Silent assassin

13th May 2005 at 01:00
It's commonest in babies and teens and can be deadly. Jill Wyatt alerts you to meningitis

Any sane and responsible professional who works with children should have the knowledge to help them recognise then deal quickly and confidently with medical emergencies. Such things as serious cuts, head injuries, broken limbs, choking, poisoning, epileptic fits, diabetic hypoglycaemia and the onset of potentially fatal diseases. Meningitis, a relatively rare but terrifyingly fast-developing disease, falls in the last category.

What is meningitis?

It is an inflammation of the lining of the brain and spinal cord, caused by a large number of viruses and bacteria, but the bacteria Neisseria meningitidis is responsible for meningococcal meningitis B and C, which are the most common strains of the disease in the UK and Ireland. Cases are most common during the winter months.

Neisseria meningitidis is found naturally in the back of the throat or nose and will only occasionally cause disease. It isn't known why some individuals carry the bacteria without harm while others develop meningococcal disease. About 10 per cent of the population will carry the bacteria, with the highest carriage in 15 to 19-year-olds. Infection is not easily spread. It is transmitted from person to person by inhaling respiratory secretions from the mouth and throat or by direct contact (kissing). Close prolonged contact is usually required to transmit the bacteria. They do not live long outside the body.

The second most prevalent cause of meningitis is pneumococcal bacteria.

This occurs mostly in children under two and in adults with specific problems, such as immune deficiency. It is the most destructive in terms of proving fatal or causing permanent disability. One in six children contracting this form of the disease will die; twice as many as those who contract meningo-coccal meningitis B and C.

Viral meningitis, which occurs most frequently in summer, is usually mild, but cannot be treated with antibiotics. Rest and good nursing care are required.

What are the symptoms?

Severe headache, stiff neck, dislike of bright lights, fever, vomiting and drowsiness. Septicaemia (blood poisoning) often occurs. This causes a rash that will not fade if pressed with a glass (the tumbler test). All can appear in any order and not everyone will display them all.

Who gets meningitis?

Anyone can get the disease, but the majority of meningococcal infections occur in infants younger than five. The peak incidence occurs in those under 12 months. There is a smaller, secondary peak in incidence in young adults aged between 15 and 19. Most cases of meningococcal disease occur sporadically, with less than 5 per cent occurring in clusters.

What is the treatment?

Bacterial meningitis can be treated with antibiotics and the sooner the infection is diagnosed the greater the chance of a full recovery. Anyone who has been in close contact with someone with bacterial meningitis, such as family, should be examined by a doctor and may need antibiotics.

Can meningitis be prevented?

Vaccination is the only way to prevent it. Effective vaccines are available to prevent some types. A national immunisation programme for this form of the disease began in the autumn of 1999. Babies and youths aged 15 to 17 were the first to be offered the vaccine because they are at greatest risk.

As yet, there is no safe and effective vaccine against meningitis B.

Many of the symptoms of can be easily confused with less serious illnesses, such as flu. If in doubt, take action. This is a disease that strikes fear into everyone's heart. No one will hold it against you for erring on the side of caution.

WHAT TO WATCH OUT FOR

* At least 50 types of bacteria and a number of viruses can cause meningitis

* The disease can develop quickly and prove fatal

* Meningitis B is the most common, but C causes the most deaths

* Symptoms include a severe headache, stiff neck, vomiting, drowsiness and aversion to bright lights, but will vary from person to person

* Septicaemia (blood poisoning) may also be present, starting with a rash that initially looks like tiny red pinpricks

* Vaccination is the only way to prevent meningitis - effective vaccines are available for some forms of the disease

* People who have been in close contact with someone suffering from meningitis need treatment with antibiotics

* Viral meningitis is usually mild, but cannot be treated with antibiotics.

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