I. IDENTIFICATION

A. CLINICAL DESCRIPTION: A very serious, acute disease caused by infection with the meningococcus (Neisseria meningitidis) associated with sepsis and/or meningitis. Symptoms include fever, intense headache, stiff neck, nausea and often vomiting.

B. REPORTING CRITERIA: Clinical diagnosis or laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

• Isolation of Neisseria meningitidis from a normally sterile site (such as blood, CSF, or less commonly, joint, pleural, or pericardial fluid), OR
• Gram negative diplococci on gram stain from CSF, OR
• A positive antigen test from CSF.

D. WISCONSIN CASE DEFINITION: A clinically compatible illness that is laboratory confirmed.

II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY I: Report IMMEDIATELY BY TELEPHONE to the patient's local health officer upon identification of a case or suspected case. Complete and mail an Acute and Communicable Disease Case Report (DPH 4151) to the local health officer within 24 hours.

B. EPIDEMIOLOGY REPORTS REQUIRED:

1. Acute and Communicable Diseases Case Report (DPH 4151).
2. Bacterial Meningitis and Bacteremia Follow-up Report

C. PUBLIC HEALTH INTERVENTIONS:

• Investigation of known and suspected contacts.
• Chemoprophylaxis or observation of close contacts (See Reference 4, p. 6-7).
• For each case-patient, ensure that an isolate of Neisseria meningitidis from a normally sterile site be forwarded to the WSLH for serogrouping and antibiotic susceptibility testing. (Isolates should be forwarded even if the referring laboratory has already determined the serogroup and susceptibility because this will ensure that the isolates are available for further genetic testing should an outbreak investigation become necessary.)
  

III. CONTACTS FOR CONSULTATION

A. BCDP/ COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-7321.
B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
C. WSLH / BACTERIOLOGY: (608) 263-3421.

IV. RELATED REFERENCES

1. “Meningococcal Meningitis” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets

2. Heymann DL, ed. MENINGOCOCCAL INFECTION. Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:359-366.

3. Pickering LK, ed. Meningococcal Infections. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:430-436.

4. Control and Prevention of Meningococcal Disease and Control and Prevention of Serogroup C Meningococcal Disease: Evaluation and Management of Suspected Outbreaks. MMWR 1997; 46(RR-5):1-21.

V. DISEASE TRENDS

Reporting Meningitis Form