# data[].attributes.body
My choice is to study Meningococcal Disease which is caused by the bacteria Neisseria Meningitidis.

# data[].attributes.body
1. Where was your disease of study first detected?

Meningococcal disease was first discovered in Geneva in 1805, however, the first outbreak wasn’t until the 1840s in Africa (Edward’s, 2020).

2. What was the suspected infectious agent (e.g., bacteria, virus, fungi, or parasite)?

The suspected infectious agent is meningococcal bacteria (Edward’s, 2020).

3. What type of disease was it (e.g., zoonotic, emerging infectious disease, etc.)? Be sure to include the definition of the disease typein your post.

This is an emerging infectious disease as it has rapidly increased in cases in the last 20 years but can also be zoonotic in rare instances (Strunk et al., 2010). A zoonotic disease is when an infectious disease is transmitted from animals to humans (Rahman et al., 2020).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563794/

https://pubmed.ncbi.nlm.nih.gov/20131137/

# data[].attributes.attachment_link.description
In 1906, scientists began to recommend anti-meningococcal serum therapy to protect humans against meningococcal disease; a therapy based on antibodies initially derived from the blood of horses, and later from patients, or individuals recovering from meningococcal disease. Its effectiveness meant that it was used prophylactically in those who had been in close contact with patients of meningococcal disease – though it was a risky procedure. However, once it was realised that people could carry meningococcal bacteria without showing any clinical signs of disease, efforts were focused on eliminating this carrier status. Attempts at spraying dried anti-meningococcal serum into the nostrils however produced disappointing results.

# data[].attributes.body
1. Where (e.g., what geographical regions) did the disease spread to?

Meningitis spread from Geneva and Africa. It is now most commonly found in sub-Subharan Africa and this area is referred to as the ‘meningitis belt’ (2022).

2. What was the timeline of the spread?

The exact year of the spread from Geneva to Africa is not known however it occurred sometime between 1805 and 1840 (2022).

3. Approximately how many people were affected (illness and/or death)?

There is not an exact number since the first outbreak, however, there are 2.5 million cases worldwide every year (Anderson, 2021).

4. If available, include a picture or a link to a map in your Padlet post that shows location the disease has been detected.

https://www.cdc.gov/meningococcal/global.html#:~:text=Meningococcal%20disease%20occurs%20worldwide%2C%20with,1%2C000%20cases%20per%20100%2C000%20population.

https://www.path.org/our-impact/articles/toward-world-without-meningitis/

# data[].attributes.body
1. How was the disease handled by the health care community?

This disease was not very easy to handle and unfortunately did not have any vaccines available until 1999 (https://www.paho.org/en/topics/meningococcus#:~:text=Since%201999%2C%20meningococcal%20C%20conjugate,Canada%2C%20and%20Europe%20in%202005.). The World Health Organization does have a roadmap for their plans on how they are handling meningitis and its spread. By 2030 they plan eliminate bacterial meningitis epidemics, and reduce preventable cases and deaths from meningitis (Who.int).

2. What medical advances were used in combatting the disease?

Vaccines and preventative antibiotics have been made in order to combat the disease and the spread of this disease. The antibiotics must be given to people in close contact with a patient with meningitis as soon as possible to reduce the chance of it being transmitted (who.int).

3. Were any new technologies applied to this disease? What were they?

The meningitis research foundation have been studying genetic changes in meningitis causing bacteria to attempt to better understand how to prevent this disease (https://www.meningitis.org/blogs/using-technology-to-defeat-meningitis).

# data[].attributes.attachment_link.readable_text
The focus of this fact sheet is on the four main causes of acute bacterial meningitis:

Neisseria meningitidis (meningococcus)

Streptococcus pneumoniae (pneumococcus)

Haemophilus influenzae

Streptococcus agalactiae (group B streptococcus)

These bacteria are responsible for more than half of the deaths from meningitis globally and they cause other severe diseases like sepsis and pneumonia.

Other bacteria e.g., Mycobacterium tuberculosis, Salmonella, Listeria, Streptococcus and Staphylococcus, viruses such as enteroviruses and mumps, fungi especially Cryptococcus, and parasites like Amoeba are also important causes of meningitis.
Who is at risk?
Although meningitis affects all ages, young children are most at risk. Newborn babies are at most risk from Group B streptococcus, young children are at higher risk from meningococcus, pneumococcus and Haemophilus influenzae. Adolescents and young adults are at particular risk of meningococcal disease while the elderly are at particular risk of pneumococcal disease.

