|Meningitis is an immediately notifiable disease in Lebanon. Since 2001, efforts are done to gather data on clinical and laboratory findings of reported meningitis cases and update the national database. |
|The objectives of meningitis surveillance are:
- To detect meningitis due to Neisseria meningitidis or Haemophilus influenzae in order to undertake immediate response.
- To better understand the epidemiology of meningitis in the country.
|Case definition |
|Meningitis case is suspected in case of fever of acute onset (38.5 C rectal or 38.0 C axillary), and stiff neck. For patients under 1 year of age, meningitis case is suspected when fever is accompanied by a bulging fontanelle, altered consciousness or irritability. |
|Following reporting, hospitals are asked to complete the meningitis specific investigation form. It aims to collect data on clinical symptoms, laboratory results (CSF and blood testing), immunization status, travel history and occupational status. |
|Case classification |
|According to the data and laboratory findings gathered, cases are classified into different categories related to infectious agents:
- Neisseria meningitidis: Suspected cases are those with purpura. Probable cases are those with petechial or purperal rash or with Gram-negative cocci (CSF). Confirmed cases are those with positive CSF antigen detection or positive culture (CSF or blood).
- Haemophilus influenzae: Confirmed cases are those with positive CSF antigen detection or positive culture (CSF or blood).
- Streptococcus pneumoniae: Confirmed cases are those with positive CSF antigen detection or positive culture (CSF or blood).
- Other bacteria: meningitis due to other identified bacterial organisms.
- Bacterial not elsewhere classified (BNOS): Meningitis case in which no specific bacteria has been identified with negative CSF culture (and negative blood culture and negative CSF antigens if conducted) and one of the following: CSF turbid appearance, increase in CSF protein (> 100 mg/dl) or increase CSF WBC count (> 500/ mm3).
- Aseptic: Meningitis case with negative CSF culture (and negative blood culture and negative CSF antigens if conducted) and that is not purulent. These cases are considered to be viral.
- Not documented: Meningitis case with no CSF culture documented.
|In case of Neisseria meningitidis or Haemophilus influenzae disease, prophylaxis is conducted by the Caza health offices, using the national guidelines. ||