Vaccination

What Is Meningitis?
In Greek, the word for membrane is "menix." This is the source of the word "meningitis," which means an inflammation of the membranes (the thin covering layers) that surround the brain and the spinal cord. These membranes are known as the meninges, and inflammation (swelling) is the body's reaction to infection or injury. The most common form of the disease is viral meningitis. In 9 out of 10 cases, the cause of viral meningitis is one of a large group of viruses known as enteroviruses. These viruses infect the digestive tract, but they easily spread to other parts of the body. The second most common form of the disease is bacterial meningitis, which is caused by bacteria. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis. However, new vaccines for children have reduced this problem. Today, Strepto-coccus pneumoniae and Neisseria meningitidis are the chief causes. Meningitis also can be caused by fungi such as Cryptococcus neoformans, or things other than infection, such as a drug reaction or cancer involving the meninges. It is important to know the cause of meningitis, because this determines how severe the disease may be and its treatment. Viral meningitis usually is less severe than bacterial meningitis. Most people recover in 7 to 10

days. In contrast, bacterial meningitis can be very serious. If not treated promptly, it can lead to permanent hearing loss, brain damage, learning disorders, or even death.

How Do People Catch Meningitis?

Some, but not all, types of viral and bacterial meningitis are contagious. People infected by a virus that causes meningitis may not always develop the disease, but they can pass on the virus to others, who may get meningitis. Fewer than 1 in 1,000 people infected with viruses that cause meningitis actually get meningitis. Most infected people do not get sick, or they become only mildly ill with a cold, rash, or low-grade fever. Enteroviruses, the most common cause of viral meningitis, are very common in the summer and early fall, and many people catch them. Enteroviruses usually are spread through contact with saliva or mucus. This typically happens when people are exposed to the virus on the hands of, or on objects touched by, people with enteroviruses, then rub their own eyes, nose, or mouth. The virus also is found in the stool (bowel movement) of people who are infected with enteroviruses. It is spread this way mainly by young children who are not toilet trained, or by adults who change the diapers of infected babies. Good hand washing (thoroughly and often) is important to prevent the spread of the viruses that cause meningitis. Some forms of bacterial meningitis are contagious. The bacteria are spread through coughing, kissing, and other breath and throat secretions. They are not spread by casual contact. However, people who

are in close contact with an infected person may catch the infection. This includes those who live in the same house as the infected person or children who go to the same daycare center as infected children. It also may include girlfriends or boyfriends who kiss infected people. Outbreaks may occur in places like dormitories, military barracks, and prisons.

Anatomy of the brain. In meningitis, the meninges that line the brain become swollen and inflamed. Most cases of both viral and bacterial meningitis occur in babies and children under the age of five. Most cases of meningitis caused by a fungus occur in people with an immune system * that has been weakened by other diseases (such as AIDS) or by taking certain medications.

What Are the Symptoms of Meningitis?

The symptoms of meningitis vary from person to person but common symptoms in people over the age of two are:

fever severe headache stiff neck eyes that are sensitive to bright light sleepiness confusion nausea vomiting system Is the system that defends the body against disease.

* Immune

In babies, the classic symptoms of fever, headache, and a stiff neck may not be present, or they may be hard for other people to notice. Possible symptoms in babies include fever (sometimes), crankiness, lack of activity, vomiting, refusing to eat, and being hard to wake up. As meningitis gets worse, people of any age may have seizures. In severe cases, the disease can lead to coma or even death. The symptoms of both viral and bacterial meningitis may develop over a period of several hours or several days. With bacterial meningitis, adults may get very sick within 24 hours and children even sooner. In contrast, meningitis caused by a fungus, cancer, or other noninfectious disease may take weeks to develop. A few types of bacteria and viruses also lead to slow-developing meningitis. These include the bacteria that cause tuberculosis, Lyme disease, and syphilis, and the virus that causes AIDS.

How Is Meningitis Diagnosed and Treated?

Diagnosis

The symptoms of viral and bacterial meningitis often are the same. Therefore, it is important to see a doctor right away if these symptoms appear, because early diagnosis and treatment are critical for bacterial meningitis. A diagnosis usually is made by testing a sample of the fluid that surrounds the spinal cord. This sample is obtained by a spinal tap, a procedure in which a thin hollow needle is inserted into an area of the spine at the lower back and a small amount of fluid is withdrawn. This fluid is tested in a laboratory for signs of meningitis and to identify which type of bacteria, if any, is causing the disease, because this affects the kind of antibiotics that will be used to treat it.
Treatment

The treatment for meningitis depends on the cause. People with most types of viral meningitis usually get better on their own. To help them feel better, doctors may advise them to rest and to take non-prescription medication to relieve headache and fever. People with bacterial meningitis can be treated with a number of effective antibiotics, depending on the type of bacteria involved. People with meningitis caused by a fungus can be treated with antifungal medication. For the best results, treatment should be started as early as possible.