People all over the world are at risk of meningitis. The highest burden of disease is seen in a region of sub-Saharan Africa, known as the African Meningitis Belt, especially recognised to be at high risk of epidemics of meningococcal but also pneumococcal meningitis.

Higher risk is seen when people are living in close proximity, for example at mass gatherings, in refugee camps, in overcrowded households or in student, military and other occupational settings. Immune deficiencies such as HIV infection or complement deficiency, immunosuppression, and active or passive smoking can also raise the risk of different types of meningitis.
Transmission
The route of transmission varies by organism. Most bacteria that cause meningitis such as meningococcus, pneumococcus and Haemophilus influenzae are carried in the human nose and throat. They spread from person to person by respiratory droplets or throat secretions. Group B streptococcus is often carried in the human gut or vagina and can spread from mother to child around the time of birth.

Carriage of these organisms is usually harmless and helps build up immunity against infection, but the bacteria occasionally invade the body causing meningitis and sepsis.
Signs and symptoms
The incubation period is different for each organism and can range between two and 10 days for bacterial meningitis. Since bacterial meningitis is often accompanied by sepsis, the signs and symptoms cover both conditions.

Signs and symptoms can include:

severe headache

stiff or painful neck

high fever

avoiding bright light

drowsy, confused, comatose

convulsions

rash

joint pains

cold hands and feet

vomiting

In babies, signs can include:

poor feeding

sleepy, difficult to wake, comatose

irritable, crying when handled

difficulty breathing, grunting

fever

neck rigidity

bulging soft spot on top of head (fontanelle)

high pitched cry

convulsions

vomiting

rash

pale or blotchy skin

Prevention

Preventing meningitis through vaccination is the most effective way to reduce the burden and impact of the disease by delivering long-lasting protection.

Antibiotics are also used to help prevent infection in those at high risk of meningococcal and group B streptococcal disease. Controlling epidemics of meningococcal meningitis relies on both vaccination and antibiotics.

1. Vaccination

Licensed vaccines against meningococcal, pneumococcal and Haemophilus influenzae disease have been available for many years. These bacteria have several different strains (known as serotypes or serogroups) and vaccines are designed to protect against the most harmful strains. Over time, there have been major improvements in strain coverage and vaccine availability, but no universal vaccine against these infections exists.

Meningococcus

The meningococcus has 12 serogroups, with A,B,C,W,X,and Y causing most meningitis.

There are three types of vaccine available:

Polysaccharide-protein conjugate vaccines (conjugate vaccines) are used in prevention and outbreak response:

They confer longer-lasting immunity, and also prevent carriage, thereby reducing transmission and leading to herd protection.

They are effective in protecting children under two years of age.

Vaccines are available in different formulations:

monovalent vaccines (serogroup A or C)

tetravalent vaccines (serogroups A, C, W, Y).

in combination (serogroup C and Haemophilus influenzae type b)

Protein based vaccines against serogroup B. These vaccines protect against meningitis in all ages but are not thought to prevent carriage and transmission so do not lead to herd protection.

Polysaccharide vaccines are safe and effective in children and adults, but weakly protective in infants. Protection is short-lived and they do not lead to herd protection as they do not prevent carriage. They are still used for outbreak control but are being replaced by conjugate vaccines.

Global public health response - elimination of meningococcal A meningitis epidemics in the African meningitis belt

In the African meningitis belt, meningococcus serogroup A accounted for 80-85% of meningitis epidemics before the introduction of a meningococcal A conjugate vaccine through mass preventive campaigns (since 2010) and into routine immunization programmes (since 2016). As of April 2021, 24 of the 26 countries in the meningitis belt have conducted mass preventive campaigns targeting 1-29 year olds (nationwide or in high-risk areas), and half of them have introduced this vaccine into their national routine immunization schedules. Among vaccinated populations, incidence of serogroup A meningitis has declined by more than 99% - no serogroup A case has been confirmed since 2017. Continuing introduction into routine immunization programmes and maintaining high coverage is critical to avoid the resurgence of epidemics.

Cases of meningitis and outbreaks due to other meningococcal serogroups, apart from serogroup B, continue to strike. The roll out of multivalent meningococcal conjugate vaccines is a public health priority to eliminate bacterial meningitis epidemics in the African Meningitis Belt.
Pneumococcus
The pneumococcus has over 97 serotypes, 23 causing most disease.

