Meningococcal disease

Meningococcal disease, caused by Neisseria meningitidis, is a rapidly progressive, potentially life-threatening infection. The organism, an encapsu-lated Gram-negative diplococcus, is classified into at least 13 serogroups, with A, B, C, W, X, and Y being responsible for most invasive cases. Host susceptibility is increased in individuals with complement deficiencies, asplenia, or immature immune systems. Transmission occurs via respiratory droplets, and asymptomatic carriage is common. Clinical presentation ranges from meningitis and fulminant septicaemia to less common manifes-tations such as pneumonia, arthritis, and peri-carditis. Timely recognition and empirical treatment with third-generation cephalosporins are critical for patient survival.
Diagnosis is confirmed by blood and cerebrospinal fluid cultures, supported by polymerase chain reaction and other ancillary investigations. Vacci-nation remains the most effective preventive measure, with conjugate vaccines available for the virulent serogroups. However, in Sri Lanka, mening-ococcal vaccination is not included the routine immunisation program, except for high-risk groups and during outbreak situations. Public health measures such as notification, chemoprophylaxis for close contacts, and implementation of droplet precautions are essential to control and prevent further transmission. The lack of serogroup-specific surveillance in Sri Lanka hinders effective outbreak management and policy development. Enhanced diagnostic capacity, routine surveillance, and context-specific vaccination strategies are essential to reduce the burden of meningococcal disease and improve outcomes in affected populations.