from reportlab.lib.pagesizes import A4
from reportlab.pdfgen import canvas
from reportlab.lib import colors
from reportlab.lib.utils import ImageReader
from reportlab.pdfbase.pdfmetrics import stringWidth
from reportlab.lib.colors import HexColor
from reportlab.pdfbase.ttfonts import TTFont
from reportlab.pdfbase import pdfmetrics
from PIL import Image, ImageDraw, ImageFont
from pathlib import Path

BASE = Path('/tmp/workspace/meningococcal-respiratory-presentation')
OUT = BASE/'output'/'Respiratory_Infections_Meningococcal_Infection_Paras_Gupta_2A.pdf'
ASSET = BASE/'assets'
W,H = A4
NAVY=HexColor('#123047'); TEAL=HexColor('#147C83'); SKY=HexColor('#EAF6F7'); RED=HexColor('#BE3E4B'); GOLD=HexColor('#F3B64A'); INK=HexColor('#1D2B36'); GREY=HexColor('#5F6C75')

# fonts
REG='Helvetica'; BOLD='Helvetica-Bold'; IT='Helvetica-Oblique'

def wrap(c,text,font,size,maxw):
    words=text.split(); lines=[]; cur=''
    for w in words:
        test=(cur+' '+w).strip()
        if stringWidth(test,font,size)<=maxw: cur=test
        else: lines.append(cur); cur=w
    if cur: lines.append(cur)
    return lines

def header(c,title,num):
    c.setFillColor(NAVY); c.rect(0,H-48,W,48,fill=1,stroke=0)
    c.setFillColor(colors.white); c.setFont(BOLD,18); c.drawString(34,H-31,title)
    c.setFillColor(TEAL); c.circle(W-34,H-24,13,fill=1,stroke=0)
    c.setFillColor(colors.white); c.setFont(BOLD,9); c.drawCentredString(W-34,H-27,str(num))

def footer(c):
    c.setStrokeColor(HexColor('#CFD9DD')); c.line(34,31,W-34,31)
    c.setFillColor(GREY); c.setFont(REG,8); c.drawString(34,18,'Respiratory infections: meningococcal infection')
    c.drawRightString(W-34,18,'Paras Gupta (2A)')

def bullets(c,items,x,y,width,fontsize=14,leading=20):
    c.setFont(REG,fontsize); c.setFillColor(INK)
    for item in items:
        lines=wrap(c,item,REG,fontsize,width-22)
        c.setFillColor(TEAL); c.circle(x+4,y+3,3,fill=1,stroke=0)
        c.setFillColor(INK)
        for j,line in enumerate(lines):
            c.drawString(x+17,y-j*leading,line)
        y-=leading*len(lines)+10
    return y

def note(c,text,x,y,width):
    c.setFillColor(SKY); c.roundRect(x,y-42,width,49,8,fill=1,stroke=0)
    c.setFillColor(NAVY); c.setFont(BOLD,10); c.drawString(x+12,y-10,'Key point')
    c.setFillColor(INK); c.setFont(REG,10)
    for i,l in enumerate(wrap(c,text,REG,10,width-24)): c.drawString(x+12,y-24-i*12,l)

def img(c,path,x,y,w,h):
    im=Image.open(path); iw,ih=im.size; scale=min(w/iw,h/ih); nw,nh=iw*scale,ih*scale
    c.drawImage(ImageReader(im),x+(w-nw)/2,y+(h-nh)/2,nw,nh,mask='auto')

def draw_lungs(c,x,y,s):
    c.setStrokeColor(RED); c.setLineWidth(5); c.line(x+s*.5,y+s*.94,x+s*.5,y+s*.65)
    c.setFillColor(HexColor('#F4A7AC')); c.setStrokeColor(RED); c.setLineWidth(2)
    c.ellipse(x+s*.08,y+s*.12,x+s*.48,y+s*.70,fill=1,stroke=1); c.ellipse(x+s*.52,y+s*.12,x+s*.92,y+s*.70,fill=1,stroke=1)
    c.setFillColor(RED); c.circle(x+s*.68,y+s*.43,s*.055,fill=1,stroke=0); c.circle(x+s*.75,y+s*.35,s*.035,fill=1,stroke=0)