Conjugate vaccines are effective from 6 weeks of age at preventing meningitis and other severe pneumococcal infections and are recommended for infants and children up to the age of 5 years, and in some countries for adults aged over 65 years, as well as individuals from certain risk groups. Two different conjugate vaccines are in use that protect against 10 and 13 serotypes. New conjugate vaccines designed to protect against more pneumococcal serotypes are either in development or have been approved for use in adults. Research continues into protein based vaccines.

A polysaccharide vaccine against 23 serotypes is available but, as for other polysaccharide vaccines, this type of vaccine is considered less effective than conjugate vaccines. It is used mostly in those aged over 65 years to protect against pneumonia, as well as in individuals from certain risk groups. It is not used in children under 2 years of age and is less useful in protecting against meningitis.

Haemophilus influenzae
Haemophilus influenzae has 6 serotypes, serotype b causing most meningitis.

Conjugate vaccines protect specifically against Haemophilus influenzae serotype b (Hib). They are highly effective in preventing Hib disease and are recommended for routine use in infant vaccine schedules.
Group B streptococcus
Group B streptococcus has 10 serotypes, 1a, 1b, II, III, IV and V causing most disease.

Conjugate and protein vaccines designed to protect against group B streptococcal disease in mothers and babies are in clinical development.

2. Antibiotics for prevention (chemoprophylaxis)
Meningococcus
Antibiotics for close contacts of those with meningococcal disease, when given promptly, decreases the risk of transmission. Outside the African meningitis belt, chemoprophylaxis is recommended for close contacts within the household. Within the meningitis belt, chemoprophylaxis for close contacts is recommended in non-epidemic situations. Ciprofloxacin is the antibiotic of choice, and ceftriaxone an alternative.
Group B streptococcus
Identifying mothers whose babies are at risk of getting Group B streptococcal disease is recommended in many countries. One way to do this is by universal screening for carriage of Group B streptococcus in pregnancy. Mothers at risk are offered intravenous penicillin during labour to prevent their babies developing Group B streptococcal infection.

Diagnosis

Initial diagnosis of meningitis can be made by clinical examination followed by a lumbar puncture. The bacteria can sometimes be seen in microscopic examinations of the spinal fluid. The diagnosis is supported or confirmed by growing the bacteria from specimens of cerebrospinal fluid or blood, by rapid diagnostic tests or by polymerase chain reaction (PCR). The identification of the serogroups and susceptibility to antibiotics are important to define control measures. Molecular typing and whole genome sequencing identify more differences between strains and inform public health responses.

Treatment

Meningitis is fatal in up to half of patients, when left untreated, and should always be viewed as a medical emergency. Admission to a hospital or health centre is necessary. Isolation of the patient is not usually advised after 24 hours of treatment.

Appropriate antibiotic treatment must be started as soon as possible in bacterial meningitis. Ideally, lumbar puncture should be done first as antibiotics can make it more difficult to grow bacteria from the spinal fluid. However, blood sampling can also help to identify the cause and the priority is to start treatment without delay. A range of antibiotics is used to treat meningitis, including penicillin, ampicillin, and ceftriaxone. During epidemics of meningococcal and pneumococcal meningitis, ceftriaxone is the drug of choice.

Complications and sequelae

One in five people surviving an episode of bacterial meningitis may have long lasting after-effects. These after-effects include hearing loss, seizures, limb weakness, difficulties with vision, speech, language, memory, and communication, as well as scarring and limb amputations after sepsis.

Support and after-care

Meningitis sequelae can have an enormous impact on individuals, families and communities, both financially and emotionally. Sometimes, complications such as deafness, learning impairment or behavioural problems are not recognized by carers and healthcare workers and therefore go untreated.

Those who have lived through meningitisoften have health-care needs requiring long-term medical treatments. The ongoing psychosocial impacts of disability from meningitis can have medical, educational, social and human rights-based implications. Despite the high burden of meningitis sequelae on people with meningitis, their families and the community, access to both services and support for these conditions is often insufficient, especially in low and middle income countries. Individuals and families with members disabled by meningitis should be encouraged to seek servies and guidance from local and national Organizations of Disabled People (ODPs) and other disability focused organizations, which can provide vital advice about legal rights, economic opportunities and social engagement to ensure people disabled by meningitis are able to live full and rewarding lives.

Surveillance

Surveillance, from case detection to investigation and laboratory confirmation is essential to the control of meningitis. Main objectives include:

Detect and confirm outbreaks.

