Meningitis

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Meningitis
The meninges are a system of membranes which cover the central nervous system (CNS) and when these become infected it is known as meningitis.

The purpose of the mengines is to act as a barrier between the CNS and the rest of the body to provide extra protection against infection. Meningitis affects 3500-4000 people in the UK every year. There are two types of meningitis - viral and bacterial.

Bacterial Meningitis

This is the less common form of meningitis but it is often much more serious. Several types of germs live naturally at the back of the nose and throat in one in ten people and can be spread by close contact such as coughing, sneezing and kissing. In some of these people, the germs overwhelm the body's defences and cause meningitis. The bacteria can only live inside the body so cannot be picked up from water supplies, swimming pools, buildings or factories. Certain types of bacteria (meningococcal C) spread more rapidly in crowded areas. It takes between two and ten days for the infection to develop after you have been exposed to the bacteria.

The most common cause of bacterial meningitis in the UK is infection with the meningococcal or pneumococcal bacteria, but Hib, TB, E.Coli, and Group B streptococcal bacteria are also known to cause meningitis.

Bacterial meningitis is a very serious illness. In babies and young children, death can occur in a matter of hours if left untreated. In other cases, the child can be left seriously brain damaged.

Early symptoms of meningitis can appear similar to flu so it is not always easy to identify. Sometimes it takes a few days for symptoms to develop, other times they appear in a matter of hours. If you suspect you or your child has meningitis you should seek urgent medical help.

The following are symptoms of bacterial meningitis. You may suffer any number of them in any order:
BulletConstant headache
BulletConfusion
BulletHigh temperature but a chilly feeling in the hands and feet
BulletDrowsiness
BulletVomiting
BulletStomach pain
BulletDiarrhoea
BulletRapid breathing
BulletStiff neck - it may be painful to move the chin to the chest
BulletRed or purple spotty or bruised rash which does not fade when you press a glass or finger against it
BulletJoint or muscle pain
BulletSensitivity to bright lights, daylight or even the television.

Meningitis Symptoms in babies and infants may include:
BulletHigh temperature, possibly with cold hands and feet
BulletVomiting and refusing feeds
BulletHigh pitched moaning or whimpering cry
BulletBlank staring expression
BulletPale, itchy complexion
BulletFloppiness
BulletDislike of being handled
BulletNeck retraction with arching of back
BulletConvulsions
BulletDifficult to wake
BulletTense or bulging fontanelle (soft spot on head).

The Meningitis Research Foundation outlines the early warning signs of meningitis in children as:
BulletCold hands and feet
BulletLeg pains
BulletAbnormal skin colour.

These are symptoms of blood poisoning (septicaemia) that is often associated with meningitis. They tend to appear a few hours before other symptoms such as a rash or sensitivity to light. However, you should not wait for more symptoms to develop, you need to seek help immediately. This is a medical emergency and it might be able to be treated with antibiotics.

The glass test is an effective method of determining whether septicaemia is responsible for the rash. Press the side of a clear drinking glass onto the rash or bruises and check that they fade under the pressure. If they do not fade, you should suspect septicaemia. In some cases the rash may fade at first but may later change into one that does not fade.

Viral Meningitis

This form of meningitis is a less severe illness in most cases. However, it can sometimes progress through headache, fever and drowsiness to deep coma. The incubation period for viral meningitis can be up to 3 weeks.

Viruses such as coxsackie, herpes simplex, mumps, the varicella zoster virus of chickenpox and shingles, poliovirus and echoviruses (including enterovisuses) are responsible for viral meningitis. Meningitis can also be a feature of other diseases like typhus, tuberculosis, lyme disease and leptospirosis. Germs can be spread through coughing, sneezing, poor hygiene or sewage polluted water.

The majority of people who suffer from viral meningitis make a full recovery within one or two weeks. Very occasionally there might be long term problems such as hearing or memory impairment.

Severe cases of viral meningitis can lead to:
BulletMuscle weakness
BulletParalysis
BulletSpeech disturbances
BulletDouble vision
PBulletPartial loss of vision
BulletEpileptic fits.

Diagnosis

A diagnosis can be made based on the symptoms you suffer, importantly a stiff neck, and by analysing samples of cerebrospinal fluid and germ culture.

Treatment

If meningitis is suspected, antibiotics must be given immediately without waiting for confirmation from germ culture.

The sooner bacterial meningitis is diagnosed and treated, the greater chance there is of a full recovery. For this reason it is important to seek medical help at any signs of meningitis so antibiotics can be prescribed urgently. Anyone who has been in close contact with the affected person should also be given appropriate medication if necessary.

Viral meningitis cannot be treated with antibiotics. The best chance of recovery is based on good nursing care. Recovery is normally complete, but headaches, tiredness and depression may persist for weeks or months after.

Prevention

Vaccines such as Meningococcal C and HiB are now part of the immunisation schedule for child health so most children in the UK are vaccinated against meningitis.

It is recommended that everyone under the age of 25 should be immunised.

June 2011

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