Meningitis is an inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. Meningitis is also referred to as spinal meningitis. This inflammation is caused by a viral, bacterial, or fungal infection of the fluid around the brain and the spinal cord. Physical injury, brain surgery, cancer] or certain medications can also cause meningitis.
Signs and symptoms
Meningitis symptoms are similar to those of the flu. Symptoms may develop in a matter of hours or over 1 to 2 days. For those above 2 years old, these include:
- Discomfort with bright lights
- Excessive Sleepiness
- High fever
- Joint or muscle pains
- Stiff neck
Among newborns and infants, symptoms of meningitis may include:
- Bulging fontanel
- Excessive sleepiness
- High fever
- Irritability / Constant Crying
- Low activity
- Poor feeding
- Stiffness in body and neck
Causes and risk factors
Bacteria that enters the bloodstream and travels to the brain and spinal cord can cause bacterial meningitis. Bacteria can also directly invade the meninges through an ear infection or skull fracture.
The following bacteria strains can cause bacterial meningitis:
- Streptococcus pneumoniae (pneumococcus). This is the most common cause of bacterial meningitis.
- Neisseria meningitis (meningococcus). This occurs when bacteria from an upper respiratory infection invades the bloodstream. It is highly contagious.
- Haemophilus influenzae (haemophilus). Before Haemophilus influenzae type b (Hib) vaccines were developed, this was the leading cause of bacterial meningitis in children.
- Listeria monocytogenes (listeria). This bacteria can be found in contaminated soil and food, as well as animals. Pregnant women, infants and the elderly are the most susceptible to this bacteria. Listeria can attack the placenta, which can cause childbirth complications like a still birth or for the baby to die shortly after birth. Individuals who work with domestic animals are at an increased risk of catching listeriosis.
Bacterial meningitis is highly contagious. Bacteria is transmitted through prolonged close contact, coughing, sneezing and saliva exchange. If not treated promptly, it can result in disabilities, brain damage, deafness, amputation, or death.
Before childhood vaccines against bacterial meningitis were available, this kind of meningitis was the most commonly diagnosis meningitis among children. Currently it is more commonly diagnosed among teens and young adults.
Viral meningitis is serious but hardly fatal for individuals with healthy immune systems. Different viruses that result in viral meningitis can be spread in a variety of ways. Enteroviruses are the most common cause of viral meningitis and is spread through contact with an infected person’s feces. Enteroviruses, mumps, and varicella-zoster viruses can also be transmitted through oral secretions (saliva, sputum) of one infected. This can be spread when infected people sneeze or cough, sending viruses airborne. Viruses can also settle on surfaces and can be transferred from one object to another. Shaking hands or passing something an infected person has handled then rubbing breath ways such as the nose or mouth is another way of the virus spreading. Arboviruses is spread by mosquitoes and other insects. Lymphocytic choriomeningitis is a rare viral meningitis caused by rodents.
Viral meningitis strikes mostly in children younger than 5 years old.
Meningitis may also result from a fungal infection spreading to the spinal cord. Several genus of fungi that cause meningitis are cryptococcus neoformans, histoplasma, blastomyces, and coccidioides. When there environments are agitated, these fungal spores can be inhaled. Fungal meningitis is not contagious.
The longer an infected individual goes without treatment, the higher the risk of neurological damage such as:
- Brain damage
- Impaired hearing
- Kidney failure
- Learning disabilities
- Loss of speech
Diagnosis and tests
Early diagnosis and immediate treatment are extremely important.
Meningitis is usually diagnosed through a laboratory test called a “spinal tap.’’ Spinal fluid is obtained by inserting a needle in the lower back where fluid in the spinal cord can be collected. The type of bacteria or virus infecting the individual can then be identified. This is critical in selecting the most effective antibiotics for the patient.
- Bacterial meningitis - Antibiotic treatment is prescribed for the most common types of bacterial meningitis.
- Viral meningitis - Bed rest, plenty of fluids and medication to combat fever and headaches are often prescribed in the treatment of viral meningitis.
- Fungal meningitis - Antifungal medications are prescribes for those with fungal meningitis. This is usually administered intravenously.
Some forms of bacterial meningitis can be prevented with vaccinations.
- Haemophilus influenzae type b (Hib) vaccine is recommended for children starting at 2 months of age, with several doses following on the 4th, 6th and 12th month of age.
- Pneumococcal conjugate vaccine (PCV7) is recommended as part of an infant’s regular immunization schedule, also on his 2nd, 4th, 6th and 12th month.
- Pneumococcal polysaccharide vaccine (PPSV) is recommended for children and adults who have weak immune systems or chronic illnesses.
- Meningococcal conjugate vaccine (MCV4) can be given to children or adults who are at high risk of bacterial meningitis or who have been exposed to infected individuals.
As meningitis is usually a result of contagious infections, the following can help prevent the disease: careful hand washing, maintaining a healthy immune system through regular exercise, a healthy diet and adequate rest, and being careful with food choices especially during pregnancy.
Meningitis in the Philippines
In the Philippines, bacterial meningitis is one of the top ten causes of death among children less than four years old. While bacterial meningitis is endemic in the Philippines, cases are mostly sporadic.
In 2005, a total of 98 cases of bacterial meningitis were reported. Coverage ranged from October 2004 to January 28, 2005. Seventy-four cases were from Baguio City, 22 from the Mt. Province and 2 from Ifugao. Of these, thirty-two deaths were recorded.
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