def page(c,title,num,items=None,visual=None,key=None):
    header(c,title,num)
    if visual=='lungs':
        draw_lungs(c,340,250,190)
        c.setFillColor(GREY); c.setFont(IT,10); c.drawCentredString(435,220,'Focal consolidation can occur in pneumonia')
    elif visual=='pathway': img(c,ASSET/'meningococcal_pathway.png',325,240,220,220)
    elif visual=='droplets':
        c.setFillColor(SKY); c.roundRect(345,260,190,150,16,fill=1,stroke=0)
        c.setFillColor(NAVY); c.setFont(BOLD,14); c.drawCentredString(440,375,'Respiratory droplets')
        c.setStrokeColor(TEAL); c.setLineWidth(3); c.line(375,330,500,330)
        for xx,yy in [(405,345),(430,325),(455,350),(478,315),(445,300)]: c.setFillColor(TEAL); c.circle(xx,yy,6,fill=1,stroke=0)
        c.setFillColor(GREY); c.setFont(REG,10); c.drawCentredString(440,280,'Close, prolonged contact increases risk')
    elif visual=='lab':
        c.setFillColor(SKY); c.roundRect(350,245,170,180,15,fill=1,stroke=0)
        c.setFillColor(NAVY); c.setFont(BOLD,18); c.drawCentredString(435,385,'Diagnosis')
        for i,t in enumerate(['Blood culture','Sputum/respiratory sample','PCR when available','Chest radiograph']):
            yy=355-i*30; c.setFillColor(TEAL); c.circle(370,yy+3,4,fill=1,stroke=0); c.setFillColor(INK); c.setFont(REG,11); c.drawString(382,yy,t)
    elif visual=='shield':
        c.setFillColor(HexColor('#D7F0EE')); c.roundRect(370,260,130,160,22,fill=1,stroke=0)
        c.setFillColor(TEAL); p=c.beginPath(); p.moveTo(435,400); p.lineTo(485,382); p.lineTo(478,315); p.curveTo(470,280,435,270,435,270); p.curveTo(400,280,392,315,392,315); p.lineTo(385,382); p.close(); c.drawPath(p,fill=1,stroke=0)
        c.setFillColor(colors.white); c.setFont(BOLD,28); c.drawCentredString(435,325,'✓')
    elif visual=='emergency':
        c.setFillColor(HexColor('#FCE7E9')); c.roundRect(340,260,190,150,16,fill=1,stroke=0)
        c.setFillColor(RED); c.setFont(BOLD,25); c.drawCentredString(435,360,'URGENT')
        c.setFont(BOLD,15); c.drawCentredString(435,330,'Suspected invasive disease')
        c.setFillColor(INK); c.setFont(REG,11); c.drawCentredString(435,300,'Needs immediate medical assessment')
    y=H-96
    if items: y=bullets(c,items,45,y,265,13.4,18)
    if key: note(c,key,45,max(75,y-15),265)
    footer(c); c.showPage()

c=canvas.Canvas(str(OUT),pagesize=A4)
c.setTitle('Respiratory Infections of Meningococcal Infection')
c.setAuthor('Paras Gupta (2A)')
# 1 cover
c.setFillColor(NAVY); c.rect(0,0,W,H,fill=1,stroke=0)
c.setFillColor(TEAL); c.circle(W-80,H-90,95,fill=1,stroke=0); c.setFillColor(HexColor('#1B5267')); c.circle(88,140,115,fill=1,stroke=0)
c.setFillColor(colors.white); c.setFont(BOLD,33); c.drawString(47,H-220,'Respiratory Infections')
c.setFont(BOLD,29); c.drawString(47,H-260,'of Meningococcal Infection')
c.setFillColor(HexColor('#BDE6E5')); c.setFont(REG,15); c.drawString(50,H-300,'Transmission, clinical features, diagnosis, treatment and prevention')
img(c,ASSET/'meningococcal_pathway.png',85,220,420,220)
c.setFillColor(colors.white); c.setFont(BOLD,15); c.drawRightString(W-43,52,'Paras Gupta (2A)')
c.showPage()

