-- Petechiae (small pinpoint hemorrhages in the skin and mucous
membranes) can be found early (before clinical meningitis is apparent).
--
Usually, they are found early in the armpits and about wrists and
ankles.
--
Later in the disease, they may cover the entire body.
Any recruit with fever, upper respiratory symptoms, and petechiae should
be suspected of having a meningococcal infection until proved otherwise.
--
Take appropriate laboratory specimens (culture of blood, petechiae).
--
Take spinal fluid; perform spinal fluid examination.
--
Initiate specific treatment.
c. New Strains. In the United States, peak years of meningitis occur about
every 10 years. In military populations, cases occur during times of mobilization or
crowding.
Before 1950, most epidemics, including military, were because of closely
related strains of N. meningitides.
Beginning in the spring of 1963, new strains became more prominent as
causative agents did.
This was important because the new strains were found to be sulfa
resistant.
During, 1964, over 100 cases of meningococcal meningitis occurred at
Fort Ord, California.
Prophylaxis was of no avail because of the predominance of the sulfa
resistant strains.
d. Prevention/Control Measures. Prevention and control of meningococcal
meningitis consists of all measures aimed at:
Reducing the spread of the organism
Reducing stresses and fatigue in recruits
Because these measures will not eliminate the problem, early diagnosis through a high
index of suspicion and careful examination is paramount in preventing death.
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