Monitor the incidence trends, including the distribution and evolution of serogroups and serotypes.

Estimate the disease burden.

Monitor the antibiotic resistance profile.

Monitor the circulation, distribution, and evolution of specific strains (clones).

Estimate the impact of meningitis control strategies, particularly preventive vaccination programmes.

WHO response

The global roadmap "Defeating Meningitis by 2030" was developed by WHO with the support of many partners. The strategy was approved in the first ever resolution on meningitis by the World Health Assembly in 2020 and endorsed unanimously by WHO member states.

The roadmap sets a comprehensive vision "Towards a world free of meningitis" and has three visionary goals:

Elimination of bacterial meningitis epidemics.

Reduction of cases of vaccine-preventable bacterial meningitis by 50% and deaths by 70%.

Reduction of disability and improvement of quality of life after meningitis due to any cause.

It sets a path to achieve goals, through concerted actions across five interconnected pillars:

Prevention and epidemic control focused on the development of new affordable vaccines, achievement of high immunization coverage, improvement of prevention strategies and response to epidemics.

Diagnosis and treatment, focused on speedy confirmation of meningitis and optimal patient care.

Disease surveillance to guide meningitis prevention and control.

Care and support of those affected by meningitis, focusing on early recognition and improved access to care and support for complications from meningitis, and

Advocacy and engagement, to ensure high awareness of meningitis, to promote country engagement and to affirm the right to prevention, care, and after-care services.

In a complementary initiative, the WHO is working on the I ntersectoral global action plan on epilepsy and other neurological disorders in consultation with Member States to address many challenges and gaps in providing care and services for people with epilepsy and other neurological disorders that exist worldwide. Human rights for people affected by disability are also recognised and addressed in the WHO Global Disability Action Plan in alignment with the Convention on the Rights of the Child and the Convention on the Rights of Persons with Disability (CRPD) and in a landmark resolution on attaining the highest standard of health for persons with disabilities adopted at the 74th World Health Assembly.

While the road map on defeating meningitis addresses all meningitis regardless of the cause, it primarily focuses on the main causes of acute bacterial meningitis (meningococcus, pneumococcus, Haemophilus influenzae and group B streptococcus). These bacteria were responsible for over 50% of the 250,000 deaths from all-cause meningitis in 2019. They also cause other severe diseases like sepsis and pneumonia. For each of these infections, vaccines are either available, or in the case of group B streptococcus, likely to become available in the next few years.
Source: Defeating meningitis 2030: baseline situation analysis Defeating meningitis 2030: global roadmap
Confederation of Meningitis Organizations - Facts | CoMO (comomeningitis.org)
Web-based consultation on the first draft of the Intersectoral global action plan on epilepsy and other neurological disorders

# data[].attributes.attachment_link.description
The focus of this fact sheet is on the four main causes of acute bacterial meningitis: Neisseria meningitidis (meningococcus) Streptococcus pneumoniae (pneumococcus) Haemophilus influenzae Streptococcus agalactiae (group B streptococcus) These bacteria are responsible for more than half of the deaths from meningitis globally and they cause other severe diseases like sepsis and pneumonia.

# data[].attributes.body
1. How was the disease handled by the leadership and/or governmental bodies to the disease?

There is not much information on how the disease was handled when the first outbreaks occurred due to it being a very long time ago. However, there has been a recent increase in meningitis in the United States and the CDC issued a health alert to report the increase in cases to health workers. They are also recommending everyone be vaccinated against meningococcal disease to reduce the spread (https://emergency.cdc.gov/han/2024/han00505.asp).

2. Were any innovative initiatives used in combatting the disease? What were they?

There are many different innovative initiatives used in combatting meningitis. Many of these being the creation of multiple vaccines and vaccinating hundreds of millions of people against meningitis. For instance, Nigeria just created and released a new 5 in 1 vaccine against meningitis called the Men5CV which protects against five different strains of meningitis as opposed to just one specific strain (https://www.who.int/news/item/12-04-2024-in-world-first--nigeria-introduces-new-5-in-1-vaccine-against-meningitis).

3. What could leadership have done better in response to this disease?

I believe that there could be more of a push for vaccinating against meningitis to slow the spread. There could also be more education on this disease and on what this disease can cause. I was not very educated on meningococcal disease until studying it this semester and I believe everyone could be more educated on this disease that has such bad complications.