How Can Meningitis Be Prevented?

It is difficult to avoid the enteroviruses that cause most cases of viral meningitis. However, it helps to wash the hands thoroughly and often. People who are close to others who have bacterial meningitis caused by N. meningitidis may receive antibiotics to prevent spread of the disease.
Vaccination

There are vaccines against several bacteria that cause bacterial meningitis, including Haemophilis influenzae type b (Hib), some strains of Neisseria meningitidis, and many types of Streptococcus pneumoniae.

The U.S. and the World

There are about 500,000 cases of meningococcal meningitis (N. meningitidis) worldwide each year. There are about 50,000 deaths worldwide each year. I The largest outbreaks occur in Africa south of the Sahara desert during the dry season. The World Health Organization recommends that travelers to countries affected by meningitis outbreaks get the N. meningitidis vaccine.

The vaccines against Hib are safe and very effective. It is now standard for all children in the United States to receive Hib vaccine. The vaccine against N. meningitidis is not routinely given as part of childhood immunizations. However, it is sometimes used to control small out-

breaks of meningitis in the United States in schools, prisons, and other closed settings. Large outbreaks of the disease occur in some countries, and travelers to these areas may need to get the N. meningitidis vaccine as well. The vaccine against many types of S. pneumoniae helps prevent not only meningitis but also pneumonia caused by these bacteria. The vaccine is recommended for everyone over the age of 65 and for younger people with certain ongoing medical problems. See also AIDS and HIV Bacterial Infections Cancer Fever Fungal Infections Immunodeficiency Infection Lyme Disease Pneumonia Seizures Syphilis Tuberculosis Viral Infections

Resources

U.S. Centers for Disease Control and Prevention (CDC), 1600 Clifton Road N.E., Atlanta, GA 30333. CDC posts fact sheets about bacterial meningitis and about viral (aseptic) meningitis at its website. Telephone 800-311-3435 http://www.cdc.gov/health/diseases.htm World Health Organization (WHO), Avenue Appia 20, 1211 Geneva 27, Switzerland. WHO posts fact sheets about meningitis and other communicable/infectious diseases worldwide at its website. http://www.who.org/home/map_ht.html

Read more: http://www.humanillnesses.com/original/KidMen/Meningitis.html#b#ixzz2K9jnLf9G

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Bacterial Meningitis
On this Page

Causes Risk Factors Transmission Signs & Symptoms Diagnosis Treatment Prevention Laboratory Methods for the Diagnosis of Meningitis Reference

Bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss, or learning disabilities. There are several pathogens (types of germs) that can cause bacterial meningitis. Some of the leading causes of bacterial meningitis in the United States include Haemophilus influenzae (most often caused by type b, Hib), Streptococcus pneumoniae, group B Streptococcus, Listeria monocytogenes, andNeisseria meningitidis. In the United States, about 4,100 cases of bacterial meningitis, including 500 deaths, occurred each year between 20032007.

Causes
Common causes of bacterial meningitis vary by age group: Age Group Causes Newborns Infants and Children Adolescents and Young Adults Older Adults Group B Streptococcus, Escherichia coli, Listeria monocytogenes Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b Neisseria meningitidis, Streptococcus pneumoniae Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes

Risk Factors
Factors that can increase your risk of bacterial meningitis include:

Age
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Infants are at higher risk for bacterial meningitis than people in other age groups. However, people of any age are at risk. See the table above for which pathogens more commonly affect which age groups.

Community setting

Infectious diseases tend to spread more quickly where larger groups of people gather together. College students living in dormitories and military personnel are at increased risk for meningococcal meningitis. There are certain diseases, medications, and surgical procedures that may weaken the immune system or increase risk of meningitis in other ways. Microbiologists who are routinely exposed to meningitiscausing pathogens are at increased risk. Travelers to the meningitis belt in sub-Saharan Africa may be at risk for meningococcal meningitis, particularly during the dry season. Also at risk for meningococcal meningitis are travelers to Mecca during the annual Hajj and Umrah pilgrimage.

