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Meningitis

 


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Condition
Meningitis
Class
Immune system
Description
Meningitis is the term used to describe inflammation of the meninges, the lining around the brain and spinal cord. Meningitis is a very serious disease and can kill within hours. Meningitis is usually the result of an infection caused by viruses, bacteria or occasionally by a fungus.

Viral meningitis is more common than bacterial meningitis. Many thousands of babies and infants get the disease each year. Although viral meningitis is rarely life-threatening and most people quickly make a full recovery, it can be very unpleasant and it can leave some with life-long problems.

Bacterial meningitis is less common but more serious than viral meningitis. Over 2,500 cases of bacterial meningitis are reported in the UK each year. Bacterial meningitis kills one in ten people who get the infection, and one in seven survivors are left with a serious disability such as brain damage, hearing or sight loss or limb amputations. Many others are left with memory loss, behavioural and emotional problems and excessive tiredness.
Causes
Viral meningitis is caused by many different types of virus, the most common type being the enteroviruses that usually live in the intestines and may cause sickness and diarrhoea, but which can cause viral meningitis if the body’s immune system is not working efficiently. Other viruses responsible for viral meningitis are the herpes simplex virus and the mumps virus.

Bacterial meningitis is caused by a number of different types of bacteria. The most common types are meningococcal (mainly A, B and C strains), pneumococcal and Haemophilus influenzae type b (Hib). Other bacteria responsible for causing bacterial meningitis include Mycobacterium tuberculosis (usually a cause of tuberculosis), and streptococcal B and E.coli that are a cause of meningitis in newborn babies.

Most of these bacteria live naturally in the nose, throat and airways and it is only when the body’s defences fail, for examplewhen the immune system is not working efficiently, that the bacteria multiply and causes meningitis. The bacteria are spread through close contact with other people, for example through coughing, sneezing and kissing. Bacterial meningitis cannot be spread through other routes such as contaminated water supplies because the bacteria do not survive for long periods outside the body.
Symptoms
Meningitis, regardless of whether it is caused by a bacterial or viral infection, comes with a range of symptoms, although not all of them will necessarily be seen at the same time. The main symptoms in adults and older children are high temperature, vomiting, diarrhoea, severe headache, neck stiffness, aversion to bright lights, drowsiness and pain in the muscles and joints. People struck by meningitis may also have fits and may become confused and disorientated.

In babies and infants, the tell-tale signs are different and will include a fever (hands and feet stay cold though), refusal to eat or be handled, vomiting, a high-pitched moaning cry or whimpering, lethargy and difficulty to wake. The baby or infant may also have a blank and staring expression and the skin may go pale and blotchy. Another sign is the baby may pull back its neck and arch its back.

One important sign of meningococcal bacteria that is common to both adults and children is a rash. This is actually a sign of septicaemia (blood poisoning). The rash, which can appear anywhere on the body, looks like a cluster of spots at first but later join together to look like a fresh bruise. If the side of a clear drinking glass is pressed against the rash and the rash does not fade, it means there is septicaemia. In such circumstances, urgent medical help is essential as the rash is one of the later signs of meningitis to appear.
Treatment
There are no treatments for viral meningitis. Antibiotics do not work against viruses, so the only treatment is rest to allow the body to heal itself.

However, the risk of viral meningitis can be reduced by immunisation with the MMR vaccine that protects children against mumps and measles, two of the most common causes of viral meningitis. Good standards of food and toilet hygiene will also help reduce the spread of viruses.

Immunisation is the best form of protection against bacterial meningitis. There are vaccines against meningococcal type C, Hib and pneumococcal bacteria that are given as part of the routine childhood immunisation programme that starts in babies from age 2 months. It is essential that babies are immunised to protect them against these three types of bacterial meningitis, and against other diseases such as diphtheria, polio, whooping cough, tetanus, mumps, measles and rubella.