# data[].attributes.attachment_link.readable_text
Summary
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert healthcare providers to an increase in invasive meningococcal disease, mainly attributable to Neisseria meningitidis serogroup Y (Figure). In 2023, 422 cases were reported in the United States, the highest annual number of cases reported since 2014. As of March 25, 2024, 143 cases have been reported to CDC for the current calendar year, an increase of 62 cases over the 81 reported as of this date in 2023. A specific meningococcal strain, sequence type (ST) 1466, is responsible for most (101 of 148, 68%) serogroup Y cases with available sequence type data that were reported across the United States in 2023. Cases caused by this strain are disproportionately occurring in people ages 30-60 years (65%), Black or African American people (63%), and people with HIV (15%). In addition, most cases of invasive meningococcal disease caused by ST-1466 in 2023 had a clinical presentation other than meningitis: 64% presented with bacteremia, and at least 4% presented with septic arthritis. Of 94 patients with known outcomes, 17 (18%) died; this case-fatality rate is higher than the historical case-fatality rate of 11% reported for serogroup Y cases in 2017-2021. Healthcare providers should 1) have a heightened suspicion for meningococcal disease, particularly among populations disproportionately affected by the current increase, 2) be aware that patients may present without symptoms typical of meningitis, and 3) ensure that all people recommended for meningococcal vaccination, including people with HIV, are up to date for meningococcal vaccines.

Background
Meningococcal disease, caused by the bacterium Neisseria meningitidis, is a rare but severe illness with a case-fatality rate of 10-15% even with appropriate antibiotic treatment. Meningococcal disease most often presents as meningitis, with symptoms that may include fever, headache, stiff neck, nausea, vomiting, photophobia, or altered mental status; or as meningococcal bloodstream infection, with symptoms that may include fever and chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, or, in later stages, a dark purple rash. While initial symptoms of meningococcal disease can at first be non-specific, they worsen rapidly, and the disease can become life-threatening within hours. Immediate antibiotic treatment for meningococcal disease is critical. Survivors may experience long-term effects such as deafness or amputations of the extremities.

Of the six N. meningitidis serogroups - A, B, C, W, X, and Y - responsible for most meningococcal disease worldwide, the four serogroups B, C, W, and Y circulate in the United States. Vaccines against serogroups A, C, W, Y (MenACWY) and serogroup B (MenB) are available in the United States. MenACWY vaccines are routinely recommended for adolescents and for people with other risk factors or underlying medical conditions, including HIV.

Across the United States, 101 ST-1466 cases were reported in 2023. This number is expected to increase with additional laboratory testing data. Cases of invasive meningococcal disease caused by this strain occurred in both males (65%) and females (35%) and disproportionately occurred in people ages 30-60 years (65%), Black or African American people (63%), and people with HIV (15%). In addition, most cases of invasive meningococcal disease caused by ST-1466 had a clinical presentation other than meningitis: 64% presented with bacteremia, and at least 4% presented with septic arthritis. Of 94 patients with known outcomes, 17 (18%) died; this case-fatality rate is higher than the historical case-fatality rate of 11% reported for serogroup Y cases in 2017-2021.

The serogroup Y ST-1466 strain has contributed to previously reported increases in meningococcal disease in people with HIV. Based on updated surveillance data, 24 ST-1466 cases have now been reported in people with HIV in 2022-2023; only four were previously vaccinated with MenACWY and none were up to date on recommended doses. To date, no other ST-1466 cases have been identified in people who previously received MenACWY vaccine.

Serogroup Y ST-1466 isolates tested to date have been susceptible to all first-line antibiotics recommended for treatment and prophylaxis. This strain is distinct from ciprofloxacin-resistant serogroup Y strains that are also circulating in the United States and that are disproportionately affecting Hispanic individuals.

Figure: Trends in meningococcal disease incidence per 100,000 population, by serogroup-United States, 2006-2023. Incidence of Neisseria meningitidis serogroup Y is shown in green. Source: National Notifiable Diseases Surveillance System, with additional serogroup data from Active Bacterial Core surveillance (ABCs) and state health departments. 2022 and 2023 data are preliminary.
Recommendations for Public Health Departments

Ensure healthcare providers are aware of the increasing burden of invasive meningococcal disease, particularly among people ages 30-60 years and Black or African American people.

Continue submitting all meningococcal isolates to CDC for whole-genome sequencing and antimicrobial susceptibility testing.

Contact CDC at meningnet@cdc.gov with any questions or concerns about increasing meningococcal disease cases in their jurisdiction or outbreak investigation or control measures.

