Meningococcus

Meningococci(Neisseria meningitidis) are bacteria found exclusively in humans. They can colonize the mucous membrane of the nasopharynx without causing symptoms of disease. However, if disease does occur, the course of a meningococcal infection can lead to permanent damage or even be fatal.

Meningococci mainly cause meningitis (meningococcal meningitis) and/or blood poisoning (meningococcal sepsis). The incubation period (time of infection until the first symptoms appear) is usually 3 to 4 days, but can last up to 10 days.

Illness can occur at any age, but is more common in infants, young children, and adolescents. The disease can develop very quickly.

The development of disease is rare and mostly sporadic. In Austria, about 0.3 cases per 100,000 inhabitants:in and year are registered (data from the National Reference Center of 2019).

Pneumococcus

Pneumococcal(streptococcus pneumoniae) infections occur at all times of the year, but show a seasonal peak in the winter months or in spring. Pneumococci are part of the normal flora of the upper respiratory tract. Colonization of the nasopharynx occurs in infancy, usually during the first two years of life, and decreases with age. Colonization usually lasts a few weeks, but can last up to 30 weeks.

Pneumococcus can be transmitted from person to person by droplets. Infection is often endogenous and is promoted by lowered immunity.

The incidence of invasive pneumococcal disease has two peaks. Children under 2 years of age and the elderly are particularly at risk, as are persons with immunodeficiency and other underlying diseases such as cardiopulmonary disease, previous infections (e.g., influenza), status post splenic extirpation, or complement deficiencies.

Pneumococcal diseases are very common in Austria, but they are not always recorded as such, as only invasive diseases are reportable (6.9 cases of registered invasive pneumococcal infections per 100,000 inhabitants:in, 2019 data from the National Reference Center).

Haemophilus influenzae

Haemophilus influenzae infections occur worldwide. Transmission occurs from person to person by droplet infection during close contact, i.e., coughing, sneezing, near-body talking contact, or kissing. Haemophilus influenzae (H. influenzae) colonizes the nasopharynx mostly without causing disease. This colonization of the nasopharynx can last up to several weeks.

The disease can occur in weakened or not fully developed immune system, such as in children under 5 years of age, in the elderly and in other people with immunodeficiency.

The tasks of the National Reference Center include the epidemiological surveillance of invasive meningococcal, pneumococcal and Haemophilus influenzae diseases, respectively, and accordingly the typing and antibiotic resistance determination of all isolates isolated in Austria. In addition, special investigations such as molecular biological detection and molecular biological typing are carried out. The strain collection, which has been maintained since 2002, comprises several hundred isolates.

For Haemophilus influenzae:

• Cultural cultivation, antibiotic resistance determination;

• typing by slide agglutination;

• Serotyping (a-f) by real-time PCR;

For pneumococci:

• cultural cultivation, antibiotic resistance determination;
• Serotyping by latex agglutination and new field swelling reaction;
• Sequence-based typing by means of Sanger sequencing;

For meningococci:

• Primary diagnostics by real-time PCR;
• cultural cultivation, antibiotic resistance determination;
• Typing by slide agglutination;
• Sequence-based typing using whole genome sequencing;