page(c,'Learning objectives',2,[
'Identify Neisseria meningitidis and explain its relation to the upper respiratory tract.',
'Describe respiratory droplet transmission, carriage, and factors that favour disease.',
'Recognize meningococcal pneumonia and red flags of invasive disease.',
'Outline diagnosis, urgent management, contact measures, and prevention.' ],'pathway','Meningococcal pneumonia is uncommon, but invasive meningococcal disease can deteriorate rapidly.')
page(c,'The organism and disease spectrum',3,[
'Neisseria meningitidis is an encapsulated, oxidase-positive Gram-negative diplococcus. Humans are its only reservoir.',
'Colonization usually occurs in the nasopharynx without symptoms. Only a small proportion of carriers develop invasive disease.',
'Major invasive syndromes are meningitis and bloodstream infection. Less common presentations include pneumonia, arthritis, pericarditis, and conjunctivitis.',
'Serogroups A, B, C, W, X and Y cause most disease worldwide; Y and W have been linked more often with pneumonia.' ],'lungs','Respiratory symptoms may precede pneumonia or invasive meningococcal disease.')
page(c,'Transmission and respiratory carriage',4,[
'Transmission is via respiratory droplets or saliva during close, prolonged contact.',
'Examples of higher-risk exposure: household contact, kissing, shared living quarters, or direct contact with oral/airway secretions.',
'Carriage varies widely and is commonly highest in school-age children, adolescents and young adults.',
'Crowding, active or passive smoking, and a recent viral upper respiratory infection are associated with increased risk.' ],'droplets','Routine classroom contact alone is generally not the same as direct exposure to respiratory secretions.')
page(c,'How respiratory disease develops',5,[
'After nasopharyngeal acquisition, the organism adheres to mucosa and may remain as harmless carriage.',
'Mucosal disruption or host susceptibility can permit invasion into blood, causing bacteremia and dissemination.',
'Pulmonary disease may arise after a respiratory tract infection or with bloodstream infection. Inflammation leads to alveolar consolidation.',
'Host risk is increased by complement deficiency or complement-inhibiting medicines, functional/anatomic asplenia, and some immune conditions.' ],'pathway','The bacterial capsule helps the organism evade host immune clearance.')
page(c,'Meningococcal pneumonia',6,[
'Meningococcal pneumonia is a rare cause of community-acquired pneumonia and may be difficult to distinguish clinically from other bacterial pneumonias.',
'Typical features: fever, cough, chest pain, chills, crackles/rales, and sometimes shortness of breath.',
'Pharyngitis may coexist. A rash, hypotension, confusion, headache, or neck stiffness should raise concern for invasive disease.',
'Textbook estimates describe sporadic primary pneumonia as uncommon, while pneumonia can complicate invasive meningococcal infection.' ],'lungs','Do not assume a respiratory presentation excludes meningitis or meningococcemia.')
page(c,'Clinical red flags',7,[
'Sudden high fever with severe headache, neck stiffness, photophobia, confusion, or vomiting suggests meningitis.',
'Petechial or purpuric rash, hypotension, cold extremities, altered mental status, or rapid deterioration suggests meningococcemia/sepsis.',
'Infants and young children may show nonspecific signs such as lethargy, irritability, poor feeding, or abnormal cry.',
'Suspected invasive meningococcal disease is a medical emergency: urgent assessment and antibiotics must not be delayed.' ],'emergency','A non-blanching rash with fever needs immediate medical evaluation.')
page(c,'Diagnosis',8,[
'Assess severity first: vital signs, oxygenation, perfusion, mental status, rash, and signs of meningitis or sepsis.',