Recommendations for Healthcare Providers

Maintain a heightened suspicion for invasive meningococcal disease and start immediate antibiotic treatment for persons with suspected meningococcal disease. Blood and cerebrospinal fluid (CSF) cultures are indicated for patients with suspected meningococcal disease [1].

Recognize that invasive meningococcal disease may affect people of any age or demographic group.
Current increases in disease are disproportionately affecting people ages 30-60 years, Black or African American people, and people with HIV.

Be aware that patients with invasive meningococcal disease may present with bloodstream infection or septic arthritis and without symptoms typical of meningitis (e.g., headache, stiff neck).

Ensure that all people recommended for meningococcal vaccination are up to date for meningococcal vaccines.

All 11-12 year-olds should receive a MenACWY vaccine. Since protection wanes, CDC recommends a booster dose at age 16 years.

For people at increased risk due to medical conditions (e.g., with HIV), recommended vaccination includes a 2-dose primary MenACWY series with booster doses every 3-5 years, depending on age.

Consult with your state or local health department for any questions about meningococcal disease treatment or contact prophylaxis, including any changes based on local meningococcal resistance patterns.

Recommendations for the Public

Seek medical attention immediately if you or your child develops symptoms of meningococcal disease:

Symptoms of meningitis may include fever, headache, stiff neck, nausea, vomiting, photophobia, or altered mental status.

Symptoms of meningococcal bloodstream infection may include fever and chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, or, in later stages, a dark purple rash.

While symptoms of meningococcal disease can at first be nonspecific, they worsen rapidly, and the disease can become life-threatening within hours.

Talk to your healthcare provider about meningococcal vaccines that may be recommended for you and your household or family members, including any recommended booster doses.

For More Information

Health departments

Healthcare providers

Everyone

References

1. American Academy of Pediatrics. Summaries of infectious diseases: meningococcal infections. [Section 3]. In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red book: 2021-2024 report of the Committee on Infectious Diseases. Itasca, IL: American Academy of Pediatrics; 2021:519-32.

2. Mbaeyi SA, Bozio CH, Duffy J, et al. Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep 2020;69(No. RR-9):1-41. DOI: http://dx.doi.org/10.15585/mmwr.rr6909a1

3. Rubis AB, Howie RL, Marasini D, Sharma S, Marjuki H, McNamara LA. Notes from the Field: Increase in Meningococcal Disease Among Persons with HIV - United States, 2022. MMWR Morb Mortal Wkly Rep 2023;72:663-664. DOI: http://dx.doi.org/10.15585/mmwr.mm7224a4

# data[].attributes.attachment_link.title
Increase in Invasive Serogroup Y Meningococcal Disease in the United States

# data[].attributes.attachment_link.description
Health Alert Network (HAN). Provided by the Centers for Disease Control and Prevention (CDC).

# data[].attributes.body
1. What was the most revealing aspect you learned about your disease?

The most revealing aspect I learned was how far this disease has spread and exactly when and where the disease was detected in each country. I never would have though that meningitis was as far spread or as infectious as it actually is.

2. What did you learn about your disease that surprised you?

I was most surprised about how early on Meningococcal disease was discovered. I never would have thought that the first outbreak was in the 1800’s.

3. What did you come across in your research that should have been a part of the Padlet assignment?

I believe that my padlet assignment should have included the mortality rate of meningitis and the age groups that are most at risk with this infectious disease. One in six people that catch meningitis end up dying from it and one in five have very serious complications.

# data[].attributes.body
1. Beyond the physical effect, what was the societal and sociological impact of this disease?

Meningitis has a big impact on people in terms of societal expections and behaviors after recovering from it. For example, meningitis has very demanding medical follow ups which can put families in a lot of socioeconomic struggles. Meningitis can also make it very difficult for patients to be in normal societal settings as they can have severe medical complications such as seizures, hearing/vision loss, memory loss, and behavior changes.

2. Did any society behaviors change?

The biggest society behavior that changed when meningitis was more known was the prioritization of vaccinating against this disease.

# data[].attributes.attachment_link.title
The Impact and Burden of Neurological Sequelae Following Bacterial Meningitis: A Narrative Review

# data[].attributes.attachment_link.description
The burden, impact, and social and economic costs of neurological sequelae following meningitis can be devastating to patients, families and communities. An acute inflammation of the brain and spinal cord, meningitis results in high mortality rates, with…