Certain medical conditions

o

Working with meningitis-causing pathogens

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Travel
o

Transmission
The germs that cause bacterial meningitis can be contagious. Some bacteria can spread through the exchange of respiratory and throat secretions (e.g., kissing).Fortunately, most of the bacteria that cause meningitis are not as contagious as diseases like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been. Other meningitis-causing bacteria are not spread person-to-person, but can cause disease because the person has certain risk factors (such as a weak immune system or head trauma). Unlike other bacterial causes of meningitis, you can get Listeria monocytogenes by eating contaminated food. Sometimes the bacteria that cause meningitis spread to other people. This usually happens when there is close or long contact with a sick person in the same household or daycare center, or if they had direct contact with a patient's oral secretions (such as a boyfriend or girlfriend). People who qualify as close contacts of a person with meningococcal or Haemophilus influenzae type b (Hib)

meningitis are at higher risk of getting disease and may need antibiotics (see Prevention). Close contacts of a person with meningitis caused by other bacteria, such asStreptococcus pneumoniae, do not need antibiotics. Tell your doctor if you think you have been exposed to someone with meningitis. Healthy people can carry the bacteria in their nose or throat without getting sick. Rarely, these bacteria can invade the body and cause disease. Most people who carry the bacteria never become sick.

Signs & Symptoms

Pregnancy Pregnant women are at increased risk of developinglisteriosis (caused by the bacterium Listeria monocytogenes). Pregnant women typically experience only a mild, flu-like illness withListeria infection. However, infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn, including meningitis. Pregnant women who test positive for group BStreptococcus (group B strep) can pass the bacteria to their baby, most often during labor and birth. A newborn infected with group B strep bacteria can develop meningitis or other lifethreatening infections soon after birth. You can reduce your risk of meningitis caused by Listeria monocytogenes by learning what foods to avoid and how to safely prepare and refrigerate food. If you are pregnant, you should get screened for group B strep at 35-37 weeks. Women who test positive for group B strep will be given antibiotics during labor to prevent infection in a newborn. Talk to your doctor to learn more about how to prevent these infections. Meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck. It will often have other symptoms, such as

Nausea Vomiting

Increased sensitivity to light (photophobia) Altered mental status (confusion)

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure. Babies younger than one month old are at a higher risk for severe infections, like meningitis, than older children. In newborns and infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear to be slow or inactive (lack of alertness), irritable, vomiting or feeding poorly. In young infants, doctors may look for a bulging fontanelle (soft spot on infants head) or abnormal reflexes, which can also be signs of meningitis. If you think your infant has any of these symptoms, call the doctor or clinic right away. Later symptoms of bacterial meningitis can be very severe (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

Diagnosis
If meningitis is suspected, samples of blood or cerebrospinal fluid (near the spinal cord) are collected and sent to the laboratory for testing. It is important to know the specific cause of meningitis because that helps doctors understand how to treat the disease, and possibly how bad it will get. In the case of bacterial meningitis, antibiotics can help prevent severe illness and reduce the spread of infection from person to person. If bacteria are present, they can often be grown (cultured). Growing the bacteria in the laboratory is important for confirming the presence of bacteria, identifying the specific type of bacteria that is causing the infection, and deciding which antibiotic will work best. Other tests can sometimes find and identify the bacteria if the cultures do not.

Treatment
Bacterial meningitis can be treated effectively with antibiotics. It is important that treatment be started as soon as

possible. Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk remains higher among young infants and the elderly.

Prevention
The most effective way to protect you and your child against certain types of bacterial meningitis is to complete the recommended vaccine schedule. There are vaccines for three types of bacteria that can cause meningitis: Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (pneumococcus), andHaemophilus influenzae type b (Hib). Antibiotics may be recommended for close contacts of people with meningococcal meningitis. Antibiotics may also be recommended for the entire family if a family member develops severe Hib infection and theres a high risk person in the house. This is to decrease the risk of spreading disease to a high risk person, since they are at increased risk for severe disease. Your doctor or local health department will tell you if theres a high risk person in your house and antibiotics are needed. Maintaining healthy habits, like not smoking and avoiding cigarette smoke, getting plenty of rest, and not coming into close contact with people who are sick, can also help. This is especially important for young infants, the elderly, or for those with a weakened immune system, since they are at increased risk for severe disease.

