WHAT IS MENINGITIS?
Although meningitis is a notifiable disease in many countries, the exact incidence rate is unknown. Bacterial meningitis occurs in about 3 people per 100,000 annually in western countries. Sub-Saharan Africa has been plagued by large epidemics of meningococcal meningitis for over a century leading to it being labeled the “meningitis belt”. Epidemics typically occur in the dry season (December to June).Attack rates of 100-800 cases per 100,000 are encountered in this area, which is poorly served by medical care. These cases are predominantly caused by Meningocci. The pattern of factors has been associated with the development of Epidemics in the meningitis belt. They include: medical conditions (immunological susceptibility of the population), demographic conditions (travel and large population displacements), socio economic conditions (overcrowding and poor living condition), climatic condition (drought and dust storms) and concurrent infections (acute respiratory infection).
Meningitis is an inflammation of the protective membranes covering the brain and spinal cord known as meninges. The inflammation may be caused by infection with viruses, bacteria or other microorganisms. Other things such as medications, tumors and chemical exposures can cause meningitis. Meningitis can be life threatening because of the inflammation proximity to the brain and spinal cord. Therefore the condition is classified as medical Emergency.
WHAT ARE THE CAUSES OF MENINGITIS?
The most causes of meningitis are bacteria or viruses; Rarer causes such as fungi can be seen, but often only in people with poor immune systems.
Meningitis commonly occurs when bacteria or viruses make their way into the fluid surrounding the brain. Sometimes they enter directly as a result of an operation such as brain surgery. Sometimes they erode through the small bones in our skull for instance extreme cases of severe sinusitis. Sometimes they are carried there by our blood from an infection occurring elsewhere in our body such as pneumonia (a lung infection).
Cryptococcus, a fungus can also cause meninigitis.It usually occurs in people with weakened immune systems such as people with AIDs.
Bacterial meningitis on the other hand is a very serious illness. The different types of bacteria that can cause it normally are dangerous. Over half the population carries one or another of these bacteria in the back of the nose and throat. They are commonly transmitted by coughing, sneezing, and kissing, but they can’t live outside the human body for very long. When they manage to enter the cerebrospinal fluid and begin multiplying, the bacteria cause inflammation and other symptoms of meningitis.
There are many species of bacteria that can cause meningitis. The most common causes of bacterial meningitis are meningococcus ( Neisseria Meningitis), Pneumococcus (Streptococcus Pneumoniae), group B Streptococcus ( streptococcus agalactiae ) and E.coli (Eschericia coli ).
Children under the age 2 are most susceptible to meningitis. Other things that increase the risk are:
- Brain or spinal surgery
- Head injury
- Impaired or abnormal immune system
- Kidney failure
- The use of corticosteroids ( e.g. prednisone)
- High fever over 39◦C (102◦F).
- Stiff and sore neck, especially when its moved, turned or bent ( the discomfort is caused by inflammation of the meninges ) this may not occur in people whose immune systems are not functioning properly such as :
- People taking corticosteroids
- People with AIDs
- People taking cancer or transplant medications.
3. Severe headache due to extra pressure in the head. Look for signs of
Fussiness and irritability in children too young to complain of a headache.
- Photophobia (intolerance to bright light)
- Phonophobia (intolerance to loud noises)
- Altered mental status.
If blood vessels in the brain become inflamed, the brain won’t get enough oxygen. This can make a person drowsy and less responsible and in extreme situations, they can fall into coma. Lack of oxygen to the brain can also cause seizures.
Inflammation results in increased pressure on the brain which sometimes causes vomiting.
SYMPTOMS FOR VERY YOUNG CHILDREN
Fever with cold hands and feet
Difficulty waking up
High pitched moaning or crying
Arching their backs and pulling at their necks
Rash (red or purple pinpricks)
Showing a pale, mottled complexion
Long term complication can occur and last long after the infection has been treated. These include deafness mental impairment, paralysis and sometimes seizures that require lifelong treatment.
TREATMENT AND PREVENTION
The infection that causes bacterial meningitis is treated with a combination of antibiotics. The you receive will depend on the bacteria that are suspected, your age and other factors. The antibiotics are injected into a vein. You might have to receive the antibiotics for as long as 3 weeks.
For the first few days of antibiotic treatment. You may also be given dexamethasone ( a corticosteroid) to help reduce the risk meningitis complications. People with meningitis, regardless of the cause, may need supportive treatment such as intravenous fluids and fever- reducing medications.
Children are routinely immunized with the hemophilus influenza type b (Hib) vaccine. This is an important preventive measure, since the Hib bacteria used be the most common cause of meningitis in children.
Routine vaccination against streptococcus pneumonia with the pneumococcal conjugate vaccine (PCV) which is active against seven common serotypes of this pathogen significantly reduces the incidence of pneumococcal meningitis.