Meningitis


The disease


Meningitis may be serious affections. That is the reason why they had to be treated quickly and properly.

The disease may affect  any group of the population, whatever its age, but more specifically young children and teenagers.

Meninges  are made of layers which envelop brain and spinal cord. They contain a liquid called “cephalo-rachidian liquid” (CRL) which is normally sterile. But when a germ appears in this liquid and develops itself, this generates an inflammation of meninges called “meningitis”.

Even if the symptoms are similar, different types of meningitis exist depending on the germ which appears. Thus there are two types of meningitis:

-          Viral meningitis

-          Bacterial meningitis





Different types of meningitis


Viral meningitis:

This is the most frequent and normally the least serious type of meningitis. It is provoked by numerous common virus (mumps, chickenpox, measles,  - ).  Most of the time, it is spontaneously cured within three up to eight days and does not imply any particular treatment.

Nowadays vaccinations which are systematically made on children prevent a certain number of virus which may cause meningitis to appear.


Bacterial meningitis:

This type of meningitis is less frequent and more serious than the former one. Bacterial meningitis may generate serious aftermaths (deafness, blindness, paralysis, coma), and potentially death.

About 70% of cases happen before five years old.

These bacteria are very often located in the nose and in the pharynx. They are transmitted through contaminated secretions coming from both - nose and pharynx – that is to say through sputters or sneeze.

They become really dangerous when they penetrate the circulating blood (blood poisoning or septicemia) and reach meninges.

The main bacteria at the origin of meningitis are today in France pneumococcus and  meningococcus.

* Pneumococcus meningitis :

In France, among all the bacterial infections, those which are generated by pneumococcus are the first cause of death for children who are less than two. Pneumococcus is a very common germ among children. In most of the cases it is harmless but sometimes it may generate an earinfection, a pneumonia or even meningitis.

Pneumococcus
presents itself under different forms called serotypes. A vaccine against the seven most frequent serotypes of  pneumococcus is available and recommended as soon as the child is two months old
 
* meningococcus meningitis :

Numerous types of meningococcus exist (serogroups). In France, serogroups B, C and W 135 are the most frequently detected in case of meningitis.

30% of the cases of invasive infections generated by meningococcus  lead  to a dreadful infection responsible for an important mortality rate: purpura fulminans. The appearance of red marks on the skin is the corresponding symptom and a sign of extreme seriousness and must consequently be interpreted as the signal of a necessary immediate hospitalization.

Vaccines against meningococcus A, C, Y and W 135 are available. Vaccination is recommended for persons who have been in contact with an affected person or in certain countries where the infection is frequent.

There is no similar vaccine against meningococcus belonging to serogroup B ; a few countries have developed specific vaccines of certain clones use to cure a local infection.



Consequences


This disease generates consequences more or less serious for the affected person depending on the type of meningitis he suffers from.

Indeed if the ill person suffers from a viral meningitis, the most frequent type of meningitis, he will be cured spontaneously between three and eight days. It does not require a specific treatment.

But in case of bacterial meningitis, the least frequent but the most serious meningitis, the disease may generate serious aftermath such as deafness, blindness, paralysis, coma, appearance of red marks on the skin, neurological aftermath, epilepsy - and sometimes even death.



Mark of Purpura Fulminans




Third-degree burn





Symptoms


Warning signs:

-          Sudden fever (39-40 °C = 102°F-104°F)

-          Headaches located in the area of the cranium

-          Aches, sensation that the back of the neck is stiff

-          Nausea, vomiting

-          Unusual sensation in front of vivid light

-          Red marks (purpura) on the body

-          Sleepiness

As for babies, symptoms are often less specific. Consequently it is important to pay attention to a fever added to certain modifications of the baby’s behavior - if the baby cries, refuses to eat, sleeps more than usual, and so on. 

As far as newborn children are concerned, the back of their neck may be flabby and the fontanel - flabby part on top of the head – rounded.




High-risk factors


Among others, here are a certain number of high-risk factors:

-          Having physical contacts with a person infected by meningitis – exchange of saliva during kisses, sneezes, sharing of the same glass, the same cigarette...

-          Going to a country where the disease is very frequent. The best is to inform you before your departure.

-          Smoking. Meningitis may affect smokers either active or passive ones.

-          Tiredness and stress weaken the immune system which then protects you less against the risks of disease.

If you think you are in presence of a case of meningitis, take the ill person immediately to the doctor. If the doctor foresees a case of meningitis for a reason or another, he will hospitalize immediately the patient.

A lumbar puncture – taking of cephalo-rachidian liquid – will allow to identify the bacteria or the virus  responsible for the meningitis. This will allow to adapt the treatment depending on the type of meningitis the ill person suffers from.

If it is a meningitis due to meningococcus, a preventive treatment (antibiotherapy, vaccination) will be suggested to the persons who have had a brief or prolonged contact with the ill person




Treatments


To be rapidly cured of a viral meningitis, the ill person has to combine three essential things: resting and drinking much and eating properly. The ill person can carry on taking the usual medicines against fever. 



BE CAREFUL, aspirin is not to be taken to cure a viral meningitis as it may generate Reye syndrome, a serious disease which affects brain and liver.



Only antibiotics are efficient to put an end to bacterial meningitis.

Vaccines against meningococcus A, C, Y and W 135 are currently available. They are strongly recommended for persons who have been in contact with one of the high-risk factors - physical contact with an ill person, country where there are epidemics -.
 



Prevention


Meningitis is a disease which may generate serious aftermath for the ill person. As soon as you have a doubt, go immediately to the doctor.

Certain types of bacterial meningitis can be prevented thanks to vaccination but not all of them.

There is no vaccine against the meningitis due to a meningococcus belonging to type B. There are two types of vaccines against meningococcus : the first one provides a protection against several types whereas the second one provides a protection only against serotype C.

There is a vaccine against pneumococcus. Parents are invited to have their child vaccinated while he/she is between two months and four years old in order to decrease the risk of bacterial meningitis.

Persons who suffer from a bacterial meningitis have to follow a healthy way of life – eating healthily, resting – and a good hygiene - often washing his/her hands -.

 



Key figures


About 70% of cases of bacterial meningitis happen before 5.

In 30% of cases of meningitis due to meningococcus purpura fulminans appears.

In 60% of cases, the ill person does not have any aftermath once cured, 20% suffer from serious aftermath such as deafness, blindness, paralysis, coma, -. Unfortunately, as for the 20% remaining cases the disease leads the ill persons to death.

The outbreak of meningitis is seasonal (winter/spring) and affects from 1 to 5 individuals out of 100000 inhabitants in an industrialized country.

Up to 500000 cases of infections due to meningococcus are estimated each year worldwide.

Nowadays, about 1.2 millions of cases of bacterial meningitis (meningococcus, pneumococcus) are registered among which 135000 are fatal.