Family doctor

Overview:

• Meningitis in an infection which causes inflammation of the brain
• There are several different forms of meningitis
• Forms caused by viruses are less serious than those caused by bacteria
• Symptoms include fever, vomiting, stiff neck, and light sensitivity
• Urgent antibiotic treatment for bacterial meningitis is needed to prevent brain damage and death
• Death can occur within 24 hours of the start of symptoms
• Contacts of infected people need treatment to prevent the spread of the disease
• Children can be immunised against Hib meningitis

What is it?

Meningitis is an infection that causes brain inflammation and is usually caused by bacterial infection or a virus.

The most serious infections are caused by bacterial meningitis.

Viral meningitis is a milder disease and a person can recover without treatment. However, bacterial meningitis is a serious disease which can lead to brain damage and death.

There are several different infective organisms which may cause meningitis, such as:

• H. influenza
• meningococcal (particularly dangerous and rapid/often with a rash)
• tuberculous
• pneumococcal
• staphylococcal
• cryptococcal

Haemophilus influenzae type b was a leading cause of meningitis before a vaccine for this form of meningitis was introduced in the early 1990s.

Meningococcal meningitis is now a common form of meningitis. This is a serious disease with about a five to 15 percent death rate. Most cases occur in children or teenagers. The illness peaks in the winter months.

Meningitis is spread through coughing, sneezing and kissing or having contact with an infected person, but it is not as infectious as colds or flu.

The illness strikes within three days to one week after infection. A person is contagious for three days after they have been infected, to 10 days after the start of the illness.

What are the symptoms?

The illness can start rapidly and may follow a respiratory infection. Symptoms begin with a fever, headache, sensitivity to light and a stiff neck.

Other symptoms include vomiting, nausea, sleepiness and seizures.

Infants may be hard to wake, refuse to eat and have a fever and vomiting.

A meningococcal meningitis rash of tiny red spots which does not go white when pressed is a serious sign the patient needs urgent medical attention. Death can occur within 24 hours of the onset of symptoms.

Diagnosis is made blood tests and by growing bacteria from a sample of spinal fluid (lumbar puncture). Identifying the bacteria responsible for the disease is important for treating the condition.

Complications include brain damage, hearing loss, loss of vision, shock and arthritis.

What can be done to help?

Urgent treatment is necessary to prevent complications such as permanent brain damage and death.

Treatment with antibiotics is necessary. There are a number of effective drugs and these should be started as early as possible to avoid serious complications.

It is important to know which bacteria has caused the meningitis for the purpose of treating the condition.

Meningococcal meningitis needs urgent treatment with intravenous penicillin as soon as possible.

All family members and contacts of people infected with meningitis should also be treated with drug therapy to prevent them getting the disease.

How can it be prevented?

Be alert for signs of meningitis if someone you know has been diagnosed with the disease.

All contacts (with meningococcal meningitis) should be treated with the drug rifampin to prevent infection.

Practice safe hygiene methods. Wash your hands after using the bathroom.

All children should be immunised for Hib meningitis.

There is a vaccination programme(MeNZB) in New-Zealand to prevent meningococcal B meningitis.

Prevenar (PCV7) can be given to children under 2 to prevent pneumococcal disease( meningitis and pneumonia). It will be funded in New Zealand from July 2008.

Patients need to purchase it themselves before this date.

Future trends

Research is continuing to develop an effective vaccine to prevent meningococcal meningitis in children.

Getting help

Seek urgent medical attention if you are concerned about this