'Obtain blood cultures promptly when feasible, but never delay initial antibiotics in a seriously ill person.',
'Respiratory specimens and blood culture may identify the organism in pneumonia; PCR can improve diagnostic yield where available.',
'Chest radiograph may show focal or multilobar consolidation. Lumbar puncture is considered when meningitis is suspected and it is safe to perform.' ],'lab','Notify local public-health authorities according to local reporting requirements.')
page(c,'Treatment and infection control',9,[
'Initial treatment of suspected invasive meningococcal disease uses urgent parenteral antibiotics according to local protocol, commonly a third-generation cephalosporin such as ceftriaxone or cefotaxime.',
'Provide supportive care for sepsis or respiratory failure: oxygen, fluids, hemodynamic support, and higher-level care when needed.',
'Use droplet precautions for patients with suspected or confirmed meningococcal disease until 24 hours after effective antimicrobial therapy has begun.',
'Targeted therapy is adjusted after microbiology and susceptibility results. This slide is educational, not a patient-specific prescription.' ],'emergency','Timely treatment is the most important action when invasive disease is suspected.')
page(c,'Protection of close contacts',10,[
'Close contacts of invasive cases need prompt public-health evaluation for antibiotic chemoprophylaxis.',
'Contacts include household members, childcare contacts, and people directly exposed to oral or respiratory secretions, including during airway procedures.',
'Chemoprophylaxis options depend on age, pregnancy status, allergies and local guidance; clinician/public-health direction is required.',
'Carriers who have no defined exposure to a clinical case usually do not require prophylaxis.' ],'droplets','The purpose is to eliminate nasopharyngeal carriage and prevent secondary cases.')
page(c,'Prevention by vaccination',11,[
'Meningococcal vaccines are the cornerstone of prevention, alongside outbreak control and risk-based vaccination.',
'MenACWY vaccines cover serogroups A, C, W and Y. MenB vaccines cover serogroup B; schedules vary by country, age, and risk category.',
'Groups at increased risk may include people with complement deficiency or complement-inhibitor use, asplenia, certain travellers, microbiologists handling isolates, and people exposed during outbreaks.',
'Vaccination reduces risk but does not remove the need for urgent assessment if compatible symptoms occur.' ],'shield','Follow the national immunization schedule and local public-health advice.')
# references page
header(c,'Take-home messages and sources',12)
y=H-95
bullets(c,[
'Meningococci are commonly carried in the nasopharynx and spread through close respiratory contact.',
'Meningococcal pneumonia is uncommon, but respiratory symptoms may occur before or alongside life-threatening invasive disease.',
'Rapid recognition, immediate antibiotics for suspected invasive disease, contact prophylaxis, and vaccination are key.' ],45,y,520,14,19)
c.setFillColor(NAVY); c.setFont(BOLD,14); c.drawString(45,305,'Selected sources')
sources=[
'Harrison’s Principles of Internal Medicine, 22nd ed. (2025), Meningococcal Disease, pp. 1285-1295.',
'Medical Microbiology, 9th ed., Neisseria meningitidis, pp. 279-280.',
'Murray & Nadel’s Textbook of Respiratory Medicine, Neisseria meningitidis section.',
'CDC. Meningococcal Disease: Surveillance Manual and Pink Book (accessed October 2026).',
'CDC. Meningococcal Disease Infection Control guidance (accessed October 2026).'
]
c.setFont(REG,10.3); c.setFillColor(INK)
for s in sources:
    for line in wrap(c,s,REG,10.3,510): c.drawString(52,285,line); y=0; c.translate(0,0); # no-op
    # use a manual cursor
    c.translate(0,0)
    # redraw via changing fixed loop not suited
    # use current count below
    
