1) The organism that you would find in a Gram stain of blood or cerebrospinal fluid in these cases of meningococcal disease would be the bacteria Neisseria meningitidis. N. meningitidis can be classified into 13 serogroups based on the immunologic reactivity of their capsular polysaccharides. Five serogroups B, C, and Y each cause about one-third of meningococcal disease cases in the U.S. The proportion of cases caused by each serogroup differs according to age; serogroup B causes over 50% of cases in infants younger than 1 year of age, while serogroups C, Y, and W135 cause 75% of meningococcal disease in those 11 years and older. There is currently no vaccine available for serogroup B. Humans are the only natural reservoir for N. meningitidis. N. meningitidis organisms are also gram-negative.
2)The organism gains access to the infected patient by attaching to mucosa in the nasopharynx. There, the bacteria multiply exponentially, bind to specific receptors, and are taken up by epithelial cells which then transport the bacteria across the mucosal epithelium. In a small number of people that are infected, the bacterium can actually penetrate the mucosa and gain access to the bloodstream, which would result in a systemic disease (a disease that affects a number of organs and tissues, or the body as a whole).
3) Yes, swabbing the portal of entry would detect the presence of the organism. The portal of entry is the nasopharynx, which is the back of the throat. However, the skill of the person taking the swab would play an important role in detecting the bacteria, for culture of throat swabs is labor-intensive, cannot be delayed once the sample is taken, and often takes 4 days to obtain a result. Operators must take good-quality throat swabs for accurate readings. This swab could be inaccurate due to the fact that many bacteria live within the throat and detecting this particular one could be difficult.
4) Symptoms associated with meningococcal disease include fever and chills, mental status changes such as confusion, nausea and vomiting, purple, bruise like areas, pinpoint red spots (rash), sensitivity to light, severe headache, stiff neck, agitation, rapid breathing, decreased consciousness, and poor feeding or irritability in children.
5) Steps can be taken in order to decrease risk of infection for these 895 students. Bacteria that causes meningococcal disease are contagious, and can be spread through coughing, sneezing, kissing, or sharing utensils. Careful hand washing is an important factor in preventing spread of the disease. Placing hand sanitizer in classrooms and the cafeteria and making sure soap is fully stocked in the bathroom at all times will prevent spread of this disease, as well as encouraging students to wash their hands frequently at home. Providing tissues in classrooms for students as well as encouraging covering their mouth and nose when coughing and sneezing could prevent one infected student from infecting many more. Notifying parents of the outbreak in order to increase hygiene at home would prevent spreading as well. Doing a thorough cleaning of the school, such as cleaning floors, tables, door handles, and windows could prevent the bacteria from the five already infected students from penetrating others.
