sodium lactate - 0.392g%, Calcium chloride, 2H2O - 0.0257g%, Magnesium chloride, 6H2O - 0.0153g%, Sodium chloride - 0.567g%, Dextrose, H2O - 1.5g%	Injectable solution	490,807 L.L
R03AK07	SYMBICORT	B	Formoterol fumarate dihydrate - 9mcg/Inhalation, Budesonide - 320mcg/Inhalation	Inhalation powder	3,378,420 L.L
A09AA02	CREON 10,000	B	Pancreatin protease - 600FIP-U, Pancreatin amylase - 8,000FIP-U, Pancreatin lipase - 10,000FIP-U	Capsule	1,835,689 L.L
B05D	CAPD/DPCA 17Solution for peritoneal dialysis stay safe	G	Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.1838g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 15g/l, Fructose , - up to 0.75g/l	Injectable solution	605,921 L.L
L04AA32	OTEZLA	B	Apremilast - 4x10mg- 4x20mg- 19x30mg	Tablet, film coated	34,751,325 L.L
R03AK07	BUFOMIX EASYHALER	G	Formoterol fumarate dihydrate - 9mcg, Budesonide - 320mcg	Metered dose inhaler	2,365,163 L.L
A09AA02	CREON 25,000	B	Pancreatin protease - 1000FIP-U, Pancreatin amylase - 18000FIP-U, Pancreatin lipase - 25000FIP-U	Capsule	4,598,629 L.L
B05D	CAPD/DPCA 19Solution for peritoneal dialysis stay safe	G	Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.1838g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 22.73g/l, Fructose , - up to 1.1g/l	Injectable solution	740,031 L.L
L04AA32	APRIVA STARTER PACK	G	Apremilast - 10mg, Apremilast - 20mg, Apremilast - 30mg	Tablet, film coated	22,154,866 L.L
R03AK07	FORACORT 200	G	Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 200mcg/inhalation	Metered dose inhaler	2,159,555 L.L
B05D	CAPD/DPCA 2Solution for peritoneal dialysis stay safe	G	Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.2573g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 15g/l, Glucose monohydrate - 16.5g/l	Injectable solution	707,716 L.L
C05BX51	DOXIPROCT	B	Calcium dobesilate - 4%, Lidocaine HCl - 2%	Ointment	610,104 L.L
R03AK07	FORACORT 400	G	Formoterol fumarate - 4.5mcg/inhalation, Budesonide - 400mcg/inhalation	Metered dose inhaler	3,104,276 L.L
B03AA07	TIMOFEROL	G	Iron bivalent (as dried ferrous sulfate) - 50mg (172.73mg), Ascorbic acid - 30mg	Capsule	652,931 L.L
B05D	CAPD/DPCA 3Solution for peritoneal dialysis	G	Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.2573g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 42.50g/l, Glucose monohydrate - 46.75g/l	Injectable solution	740,031 L.L
C05BX51	DOXIPROCT PLUS	B	Calcium dobesilate - 4%, Dexamethasone acetate - 0.0025%, Lidocaine HCl - 2%	Ointment	489,159 L.L
R03AK08	INUVER	B	Formoterol fumarate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose	Inhalation solution	3,493,991 L.L
B03AB	ENRICH N	G	Iron trivalent (hydroxide polymaltose complex) - 156.25mg/5ml	Syrup	279,519 L.L
B05D	CAPD/DPCA 17Solution for peritoneal dialysis sleep safe	G	Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.1838g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 15g/l, Fructose , - up to 0.75g/l	Injectable solution	715,794 L.L
G04BX14	PRIXETIN 60	G	Dapoxetine (hydrochloride) - 60mg	Tablet, film coated	1,479,123 L.L
R03AK08	INUVER NEXTHALER	B	Formoterol fumarate dihydrate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose	Inhalation powder	4,380,927 L.L
B05D	CAPD/DPCA 19Solution for peritoneal dialysis sleep safe	G	Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.1838g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 22.73g/l, Fructose , - up to 1.1g/l	Injectable solution	715,794 L.L
R03AK10	RELVAR ELLIPTA	B	Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 200mcg/dose	Inhalation powder	3,928,052 L.L
B05DA	EXTRANEAL (ICODEXTRIN 7.5%) TWIN BAG	B	Sodium lactate - 4.5g/l, Magnesium Chloride - 0.051g/l, Calcium chloride - 0.257g/l, Sodium chloride - 5.4g/l, Icodextrin - 75.0 g/l	Injectable solution	1,998,025 L.L
R03AK10	RELVAR ELLIPTA	B	Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 100mcg/dose	Inhalation powder	3,928,052 L.L
B05DA	EXTRANEAL (ICODEXTRIN 7.5%) SINGLE BAG	B	Sodium lactate - 4.5g/l, Magnesium Chloride - 0.051g/l, Calcium chloride - 0.257g/l, Sodium chloride - 5.4g/l, Icodextrin - 75.0 g/l	Injectable solution	1,998,025 L.L