Millar Beverley C, Moore P J A, Moore J E
Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast, UK.
School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
J R Army Med Corps. 2017 Aug;163(4):235-241. doi: 10.1136/jramc-2016-000695. Epub 2016 Dec 30.
Meningococcal disease is a worldwide life-threatening infection associated in many cases with debilitating long-term sequelae, both within the military and civilian populations. Military recruits are at a higher risk of acquiring this infection due to numerous factors, such as young recruits in the age group 18-25 years, high carriage rates of meningococci, communal and crowed living quarters and global deployment or training in regions with different meningococcal serogroup epidemiology. Although these increased risk factors among young recruits remain, the increased incidence of disease is now historic. Numerous outbreaks have been reported among military personnel, however although the incidence of the disease continues to decrease, there are still sporadic cases. The non-specific symptoms, sudden onset and rapid progression of the infection results in a limited time frame to both diagnose and successfully treat the patient. Many developments have been made in relation to the microbiological diagnosis of the disease, particularly in the era of molecular diagnostics, which have the potential to diagnose the infection more quickly. Developments in vaccinology, and in particular with relation to biotechnology and reverse vaccinology, have led to the availability of new meningococcal vaccines, further enabling disease prevention. This paper outlines the history of meningococcal disease in relation to the military and highlights the new developments in both diagnostics and vaccination, which have the potential to diagnose, treat and control meningococcal disease in a more efficient manner.
脑膜炎球菌病是一种全球范围内危及生命的感染病，在许多情况下，无论在军队还是平民中，都会伴有使人虚弱的长期后遗症。由于多种因素，新兵感染这种疾病的风险更高，比如年龄在18至25岁的年轻新兵、脑膜炎球菌的高携带率、集体且拥挤的居住环境以及在不同脑膜炎球菌血清群流行病学地区的全球部署或训练。尽管年轻新兵中这些增加的风险因素依然存在，但疾病发病率上升如今已成为历史。军队人员中已报告了多起疫情，然而，尽管该病发病率持续下降，但仍有散发病例。感染的非特异性症状、突然发作和快速进展导致诊断和成功治疗患者的时间有限。在该病的微生物学诊断方面已取得许多进展，特别是在分子诊断时代，这有可能更快地诊断感染。疫苗学的发展，尤其是与生物技术和反向疫苗学相关的发展，已带来新的脑膜炎球菌疫苗，进一步实现了疾病预防。本文概述了与军队相关的脑膜炎球菌病历史，并强调了诊断和疫苗接种方面的新进展，这些进展有可能更有效地诊断、治疗和控制脑膜炎球菌病。
