The Results of the Serum Treatment in Thirteen Hundred Cases of Epidemic Meningitis

Abstract

The data brought together in this report have been gathered from a wide territory and for a period extending over several years. The antimeningitis serum was first employed in 1906 and the latest figures relating to its use included in this report were furnished in 1912. There is no longer doubt that the serum has come to be applied under conditions fairly representing all known manifestations of epidemic meningitis. Hence the test of the serum treatment may be regarded as having been a rigorous one. The initial difficulties surrounding the administration by direct subdural injection have been largely overcome and doubtless will be still further mastered. Already the serum is being successfully applied in private as well as in hospital practice. This gain will probably be reflected in a still further diminution of the mortality since early injection plays such a large part in determining the results achieved. The 1,300 cases studied in this report are a part only of a far greater number of cases actually treated with the serum supplied by the Rockefeller Institute. It was not found possible to secure histories of all the cases treated; but there is no reason to suppose that the results of the analysis would have been essentially different if reports of a still larger number of cases had been returned. The decision arrived at is not based upon statistical computations alone, but upon objective data as well that are not readily misinterpreted. The conclusion that follows was first stated in 1909 as the result of an analysis of 400 serum-treated cases. It is supported by the study of the larger series of cases just presented. "In view of the various considerations presented, the conclusion may be drawn that the antimeningitis serum, when used by the subdural method of injection, in suitable doses and at proper intervals, is capable of reducing the period of illness; of preventing, in large measure, the chronic lesions and types of the infection; of bringing about complete restoration of health, in all but a very small number of the recovered, thus lessening the serious, deforming, and permanent consequences of meningitis; and of greatly diminishing the fatalities due to the disease."

Hospital-based surveillance of meningococcal meningitis in Salvador, Brazil

“…Without appropriate antimicrobial treatment, most cases of meningococcal meningitis are fatal (Flexner, 1913), and even with prompt intervention the case fatality rate (CFR) reaches 10% (Caugant, 1998). Among those who survive, permanent sequelae, including deafness, cognitive impairment and paralysis, are common (Edwards and Baker, 1981;Kirsch et al, 1996).…”

Update on Meningococcal Disease with Emphasis on Pathogenesis and Clinical Management

“…Serum therapy with serum from immunized horses, introduced at the beginning of this century by Jochmann in Germany and Flexner in the United States, has reduced mortality from nearly 100 to 30% (145,241). Since their introduction in 1937, sulfonamides decreased mortality to 10% (423) .…”

Prospects for Vaccine Prevention of Meningococcal Infection

“…In the early part of the 20th century, the American physician Simon Flexner reported on the use of antimeningococcal serum therapy, first in an animal model and subsequently in humans, demonstrating that intrathecal administration reduced the mortality of meningococcal meningitis (111)(112)(113)(114). In 1915, a serogrouping scheme was proposed that separated meningococcal isolates into types I to IV (later changed to the letter-based nomenclature that is used today), which eventually was adopted in the United States (140,365).…”