# overwrite formatted sources with stable layout
c.setFillColor(colors.white); c.rect(42,110,520,190,fill=1,stroke=0)
c.setFillColor(INK); c.setFont(REG,10.3); yy=282
for s in sources:
    lines=wrap(c,s,REG,10.3,500)
    c.setFillColor(TEAL); c.circle(49,yy+3,2.5,fill=1,stroke=0); c.setFillColor(INK)
    for line in lines: c.drawString(60,yy,line); yy-=13
    yy-=5
c.setFillColor(GREY); c.setFont(IT,9); c.drawString(45,72,'Prepared for classroom presentation. Verify local clinical and immunization guidance before clinical use.')
footer(c); c.showPage(); c.save()
print(OUT)

from reportlab.lib.pagesizes import A4
from reportlab.pdfgen import canvas
from reportlab.lib import colors
from reportlab.lib.colors import HexColor
from reportlab.lib.utils import ImageReader
from reportlab.pdfbase.pdfmetrics import stringWidth
from PIL import Image
from pathlib import Path

BASE=Path('/tmp/workspace/meningococcal-respiratory-presentation')
ASSETS=BASE/'assets'
OUT=BASE/'output'/'Respiratory_Infections_Meningococcal_Infection_Paras_Gupta_2A_Real_Images.pdf'
W,H=A4
NAVY=HexColor('#0D2B45'); TEAL=HexColor('#087E8B'); PALE=HexColor('#E9F5F6'); RED=HexColor('#B4233B'); INK=HexColor('#162A38'); GREY=HexColor('#5E6B75'); GOLD=HexColor('#F7B84B')
REG='Helvetica'; BOLD='Helvetica-Bold'; IT='Helvetica-Oblique'

IMAGES={
 'micro':('cdc_micrograph.jpg','CDC PHIL 6423: photomicrograph of N. meningitidis, 1150x.'),
 'bacteria':('cdc_bacteria_3d.jpg','CDC PHIL 22881: 3D rendering based on SEM imagery.'),
 'cdc':('cdc_bacteria_page.jpg','CDC: N. meningitidis illustration.'),
 'cxr':('meningococcal_cxr.jpg','Walayat et al., 2018, PMC5905520: chest radiograph from invasive meningococcal disease case.'),
 'cxr2':('meningococcal_cxr_followup.jpg','Valdez et al., 2022, PMC9290109: radiographic follow-up in meningococcal pneumonia case.'),
 'prevention':('cdc_prevention.png','CDC: meningococcal disease prevention graphic.')
}

def wrap(c,t,font,size,width):
    out=[]; cur=''
    for word in t.split():
        test=(cur+' '+word).strip()
        if stringWidth(test,font,size)<=width: cur=test
        else: out.append(cur); cur=word
    if cur: out.append(cur)
    return out

def draw_img(c,key,x,y,w,h):
    fname,credit=IMAGES[key]; p=ASSETS/fname
    im=Image.open(p); iw,ih=im.size; s=min(w/iw,h/ih); nw,nh=iw*s,ih*s
    c.setFillColor(colors.white); c.roundRect(x-4,y-4,w+8,h+8,7,fill=1,stroke=0)
    c.drawImage(ImageReader(im),x+(w-nw)/2,y+(h-nh)/2,nw,nh,mask='auto')
    c.setFillColor(GREY); c.setFont(IT,7.1)
    for i,line in enumerate(wrap(c,credit,IT,7.1,w)): c.drawString(x,y-14-i*8,line)

def header(c,title,n):
    c.setFillColor(NAVY); c.rect(0,H-54,W,54,fill=1,stroke=0)
    c.setFillColor(colors.white); c.setFont(BOLD,18); c.drawString(34,H-34,title)
    c.setFillColor(TEAL); c.circle(W-34,H-27,14,fill=1,stroke=0)
    c.setFillColor(colors.white); c.setFont(BOLD,9); c.drawCentredString(W-34,H-30,str(n))

def footer(c):
    c.setStrokeColor(HexColor('#CBD5DA')); c.line(34,29,W-34,29)
    c.setFillColor(GREY); c.setFont(REG,8); c.drawString(34,17,'Respiratory infections of meningococcal infection')
    c.drawRightString(W-34,17,'Paras Gupta (2A)')

