The disease's pathogenesis is not fully understood. The pathogen colonises a large number of the general population harmlessly, but in some very small percentage of individuals it can invade the blood stream, and the entire body but notably limbs and brain, causing serious illness. Over the past few years, experts have made an intensive effort to understand specific aspects of meningococcal biology and host interactions.
Meningitis is "silently" present, and there are always a few cases. When the number of cases passes five per population of 100,000 in one week, teams are on alert. Epidemic levels are reached when there have been 100 cases per 100,000 populations over several weeks. The pandemic that began in 1996 has resulted so far in approximately 300,000 cases being reported
When meningococcal disease is suspected, treatment must be started immediately and should not be delayed while waiting for investigations. The antibiotics of choice are usually IV broad spectrum 3rd generation cephalosporins, e.g., cefotaxime or ceftriaxone. Benzylpenicillin and chloramphenicol are also effective. Supportive measures include IV fluids, oxygen, inotropic support, e.g., dopamine or dobutamine.
Major research on disease:
Effectiveness of meningococcal serogroup C conjugate vaccine 4 years after introduction. Steroid therapy may help in some adult patients, but is unlikely to affect long term outcomes.Genomic epidemiology of age-associated lineages in national surveillance.