Abstract
In the State of Amazonas, particularly in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years. Bacterial meningitis is caused by several different species and represents a major issue of public health importance. The present study reports the meningitis case numbers with different etiologies in Amazonas from January 1976 to December 2012. Since the 1970s, the (currently named) Tropical Medicine Foundation of Doutor Heitor Vieira Dourado [Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD)] has remained a reference center in Amazonas for the treatment of meningitis through the diagnosis and notification of cases and the confirmation of such cases using specific laboratory tests. The foundation has achieved coverage of over 90% of the state medical records for many years. Between 1990 and 2012, meningitis cases caused by Haemophilus influenzae decreased with the introduction of the H. influenzae vaccine. Meningococcal disease previously had a higher frequency of serogroup B disease, but starting in 2008, the detection of serogroup C increased gradually and has outpaced the detection of serogroup B. Recently, surveillance has improved the etiological definition of viral meningitis at FMT-HVD, with enteroviruses, Epstein-Barr virus (EBV) and varicella zoster virus (VZV) prevailing in this group of pathogens. With the advent of acquired immunodeficiency syndrome (AIDS), cryptococcal meningitis has become an important disease in Amazonas. Additionally, infectious meningitis is an important burden in the State of Amazonas. Changes in the epidemiological profile for the different etiology-defined cases are the result of continuous epidemiological surveillance and laboratory capacity improvements and control measures, such as Haemophilus influenzae vaccination.
Highlights
In the State of Amazonas, in the capital Manaus, meningitis has affected populations of different cultures and social strata over the years
Meningitis often has signs and symptoms that suggest the clinical diagnosis, such as the classic triad of fever, headache and nuchal rigidity. Another example is the sudden onset of hemorrhagic rash accompanied by fever, which is a Saraiva MGG et al - Meningitis in Amazonas clinical criterion for the diagnosis of meningococcal disease(5)
The present article describes a time series of recorded meningitis cases that were caused by N. meningitidis, H. influenzae type b (Hib), S. pneumoniae, and M. tuberculosis as well as cases of aseptic meningitis and cryptococcal meningitis in Amazonas
Summary
Meningitis is a disease that affects the membranes surrounding the central nervous system (CNS) and is characterized by fever, headache, nausea, vomiting, meningeal irritation, and alterations in the cerebrospinal fluid (CSF). The most important bacterial agents for this disease are Neisseria meningitidis, Streptococcus pneumoniae, Mycobacterium tuberculosis, and Haemophilus influenzae. The UVE/FMT-HVD served as the surveillance unit of the state surveillance system and played an important role in the reporting and investigation of meningitis, including outbreak investigation together with COOREP until May 1999. The present article describes a time series of recorded meningitis cases that were caused by N. meningitidis, H. influenzae type b (Hib), S. pneumoniae, and M. tuberculosis as well as cases of aseptic meningitis and cryptococcal meningitis in Amazonas. Data regarding N. meningitidis disease were collected from the records of COOREP/SESAU and UVE/FMT-HVD for 1976 to 2012. H. influenzae type b, S. pneumoniae, and M. tuberculosis as well as aseptic meningitis data were collected from the UVE/FMT-HVD for 1990 to 2012. Specific viral etiology data were recorded from a more recently established laboratory surveillance system at the FMT-HVD in 2010
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