The brain and spinal cord are bathed in a special fluid called cerebrospinal fluid. Membranes (meninges) surround and protect the brain, spinal cord and fluid. Inflammation of these membranes is called meningitis.
Signs of meningitis usually begin rapidly. Fever, headache and generally not feeling well are common symptoms. Some patients find they are sensitive to light. Nausea and vomiting often occur. The patient may feel irritable and restless, and a change in personality may be apparent. Depending on the type of meningitis, there can be a rash.
Symptoms in a baby can be different from those of an older child or an adult. The baby may be irritable and seem uncomfortable when held. There may be fever and vomiting. The soft spot (the fontanelle) on the top of the baby’s head can bulge out because of pressure from the inflamed meninges.
Doctors look for specific signs of meningitis. When the meninges are inflamed, it hurts to touch the chin to the chest. Sometimes the person cannot bend the neck at all. Meninges are stretched when the neck is bent, and if they are inflamed they cause pain.
The doctor needs to know what germ is causing the meningitis. The fluid surrounding the brain and spinal cord can provide the answer. During the exam, a needle is inserted at the base of the spine. It passes between the vertebrae to reach the fluid in the spinal canal. A sample of the fluid is collected and sent to the lab for testing. The technician will look at the fluid under a microscope, measure chemicals in it, and try to grow the organism causing the meningitis. The patient’s blood is also tested because the germ is often present in the blood as well.
Meningitis is usually caused by an infection from either a virus, bacterium, parasite, or fungus. Different organisms can cause the meningitis at different ages. The most common causes of meningitis are two types of bacteria (Meningococcus and Hemophilus influenza – not related to influenza) and viruses. In adults, Streptococcus pneumonia bacteria are a more frequent cause of meningitis. The strategy for preventing the spread of these diseases varies according to type.
Meningococcal meningitis is spread through droplets of fluid from the throat and nose. To stop the spread, do not share food, cigarettes, drinks and eating utensils. Always sneeze into a tissue and then discard it into the garbage.
Wash your hands after blowing your nose or touching your own saliva. Kissing can spread the bacteria. Good hygiene is very important for stopping the spread of this disease.
Overcrowded living quarters, workplaces, schools, and daycares will increase the risk of spreading the infection. Reducing the number of people in one place is advised during an outbreak.
Despite these ways to control the spread of the meningococcal bacteria, cases of meningitis still occur. If you suspect someone might have meningitis, get help right away. The infected person can be treated immediately and admitted to hospital. If meningitis is not treated quickly and properly, it can cause death or long-term serious complications. Unlike other throat infections such as Strep throat in which the bacteria is grown and identified prior to giving antibiotics, treatment for meningitis must not wait.
Close contacts must be watched for any sign of developing meningococcal meningitis. They must be treated quickly if they appear to have the disease. Close contacts include people who live in the same household as the patient or those who have shared a drink or cigarette. For those who have been living with the infected person, the risk of meningitis is 300 to 400 times greater than in the general population. The risk for people with only casual contact with the patient is no different from the general population.
Close contacts will be given an oral antibiotic, which can prevent the spread of the disease. It is very important to use all of the medication and to follow the instructions the doctor or public health nurse has given.
When an outbreak of meningococcal meningitis occurs, the public health department watches the situation and advises the community. People who have been in contact with the patient are checked for signs of disease and treated. Overcrowding is reduced.
Sometimes, immunization with a meningococcal vaccine may be used to stop the spread of the outbreak in high-risk groups. In 2000/2001, immunization was used very effectively in Western Canada. Travellers to parts of the world where there are many cases of meningococcal meningitis of various types are offered immunization.
A new vaccine effective for children under the age of two has recently been licensed. Routine vaccination of babies is now possible and is being considered by public health officials.
Most people who become infected with meningococcus will only have a mild infection in their throats. In some communities, five to 10 per cent of healthy people carry the bacteria in their throats. It can remain there for up to two years. The presence of the bacteria enables the person to make antibodies that help them fight the disease.
Streptococcus pneumonia (a bacterium), also known as pneumococcus, is a common cause of meningitis. It can also cause other infections such as pneumonia and ear infections and is spread through secretions from the nose and mouth. Good hygiene is again essential for combating the spread. A vaccine, which can prevent this type of meningitis, has been available for a number of years. It is offered to people older than two years. Recently a new vaccine has been licensed. It is effective for many strains of this germ and effective in children less than two years of age. Public health officials are soon likely to recommend the routine use of this vaccine in vaccination programs for infants and young children.
People with medical conditions that make them more at risk of meningitis must talk to their family doctors about ways to protect themselves. Signs and symptoms may not be as obvious as in healthy people, so patients and their families need to know when to get help quickly.
Viral meningitis generally is not as serious as meningococcal and pneumococcal meningitis. The person is often not as sick and recovers without problems.
Viral meningitis can be caused by one of many viruses. The most common is the enterovirus. the mumps virus used to be a common cause, but with the routine immunization of children it is rarely seen now. Herpes virus can cause a very serious meningitis. Most of these viruses are spread through secretions from the nose and mouth as well as from the bowels. Spread can be reduced by proper hand washing and handling of the nasal secretions and by not sharing foods, drinks, or cigarettes.
Meningitis is an infectious disease that mostly occurs in children. It can be serious and must be treated quickly. Steps can be taken to reduce the spread of the disease, depending on the type of meningitis. Proper handwashing, not sharing food, drinks, cigarettes and eating utensils, immunization, antibiotics and reducing overcrowding help cut down on the spread of meningitis. If someone’s symptoms make you think of meningitis, get help right away.
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