Fight this Infection

Meningitis can be life-threatening, but getting help quickly will decrease the risk of complications
By Tamlyn Vincent

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Every year one million people around the world will suffer from bacterial meningitis and 170 000 people will die because of it. Meningitis is an inflammation of the membranes around the brain and spinal cord, and babies, children, teenagers and the elderly are most at risk. There are two types of meningitis: viral and bacterial. Viral meningitis is more common and can cause some damage, especially when there is a component of viral encephalitis or swelling of the brain, says Cape Town paediatrician Dr Deon Smith. But it is often less severe than bacterial meningitis, which has a higher chance of causing neurological damage. According to the National Institute for Communicable Diseases, 204 cases of meningococcal meningitis, caused by bacteria, were reported in South Africa in 2012, with most patients being younger than 10.
 
Look out for these signs
 
The symptoms for both strains of meningitis are the same, with the classic signs in adults including a fever, headache, light sensitivity, vomiting and a stiff neck. But the way meningitis presents in children is quite different, advises Smith. Children younger than six months will usually be floppy and lethargic, and they won’t want to eat or drink. Other symptoms might include a high temperature, a high-pitched irritable cry, and a bulging anterior fontanel, says Smith. Sister Elsabe Redelinghuys, from a baby wellness clinic in Joburg, says children may also vomit if their temperature is very high. Older children will have a fever, headache and vomiting and, on examination, signs of neck stiffness. Another symptom of bacterial meningitis is a non-blanching rash, which may occur later. Smith suggests placing the bottom of a glass over the rash and pushing down. If the rash doesn’t go white, get to a hospital immediately.
 
Getting help
 
Bacterial meningitis can kill in four hours, so getting medical help quickly is essential. Redelinghuys advises that parents go to a paediatrician or hospital if their child has any symptoms. If doctors suspect meningitis, they may put a child onto intravenous antibiotics until they can determine whether it is viral or bacterial. The different strains of meningitis are best diagnosed by doing a lumbar puncture or spinal tap, says Smith, who adds that even blood tests may not be conclusive. Children will be hospitalised for both strains, but with viral meningitis they could go home after 24 to 48 hours, whereas bacterial meningitis will likely require 10 to 14 days of intravenous antibiotics. The bacteria that can cause meningitis is spread through droplets of respiratory secretions that may be transmitted through coughing, sneezing, kissing or being in close contact with a carrier.
 
Risky business
 
Parents may be reluctant for their child to have a lumbar puncture, but paediatricians are skilled at doing these and the risks involved are far less than leaving bacterial meningitis undiagnosed. The complications of this disease include hearing loss, deafness, learning problems, brain damage and even death.
 
But there has been a decrease in the incidence of bacterial meningitis, says Smith, thanks mainly to childhood immunisations. There are vaccines for the types of bacteria that can cause meningitis such as Bacillus Calmette-Guérin (BCG) and Haemophilus influenza type B (Hib). Smith emphasises the importance of having children immunised. “Parents don’t understand the devastation that can be wrought by this disease,” Smith adds.

Comments

Matsepo Manyokole wrote 6 years 25 weeks ago

Thank you Child Magazine for making us aware of this disease. Most people only realise the severity of these diseases once they have struck home or closer to home. Education is important, and even though rates are reduced due to vaccinations and the advances of modern medicine such as early diagnosis and treatment, most people are not aware of these diseases. Most mothers take their children for vaccinations, which is good. But nobody sits down and teaches parents or even young adults about the disease, hence we often miss the signs until it is too late. Let's spread the word and not just give vaccinations and medication.

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