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Meningitis – What to Look Out For
Parents should be aware of the facts about this multi-faceted and sometimes fatal disease, but health authorities claim there is no need for panic
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Meningitis, a multi-faceted and sometimes fatal disease, occurs when the lining surrounding the brain and spinal cord becomes inflamed. There are two types – bacterial and viral. Viral meningitis can be very unpleasant, but is almost never life threatening and most people make a full recovery within a week or two without specific treatment. However, that being said, complications can still occur. For instance, the mumps virus is a common cause of viral meningitis and can be associated with permanent hearing loss. According to Cape Town based paediatrician, Dr Mark Irvine, this can be prevented by the administration of the MMR vaccine.
The bacterial strain is far more dangerous and can lead to death within a few hours. Bacterial meningitis can be caused by any one of up to 50 different bacteria and needs quick treatment with strong antibiotics. According to Dr Irvine, common bacterial infections that cause meningitis include meningococcus, haemophilus, and strep pneumoniae (also called pneumococcus). There is a vaccine against haemophilus (this forms part of the national vaccination schedule) and one against pneumococcus (which will soon also be available free of charge). Meningococcus sometimes presents with a purple, non-blanching rash caused by bleeding into the skin. This can start as tiny purple pinpricks called petechiae. Any rash that does not change colour (blanch) when pressed with a drinking glass needs urgent attention.
How Meningitis Spreads
Meningitis infections are most commonly spread through very close contact, such as coughing, sneezing and kissing. Professor Denise White, chairman of The South African Medical Association (SAMA), recommends that “anyone who has been in contact with someone affected should undergo urgent treatment and vaccination.”
Of particular concern are the elderly, under-fives and those with a compromised immune system.
Dr Irvine reiterates this advice, cautioning that if your child has been in the same class as another child with bacterial meningitis, antibiotic prophylaxis is needed so they do not become sick. “They do not,” he says “need antibiotics if they attend the same school but have no direct contact with the child. Nor do they need antibiotics if they have been in contact with anyone with viral meningitis,’’ he says.
It is important to remember that, like the HIV virus, the bacteria that causes meningitis can only live for a few moments outside the human body, so the disease cannot be caught easily as the bacteria is not carried on items such as dishes, bedding, clothes and toys.
Concern, Not Panic
So, how worried should we be when another “warning” email lands? According to Professor White, although the current appearance of meningitis is a major source of concern (made more so by increased media coverage), there is currently no reason for panic. The National Department of Health states that there has been a steady decline in meningitis cases in the past few years.
However, SAMA does not underestimate the impact this disease can have on a community and urges parents and communities to be aware of the symptoms and immediately consult their nearest doctor if a family member suffers from these symptoms.
So, what should you be on the lookout for? Classic symptoms of meningitis (according to the Meningitis Research Foundation) may include a fever, severe headache, vomiting, pain in the muscles or joints, photophobia (when eyes become very light sensitive), petechial (patch-like) rash which may appear first on the buttocks and/or conjunctiva and neck stiffness. (Keep in mind that rashes and neck stiffness are not necessarily always present with meningitis).
These symptoms may be harder to detect in newborns and babies, in which case additional signs might include inactivity, irritability, vomiting and poor feeding.
Worried and anxious parents may feel that they should be doing more to protect their children, but The National Institute for Communicable Diseases has made it clear there is currently no need for antibiotic prophylaxis to be given to people who are not in close contact with meningitis. At the same time, there is no need for vaccination purely in response to these cases. There are vaccines that provide excellent protection against some forms of meningitis, but all strains of the disease cannot yet be prevented.
In conclusion, Professor White says that “the most important thing the public can do is to be alert, remain educated about the disease and its symptoms and take immediate action once they suspect infection has taken place.”
With thanks to Dr Mark Irvine F.C. Paed (SA) for his contribution.
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