def bullets(c,items,x,y,width,size=13):
    c.setFont(REG,size)
    for item in items:
        lines=wrap(c,item,REG,size,width-24)
        c.setFillColor(TEAL); c.circle(x+4,y+3,3,fill=1,stroke=0)
        c.setFillColor(INK)
        for j,line in enumerate(lines): c.drawString(x+18,y-j*18,line)
        y-=18*len(lines)+11

def keybox(c,text,x,y,w):
    c.setFillColor(PALE); c.roundRect(x,y,w,47,8,fill=1,stroke=0)
    c.setFillColor(NAVY); c.setFont(BOLD,9); c.drawString(x+11,y+31,'KEY MESSAGE')
    c.setFillColor(INK); c.setFont(REG,9.3)
    for i,line in enumerate(wrap(c,text,REG,9.3,w-22)): c.drawString(x+11,y+17-i*11,line)

def page(c,title,n,items,key,image=None):
    header(c,title,n)
    bullets(c,items,39,720,310 if image else 510,12.8)
    if image: draw_img(c,image,363,272,190,248)
    keybox(c,key,39,90,510)
    footer(c); c.showPage()

c=canvas.Canvas(str(OUT),pagesize=A4)
c.setTitle('Respiratory Infections of Meningococcal Infection')
c.setAuthor('Paras Gupta (2A)')
# Cover
c.setFillColor(NAVY); c.rect(0,0,W,H,fill=1,stroke=0)
c.setFillColor(TEAL); c.circle(W-35,H-86,110,fill=1,stroke=0)
c.setFillColor(colors.white); c.setFont(BOLD,32); c.drawString(45,H-208,'Respiratory Infections')
c.setFont(BOLD,28); c.drawString(45,H-248,'of Meningococcal Infection')
c.setFillColor(HexColor('#C6E8EC')); c.setFont(REG,14); c.drawString(47,H-284,'Transmission, clinical features, diagnosis, treatment and prevention')
draw_img(c,'bacteria',125,200,350,275)
c.setFillColor(colors.white); c.setFont(BOLD,15); c.drawRightString(W-42,48,'Paras Gupta (2A)')
c.showPage()