Reference
1. Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007 . N Engl J Med. 2011;364:2016-25.

http://www.cdc.gov/meningitis/bacterial.html#f1

The word "meningitis" comes from the Modern Latin word meninga and the Greek word Menix meaning "membrane". The suffix "itis" comes from the Greek word itis meaning "pertaining to". In medical English, the suffix "-itis means" "inflammation of". The membranes that surround the brain and the spinal cord are collectively known as the meninges -meningitis means inflammation of themeninges. According to According to According to Medilexicon's medical dictionary, meningitis is "Inflammation of the membranes of the brain or spinal cord". A recent study found that rates of meningitis have decreased in Canadian provinces introducing routine immunization of children and adolescents against one specific strain of meningococcal bacteria. What causes meningitis? Meningitis is generally caused by infection of viruses, bacteria, fungi, parasites, and certain organisms. Anatomical defects or weak immune systems may be linked to recurrent bacterial meningitis. In the majority of cases the cause is a virus. However, some noninfectious causes of meningitis also exist. Bacteria mimic human cells to get in and stay in A study carried out by researchers at the University of Oxford and Imperial College London, England, revealed the way in which bacteria that cause bacterial meningitis mimic human cells is to evade the body's innate immune system.

Viral meningitis Although viral meningitis is the most common, it is rarely a serious

infection. It can be caused by a number of different viruses, such as mosquito-borne viruses. There is no specific treatment for this type of meningitis. In the vast majority of cases the illness resolves itself within a week without any complications.

Bacterial Meningitis Bacterial meningitis is generally a serious infection. It is caused by three types of bacteria: Haemophilus influenzae type b, Neisseria meningitidis, andStreptococcus pneumoniae bacteria. Meningitis caused by Neisseria meningitides is known as meningococcal meningitis, while meningitis caused by Streptococcus pneumoniae is known as pneumococcal meningitis. People become infected when they are in close contact with the discharges from the nose or throat of a person who is infected. Twenty years ago Hib was the main cause of bacterial meningitis - it is not any more thanks to new vaccines which are routinely administered to children. The doctor needs to know what type of meningitis has infected the patient. Certain antibiotics can stop some types from infecting others.

http://www.medicalnewstoday.com/articles/9276.php

Meningitis can be very serious; as a matter of fact certain types of bacterial meningitis can be rapidly fatal without early treatment. It is one of the conditions considered to be a medical emergency that is related to infectious diseases. Just a little basic anatomy before I continue. The brain and spinal cord have two protective coverings; the outer bone part consisting of the skull and spinal cord, and the inner three layers of membranes called the meninges. Between and around the meninges are spaces, most importantly for our discussion is the subarachnoid space. The subarachnoid space is where cerebral spinal fluid (CSF) is found. What is CSF? It is a fluid produced by the choroid plexus. It provides buoyancy and cushioning for the brain, it carries nutrients and cleanses waste from around the brain and spinal cord and helps the brain monitor the internal environment. So what is meningitis? It is an infection within the subarachnoid space or throughout the meninges. Depending on the offending organism, meningitis is considered either septic (bacterial) or aseptic (viral). How do microorganisms find their way to the central nervous system (CNS)? There are four routes of infection: Bloodborne The organism in the bloodstream gets through the defense mechanism known as the blood-brain barrier. This is the most common way and not very well understood. From an infected site close to the CNS Infections from the middle ear or sinuses that is close to or contiguous to the CNS. The result of surgery or trauma that may allow organisms into the CNS. Certain viruses like rabies or herpes simplex can travel along nerves to the brain.

Certain factors can make you more susceptible to meningitis. First is age. Due to a immature immune system, newborns are at greater risk. They usually pick up the organism from the colonized vaginal tract of the mother. Group B streptococci, E.coli and other gram negative rods and Listeria are the main causes of bacterial meningitis in the newborn. Haemphilus influenzae type B was once the number one cause of meningitis in children under 6. But since the introduction of the Hib vaccine, it has been extremely rare. Neisseria meningitidis (meningococcal) are associated with young adults particularly in close environments like military barracks and college dormitories. In adults, Streptococcus pneumoniae (pneumococcal) and Listeria are important causes. The respiratory tract is the primary portal of several of these organisms, hence factors that predispose someone to pneumonia also do so with meningitis; alcoholism, diabetes, splenectomy and immunosuppression. In bacterial meningitis, the following symptoms are typical: high fever, severe headache, stiff neck, photophobia (sensitivity to light), skin rashes and seizures. Quick treatment is paramount to prevent serious complications and death. Permanent deafness, neurological problems and hydrocephalus are all sequelae. Chronic meningitis is a frequent problem in those people that are immunocompromised. Unlike acute bacterial meningitis, the chronic form may persist for long periods of time and are frequently the result of a slower growing organism like a fungus. Cryptococcus neoformans is a common cause of chronic meningitis. Aseptic meningitis is associated with viral infections and is usually self-limiting. Some symptoms are like those in bacterial meningitis. Enteroviruses are by far the most common cause of aseptic meningitis.

