Meningitis is a very serious illness and is often fatal in young children. Health departments have been working very hard in recent years to raise awareness of its symptoms and encourage anyone in doubt to contact a doctor asap.
Meningitis attacks the nervous system, specifically by causing inflammation around the brain and spinal cord. The inflammation itself can have a variety of causes. Both bacterial infections and viruses can cause meningitis, which is one of the reasons why it is vital to get it properly diagnosed and treated. The only way to treat it is to fight the infection, and that means antiviral drugs or antibacterial (e.g. penicillin).
Bacterial meningitis is the most serious form of the disease as it can lead to brain damage and cause septicaemia (blood infection). Vital meningitis is still serious but is easier to treat. Viral meningitis often goes untreated as many people mistake it for being influenza.
Common Symptoms of Meningitis
Meningitis usually causes headache, a stiff neck and fever. Confusion and lapses in concentration or even altered conciousness and delirium can develop. Vomiting is also frequently experienced, as is pain associated with bright lights (often linked to headaches) and a general nervousness and anxiety with loud noises.
When speaking with a nurse or doctor for the first time they will always ask if a child is suffering from any of these conditions, e.g.
- Do they have a headache?
- Do they have a high-pitched, weak or continuous cry?
- Has their skin become pale, blotchy or turned blue
- Are they responsive?
- Are they suffering with floppiness and listlessness, or stiffness with jerky movements
- Are they feeding well?
- Are they vomiting or have diarrhoea? Is the vomit bile stained (green?)
- Do they have a temperature over 38 degrees for babies under 3 months, or over 39 degrees for babies 3 months to 6 months?
- Do they have a rash that does not vanish when pressed?
- Are they complaining of bright lights?
- Are they concious?
- Are they coherent?
If any of these symptoms occurs the further medical testing will need to be carried out. This is usually done with a lumber puncture (spinal tap) which extracts spinal fluids (cerebrospinal fluid) for testing. This is the only way to accurately diagnose meningitis.
A common diagnosis of meningitis is to examine a rash if present. Rashes are not present in all forms of meningitis. Rashes may accompany meningitis caused by meningococcal bacteria. The standard method to diagnose when a rash is present is to push down on the rash with a glass and if the redness disappears it is not meningitis but if the rash does not go, it is.
Rashes can start as small red pin pricks but soon they can develop and spread to cover the arms and legs. In the most severe cases amputation is required.
The bacteria that causes meningitis is often present in an adults body. Most people over the age of 25 have some level of immunity to meningococcal bacteria so can carry it without becoming ill. However, it can be passed on through coughing and sneezing, kissing, sharing cutlery, toothbrushes, glasses and cigarettes.
Meningitis is usually an isolated infection, i.e. it only affects one person at a time and is not passed on. However, it is spread when there are many young people in close proximity to one and other, such as in boarding schools, at university, in the military or in student housing.
Viral meningitis is caused in the same way, although hand-to-hand spread is more likely. If you touch a surface that has the meningitis virus on it there is a good chance that you will develop the illness. The best preventative action is to wash your hands regularly, especially if you work in a crowded space.
Herpes Simplex Virus Type 2
Herpes Simplex Virus Type 2 is a common cause of acute and recurrent aseptic meningitis. Being a viral meningitis it can often be successfully treated with anti-vital medication and rest.
Methylprednisone – Lower Back Painkiller caused Fungal Meningitis
Meningitis can have the most unexpected causes. In October 2012 methylprednisone, a steroid injection for lower back pain, caused several cases of fungal meningitis in the USA. By 10th October there had been 7 deaths and a further 64 known cases across 9 US states. 29 of the cases were in Tennessee.
Two types of fungus were identified as being the cause – Aspergillus and Exserohilum. Antifungal therapy is the only treatment.
When To Call For Emergency Aid
It is vital to call an ambulance as soon as the condition worsens. If someone is suffering from the above symptoms seek medical aid urgently. Also, if any of the following occurs call emergency services immediately (this is standard for any illness, not just meningitis):
- If they stop breathing
- Skin that is pale, blotchy or turning blue
- If they are struggling for breath
- If they lose conciousness or appear unaware of their surroundings – if they switch off
- If they will not wake up
- If they have a fit / convulsion
Treatment for viral meningitis is generally bed rest and painkillers. The body’s immune system can fight the viral infection itself in an otherwise healthy individual.
Bacterial meningitis on the other hand requires antibiotics as the body’s natural defence against such infections is usually not strong enough to tackle the infection. While we do have some defences against bacterial infections, they are often ineffective with a serious case of meningitis. It has only been in the last decade or so that we have been able to successfully treat bacterial meningitis.
Prevention – Vaccination
There is a vaccination that protects against many forms of bacterial meningitis. The meningococcal C conjugate (MenC) vaccine protects against the meningococcal group C bacteria, which can lead to meningitis and septicaemia. However, it does not protect against any other form. Vaccines are given to babies at 3 months and then a booster is given at 12 months. Any child or adult may, and should, be vaccinated if they have not already received a vaccine.
There is still no vaccination for the meningococcal group B disease. This is currently the most common form of meningitis in the developed world and is the form that commonly infects young children and babies.
General cleanliness helps to reduce incidence of bacterial meningitis. The skin provides an effective barrier to bacteria so most infections enter through the mouth or broken skin.
Complications and Risks
The more severe a case of meningitis is, the greater the risk of long-term complications. If diagnosed and treated early a child can recover with no permanent damage. However, in severe cases serious complications do occur. These include:
- Partial or total hearing loss
- Partial vision loss or total blindness
- Speech problems
- Memory and concentrations problems
- Co-ordination and balance issues
- Learning difficulties
- Epilepsy can be triggered by meningitis
- Cerebral palsy and motor neuron disease
Gangrene – Amputations
More Information on Meningitis
The following organisations provide further advice and support;
- Meningitis Research Foundation. Phone the free 24-hour helpline on 0808 800 3344, or go to www.meningitis.org.
- The Meningitis Trust. Phone their free helpline on 0800 028 1828 or go to www.meningitis-trust.org.
- NHS Choices – Meningitis
- “Outcomes of bacterial meningitis in children: a meta-analysis” by Baraff LJ, Lee SI, Schriger DL