page(c,'Learning objectives',2,[
 'Identify Neisseria meningitidis and relate it to respiratory carriage.',
 'Explain respiratory droplet transmission and factors that increase disease risk.',
 'Recognize features of meningococcal pneumonia and invasive disease.',
 'Summarize diagnosis, urgent treatment, contact management, and prevention.'
],'Meningococcal disease is uncommon but can become life-threatening within hours.', 'cdc')
page(c,'The organism',3,[
 'Neisseria meningitidis is an encapsulated, oxidase-positive Gram-negative diplococcus.',
 'It is a human pathogen. The nasopharynx is the usual site of asymptomatic carriage.',
 'On microscopy, paired diplococci may be seen. Culture and molecular tests help confirm disease.',
 'Serogroups A, B, C, W, X, and Y account for most invasive disease worldwide.'
],'The bacterial capsule contributes to immune evasion and invasive potential.', 'micro')
page(c,'Transmission and respiratory carriage',4,[
 'Spread occurs through respiratory droplets and saliva during close or prolonged contact.',
 'Household contact, kissing, shared living quarters, and direct airway secretion exposure carry more risk.',
 'Many people carry the organism without illness. Carriage is common in adolescents and young adults.',
 'Crowding, smoking exposure, and recent viral upper respiratory infection are associated with risk.'
],'Meningococci are less contagious than influenza, but close contact matters.', 'cdc')
page(c,'From the nasopharynx to disease',5,[
 'Most colonization remains localized and asymptomatic.',
 'Occasionally bacteria cross mucosa into the bloodstream, causing bacteremia and dissemination.',
 'Infection may present as meningitis, meningococcemia, or less commonly pneumonia.',
 'Risk is greater with complement deficiency or complement-inhibiting therapy, asplenia, and certain immune conditions.'
],'A respiratory presentation does not exclude invasive bloodstream or central nervous system disease.', 'bacteria')
page(c,'Meningococcal pneumonia',6,[
 'This is a rare cause of community-acquired pneumonia and can resemble other bacterial pneumonias.',
 'Symptoms include fever, chills, cough, chest pain, breathlessness, and crackles on examination.',
 'Pharyngitis may coexist. Serogroups Y and W are reported more often with pneumonia.',
 'Chest imaging can show focal or lobar consolidation, but it is not specific for the organism.'
],'Meningococcal pneumonia should be considered in the appropriate clinical and epidemiologic setting.', 'cxr')
page(c,'Red flags: invasive meningococcal disease',7,[
 'Sudden high fever, severe headache, neck stiffness, photophobia, confusion, or reduced consciousness.',
 'A rapidly evolving petechial or purpuric rash, hypotension, cold extremities, or severe limb pain.',
 'In infants, symptoms may be nonspecific: poor feeding, lethargy, irritability, or a bulging fontanelle.',
 'These features require immediate emergency assessment and antibiotics. Do not wait for a rash.'
],'Clinical deterioration can be rapid. Early recognition and treatment reduce mortality.', 'cxr2')
page(c,'Diagnosis',8,[
 'Collect blood cultures promptly when possible, but never delay treatment in a strongly suspected case.',
 'PCR on blood or cerebrospinal fluid can increase diagnostic yield, especially after antibiotics.',
 'For pneumonia, evaluate with chest radiography and respiratory samples as clinically appropriate.',
 'Assess for meningitis, septic shock, respiratory failure, and other organ dysfunction.'
],'Laboratory confirmation supports public health action, but clinical urgency guides initial care.', 'micro')
page(c,'Immediate management',9,[
 'Treat suspected invasive meningococcal disease as an emergency in hospital.',
 'Start empiric intravenous antibiotics promptly according to local protocol, then tailor to microbiology results.',
 'Provide supportive care: oxygen if needed, fluids and vasopressors for shock, and intensive care support when indicated.',
 'Use droplet precautions initially; local infection-control guidance determines when they can stop.'
],'The principle is simple: suspect early, give antibiotics early, and stabilize aggressively.', 'cxr')
page(c,'Close contacts and public health',10,[
 'Close contacts are at increased risk and may need antibiotic chemoprophylaxis as soon as possible.',
 'Examples include household members and people directly exposed to oral or respiratory secretions.',
 'Healthcare workers require prophylaxis only after relevant unprotected exposure to respiratory secretions.',
 'Cases should be reported promptly to public-health authorities so contacts and outbreaks can be managed.'
],'Routine casual contact is usually not an indication for chemoprophylaxis.', 'cdc')
page(c,'Prevention',11,[
 'Vaccination is the main preventive strategy. Available vaccines target ACWY serogroups and serogroup B.',
 'Recommendations depend on age, country, risk factors, outbreak status, and travel.',
 'Higher-risk groups include people with complement disorders, asplenia, some laboratory workers, and outbreak-exposed populations.',
 'Avoid sharing saliva, reduce smoking exposure, and seek care urgently for concerning symptoms.'
],'Vaccination prevents disease but does not remove the need to act quickly if symptoms arise.', 'prevention')
page(c,'Take-home messages and sources',12,[
 'N. meningitidis commonly colonizes the nasopharynx and spreads through close respiratory contact.',
 'Meningococcal pneumonia is rare but clinically important because invasive disease may be present.',
 'Fever with rash, shock, headache, neck stiffness, or confusion is an emergency.',
 'Early antibiotics, contact prophylaxis, public health action, and vaccination are the pillars of control.'
],'Sources: CDC Meningococcal Disease pages and Pink Book; Harrison’s Principles of Internal Medicine, 22e; Medical Microbiology, 9e; Murray & Nadel’s Textbook of Respiratory Medicine.', 'prevention')
c.save()
print(OUT)