Meningitis is diagnosed by staining and culturing CSF for the offending bacteria. In addition, chemical determination of glucose and protein concentration is useful indicators. The CSF is collected by means of a spinal tap. Can meningitis be prevented? Some of the organisms that cause meningitis are spread via respiratory means. If you have close contact with someone with the disease, your risk is increased. Handwashing is the key to preventing just about every contagious disease. Avoid certain types of foods if you are pregnant or immunocompromised because of the risk of Listeria. Besides the previously mentioned vaccination for Haemophilus influenzae type B, there is also a vaccine for pneumococcal meningitis as part of the immunization schedule for children less than two.
http://www.examiner.com/article/what-is-meningitis-how-do-you-get-infected-and-how-can-youprevent-it

Meningitis Treatment
Because meningitis can cause serious damage in a short amount of time, anyone suspected of having meningitis should get immediate treatment. For bacterial meningitis, strong doses of intravenous antibiotics are required. Viruses cannot be killed by antibiotics, so most treatment for viral meningitis does not involve medications to kill the virus. Depending on the source of infection, infected sinuses may need to be drained as part of treatment.

An Overview of Meningitis Treatment

People who are suspected of having meningitis should receive immediate, aggressive treatment. This disease can progress quickly, and it has the potential to cause severe, irreversible neurological damage.

Treating Bacterial Meningitis

Early treatment for bacterial meningitis is important for people with the disease. Bacterial meningitis treatment involves strong doses of intravenous antibiotics. Antibiotics may also be given to prevent other bacterial infections.

Corticosteroids such as prednisone may be used to relieve brain pressure and swelling, and to prevent hearing loss that is common in patients with Haemophilus influenzae meningitis. Pain medicine and sedatives may be given to make patients more comfortable.

Depending on the source of infection, infected sinuses may need to be drained as part of treating meningitis.

Appropriate treatment for most types of meningitis can reduce the risk of dying from the disease to below 15 percent.

Treatment for Viral Meningitis

Unlike bacteria, viruses cannot be killed by antibiotics. Therefore most viral meningitis treatment does not involve medications to kill the virus. An exception is the herpes virus, which can be treated with the antiviral drug acyclovir. Patients with mild viral meningitis may be allowed to stay at home, while those who have a more serious infection may be hospitalized for supportive care. Patients with mild cases, which often cause only flu-like symptoms, may undergo a treatment regimen that includes:

Fluids Bed rest (preferably in a quiet, dark room) Analgesics for pain and fever.

The physician may prescribe anticonvulsants such as Dilantin(phenytoin) to prevent seizures and corticosteroids to reduce brain inflammation. If inflammation is severe, pain medicine and sedatives may be prescribed to make the patient more comfortable.

Treatment for Fungal Meningitis

Fungal meningitis treatment involves intravenous antifungal medications.

What Is the Prognosis?

The patient's outcome generally depends on the cause of meningitis, the severity of the illness, and how quickly treatment is given. In most cases, people with very mild meningitis can make a full recovery, although the process may be slow. Patients who experience only headache, fever, and stiff neck may recover in two to four weeks. Patients receiving treatment for viral meningitis usually see some relief in 24 to 48 hours and recover in about a month. Patients with bacterial meningitis typically show some relief 48 to 72 hours following initial meningitis treatment, but are more likely to experience complications caused by the disease. In more serious cases, meningitis can cause:

Hearing and/or speech loss Blindness Permanent brain and nerve damage Behavioral changes Cognitive disabilities Lack of muscle control Seizures Memory loss.

These patients may need medication, long-term therapy, and supportive care as part of their treatment.

Meningitis Treatment and Prevention

Good personal hygiene can reduce the risk of getting the disease from an infected person. Avoid sharing food, utensils, glasses, and other objects with a person who may be exposed to or have the infection. Wash hands often with soap and rinse under running water. Effective vaccines are available to prevent pneumonia, H.influenza, pneumococcal meningitis, and infection with other bacteria that can cause meningococcal meningitis. People who live, work, or go to school with someone who has been diagnosed with bacterial meningitis may be asked to take antibiotics for a few days as a preventive measure.
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