| Meningitis is an infection of the fluid of
a person's spinal cord and the fluid that surrounds
the brain. People often refer to it as spinal
meningitis. Meningitis is usually caused by a
viral infectiion or bacterial infection. Knowing whether
meningitis is caused by a virus or bacterium is
important because the severity of illness and
the treatment differ. Viral meningitis is generally
less severe and resolves without specific treatment,
while Bacterial
Meningitis can be quite severe
and may result in brain damage, hearing loss,
or learning disability. For Bacterial
Meningitis, it is also important to know
which type of bacteria is causing the meningitis
because antibiotics can prevent some types from
spreading and infecting other people. Before the
1990s, Haemophilus influenzae type b (Hib) was
the leading cause of Bacterial
Meningitis, but new vaccines being given
to all children as part of their routine immunizations
have reduced the occurrence of invasive disease
due to H. influenzae. Today, Streptococcus pneumoniae
and Neisseria meningitidis are the leading causes
of Bacterial Meningitis.
What are the signs and symptoms of meningitis?
• High fever
• headache
• stiff neck
Above are common symptoms of meningitis in anyone
over the age of 2 years. These symptoms can develop
over several hours, or they may take 1 to 2 days.
Other symptoms may include nausea, vomiting, discomfort
looking into bright lights, confusion, and sleepiness.
In newborns and small infants, the classic symptoms
of fever, headache, and neck stiffness may be
absent or difficult to detect, and the infant
may only appear slow or inactive, or be irritable,
have vomiting, or be feeding poorly. As the disease
progresses, patients of any age may have seizures.
How is meningitis diagnosed?
Early diagnosis and treatment are very important.
If symptoms occur, the patient should see a doctor
immediately. The diagnosis is usually made by
growing bacteria from a sample of spinal fluid.
The spinal fluid is obtained by performing a spinal
tap, in which a needle is inserted into an area
in the lower back where fluid in the spinal canal
is readily accessible. Identification of the type
of bacteria responsible is important for selection
of correct antibiotics.
Can meningitis be treated?
Bacterial Meningitis
can be treated with a number of effective antibiotics.
It is important, however, that treatment be started
early in the course of the disease. Appropriate
antibiotic treatment of most common types of Bacterial
Meningitis should reduce the risk of dying
from meningitis to below 15%, although the risk
is higher among the elderly.
Is meningitis contagious?
Yes, some forms of Bacterial
Meningitis are contagious. The bacteria
are spread through the exchange of respiratory
and throat secretions (i.e., coughing, kissing).
Fortunately, none of the bacteria that cause meningitis
are as contagious as things like the common cold
or the flu, and they are not spread by casual
contact or by simply breathing the air where a
person with meningitis has been.
However, sometimes the bacteria that cause meningitis
have spread to other people who have had close
or prolonged contact with a patient with meningitis
caused by Neisseria meningitidis (also called
meningococcal meningitis) or Hib. People in the
same household or day-care center, or anyone with
direct contact with a patient's oral secretions
(such as a boyfriend or girlfriend) would be considered
at increased risk of acquiring the infection.
People who qualify as close contacts of a person
with meningitis caused by N. meningitidis should
receive antibiotics to prevent them from getting
the disease. Antibiotics for contacts of a person
with Hib meningitis disease are no longer recommended
if all contacts 4 years of age or younger are
fully vaccinated against Hib disease.
Are there vaccines against meningitis?
Yes, there are vaccines against Hib, against
some serogroups of N. meningitidis and many types
of Streptococcus pneumoniae. The vaccines against
Hib are very safe and highly effective.
There are two vaccines against N. meningitidis
available in the U.S. Meningococcal polysaccharide
vaccine (MPSV4 or Menomune®) has been approved
by the Food and Drug Administration (FDA) and
available since 1981. Meningococcal conjugate
vaccine (MCV4 or MenactraT) was licensed in 2005.
Both vaccines can prevent 4 types of meningococcal
disease, including 2 of the 3 types most common
in the U.S. (serogroup C, Y, and W-135) and a
type that causes epidemics in Africa (serogroup
A). Meningococcal vaccines cannot prevent all
types of the disease. But they do protect many
people who might become sick if they didn't get
the vaccine. Meningitis cases should be reported
to state or local health departments to assure
follow-up of close contacts and recognize outbreaks.
MCV4 is recommended for all children at their
routine preadolescent visit (11 to 12 years of
age). For those who have never gotten MCV4 previously,
a dose is recommended at high school entry. Other
adolescents who want to decrease their risk of
meningococcal disease can also get the vaccine.
Other people at increased risk for whom routine
vaccination is recommended are college freshmen
living in dormitories, microbiologists who are
routinely exposed to meningococcal bacteria, U.S.
military recruits, anyone who has a damaged spleen
or whose spleen has been removed; anyone who has
terminal complement component deficiency (an immune
system disorder), anyone who is traveling to the
countries which have an outbreak of meningococcal
disease, and those who might have been exposed
to meningitis during an outbreak. MCV4 is the
preferred vaccine for people 11 to 55 years of
age in these risk groups, but MPSV4 can be used
if MCV4 is not available. MPSV4 should be used
for children 2 to 10 years old, and adults over
55, who are at risk.
Although large epidemics of meningococcal meningitis
do not occur in the United States, some countries
experience large, periodic epidemics. Overseas
travelers should check to see if meningococcal
vaccine is recommended for their destination.
Travelers should receive the vaccine at least
1 week before departure, if possible. Information
on areas for which meningococcal vaccine is recommended
can be obtained by calling the Centers for Disease
Control and Prevention at 1-404-332-4565.
There are vaccines to prevent meningitis due
to S. pneumoniae (also called pneumococcal meningitis)
which can also prevent other forms of infection
due to S. pneumoniae. The pneumococcal polysaccharide
vaccine is recommended for all persons over 65
years of age and younger persons at least 2 years
old with certain chronic medical problems. There
is a newly licensed vaccine (pneumococcal conjugate
vaccine) that appears to be effective in infants
for the prevention of pneumococcal infections
and is routinely recommended for all children
younger than 2 years of age. |