Older children and adults who missed out on these vaccines, because they were not available when they were younger, may also be immunised if considered to be at risk. For example, adolescents going off to university should be immunised against meningitis C.

In some parts of the world, the risk of catching other types of meningococcal infection is much higher than in the UK. For example, travellers to Saudi Arabia for the Hajj pilgrimage are advised to be vaccinated against meningococcal type A, C, W135 and Y, for which there is a vaccine available.

It must be remembered that immunisation does not protect against all forms of bacterial meningitis. In particular, there is still no vaccine to protect against meningococcal group B infection, the most common bacterial form of meningitis in the UK. It is important therefore to suspect meningitis if any of the symptoms described above occur.

If a person does get bacterial meningitis it can be treated with antibiotics. However, it is essential that treatment starts early before septicaemia sets in.
When to consult your pharmacist
There are so many different forms and names for meningitis that it can be extremely confusing. Talk to your pharmacist if there is anything about the disease that you do not understand. Your pharmacist will be able to explain the disease to you, give advice about the childhood immunisation programme and what to do in the event that you may not have been immunised.

If travelling abroad, visit your pharmacist well in advance of your departure date for advice on the types of vaccinations you will need to protect you against meningitis and other types of disease, and for tablets to take to be covered against malaria.
When to consult your doctor
If you suspect you or someone you know has meningitis or any of the symptoms of meningitis mentioned above, you must call a doctor immediately. Because the signs can be vague, it is easy to dismiss them as symptoms of flu - only the doctor can decide whether it is something serious.

If you are worried that you or your child may have missed out on their vaccinations, or if you are travelling abroad, visit your doctor who will be able to advise if you need to be vaccinated.
Protecting yourself and your family against meningitis
The childhood immunisation programme provides direct protection against the risk of bacterial meningitis caused by pneumococcal bacteria, meningococcal type C and Hib. By providing immunity against mumps and measles, the immunisation programme also helps provide protection against viral meningitis. The risks of all of the diseases covered by the immunisation programme are far, far greater than any risks associated with the vaccines themselves. It is essential that all children are vaccinated at the appropriate times.

For students going off to university, it is advisable that they are immunised against meningitis C. University students live in close communities and social contact tends to be much closer than it was when at school. Warn your children, to look after their health and advise them to be aware of the symptoms of meningitis.

Although vaccination provides a very effective way of preventing many types of meningitis, it is important to know that vaccination does not protect against many other bacteria, viruses and fungi that also cause meningitis. For example, there is no vaccine to prevent meningococcal B meningitis, the most common cause of bacterial meningitis in the UK.

Do not be lulled into a false sense of security just because you or your child has been vaccinated. If you suspect that you or a member of your family may have meningitis, trust your instincts. Seek urgent medical advice, tell the doctors and nurses what you suspect, and insist that you receive a second opinion if you are not satisfied.
Living with the after-effects of meningitis
If you, your child or other family members does get meningitis its effects can be life-changing. The speed and apparent random way in which meningitis strikes can leave families shocked, even though the person affected may make a full and quick physical recovery. For some, the disease will leave them tired and exhausted and they will need time to rest and recover. For others with more serious, long-lasting injuries, they will require long-term help.

If you or other members of your family have been affected by meningitis and require guidance, help and support, contact the Meningitis Trust who specialise in providing a comprehensive range of support services. See Further Information section.
Useful Tips
  • Be aware of the signs of meningitis, especially if you have young children so you can act quickly
  • It is important that children are kept up to date with their immunisations - see childhood vaccinations section
  • Meningitis is not highly contagious but can affect those in very close contact. These contacts may be offered antibiotics where suitable. School friends and work colleagues are unlikely to be affected so treatment is not usually necessary
Further information
Further information on all types of meningitis is available from the Meningitis Trust. The Trust also provides support services ranging from counselling to financial and practical help.

Helpline: 0800 028 18 28
www.meningitis-trust.org/



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