Question

•Tina, 17 yrs, felt nauseated and weak one afternoon 3 days after attending a New Years Eve party.

• in 4 hours, her condition had deteriorated:
-fever, nausea, confusion, stiff neck and the beginning of a rash on her extremities.
she was taken to ER, floated in and out of consciousness -rash worsened, appearing as large red-purple blotches on her arms, legs and body.
•in ER, a CSF and blood culture were drawn and antibiotic administered directly after.
CSF sent to labs for:
-microbiology: culture and (Gram stain)
-hematology: cells (mostly WBC)
-chemistry: total protein and glucose
•Within 15 minutes her condition had worsened and she was transferred to the ICU and put on a respirator.
•
•After 30 min the results came from the lab.
•Total cells in CSF: ↑ (predominantly PMN)
Protein levels: ↑
Glucose levels: ↓
Gram stain: G- diplococci
What should be done immediately from a public health point of view in this case?
A.Tracking of the source(s) and antibiotic prophylaxis to those who have been in near contact with her
B.Vaccination of all 16-24 yr olds with the appropriate serogroup specific polysaccharide vaccine
C.Isolation in a negative pressure room
D.Nothing, this is not communicable from person to person

Answer 1

The immediate public health response for Tina's condition, indicative of bacterial meningitis due to Neisseria meningitidis, is to track the source and antibiotic prophylaxis to those who have been in near contact with her (Option A).

Step-by-step explanation:

Tina's symptoms and the results from her cerebrospinal fluid (CSF) and blood cultures indicate she likely has bacterial meningitis caused by Neisseria meningitidis, a communicable bacterial infection. The increased total cells in her CSF, predominantly PMNs (polymorphonuclear neutrophils), along with elevated protein levels and decreased glucose levels, support this diagnosis. The presence of gram-negative diplococci from the Gram stain further confirms it.

From a public health perspective, tracking of the source and providing antibiotic prophylaxis to those who have been in near contact with her is the urgent action needed. This is essential to prevent the spread of the disease, as N. meningitidis can be transmitted from person to person through close contact. Immediate identification and treatment of anyone who may have been exposed is crucial for controlling the spread of this potentially fatal infection.

Thus, the correct option is A.

Answer 2

Immediate public health response for meningococcal meningitis include tracking the source(s) and administering antibiotic prophylaxis to close contacts to prevent further spread of the infection.

Step-by-step explanation:

From a public health perspective, given the lab results showing increased polymorphonuclear neutrophils (PMNs), elevated protein, lowered glucose levels, and Gram-negative diplococci in the cerebrospinal fluid (CSF), the student, Tina, is likely suffering from meningococcal meningitis caused by Neisseria meningitidis. This condition is highly communicable and can lead to outbreaks, especially in close-contact settings. Therefore, the immediate public health response should involve tracking the source(s) and administering antibiotic prophylaxis to those who have been in near contact with her. This helps prevent the spread of the infection and secondary cases. Vaccination may be recommended in an outbreak setting, but the urgent concern is to treat close contacts potentially exposed.