Meningitis describes an infection of the meninges. The meninges are the protective membranes surrounding the brain and spinal cord. The infection can be viral or bacterial.
Viral infections, whilst very scary, are usually not life threatening. Hospital tests are often required to differentiate between bacterial and viral menigitis and it’s extremely important to seek medical attention if meningitis is suspected as urgent antibiotic treatment is needed for the bacterial form of the disease. Examples of viruses which can cause meningitis are enteroviruses and the herpes simplex virus.
There are many different types of bacteria which cause meningitis but the main ones are Neisseria meningitidis (meningococcal) bacteria and pneumococcal bacteria. Pneumococcal bacteria are more easily spread but less likely to cause severe infections. Meningococcal bacteria are usually only spread through prolonged close contact and consist of several groups including A,B,C,W, X, Y and Z. They are a human only pathogen and are carried in the nasopharynx (upper throat and behind the nose).
I must be clear that bacterial meningitis is not very common but can be extremely serious, even fatal, when experienced so prompt action is always recommended. Approximately 10% of the population are thought to carry the bacteria responsible but because many adults have developed natural resistance it is not common to actually suffer from invasive infection. This means that many people may be carrying the infection without realising it as they have no symptoms. The highest incidence of invasive infection is in infants followed by the under 5’s. In Ireland the majority of infections occur in winter and early spring. Mortality rates are from 5 to 15%, with 10-15% suffering permanent disability.
Possible ways the bacteria are spread include:
- sharing utensils, such as cutlery
- sharing personal possessions, such as a toothbrush or cigarette
In most cases a meningitis infection occurs when the infection spreads through the blood from one part of the body, such as the throat or lungs, through the blood brain barrier to the meninges. The blood brain barrier is a thick membrane which normally protects our brains membrane from infection. The infection causes an immune response which causes the meninge to swell. Infection can also occur in the cerebrospinal fluid, which is the fluid surrounding the spine, and also cause inflammation. This swelling can then lead to damage of the brain and nervous system.
The symptoms of meningitis
Meningitis is often accompanied with septicaemia. Septicaemia is when bacteria release toxins into the blood which break down the walls of the blood vessels allowing blood to leak out under the skin. This can cause the characteristic rash which is associated with meningitis but it is important to remember that this rash does not have to be present!
The best summary of the symptoms that I have seen comes from www.actformeningitis.ie This awareness card also includes information on how to perform the ‘tumbler test’.
Vaccinating against meningitis
Meningococcal Group C Bacteria
MenC vaccine is included in the national childhood schedule – your child will receive this vaccine at six months and twelve months of age. They will also receive it in the first year of their second level school. The introduction of this vaccine had reduced the number of confirmed cases of this group of bacteria from 130 in the year 2000 to only 6 in the year of 2014. Brands of this vaccine include Menjugate, Meningitec, and NeisVac C.
According to the HSE since the introduction of MenC vaccine in 2000, and the Men B vaccine in 2016 the numbers of cases of
MenC and MenB decreased but since 2014 the number of MenC cases has
increased annually, with 6 cases in 2014, 11 in 2015, 22 in 2016 and 29 in
2017. If you chose not to vaccinate your child as per the childhood schedule it may be worth discussing your choice with the GP and to consider a catch up vaccination.
Meningococcal Group B bacteria
This is included in the current national childhood schedule. Babies born on or after the 1st October 2016 have been offered the vaccine as part of the standard childhood schedule. Babies born before the 1st October 2016 remain unvaccinated unless you have brought them for a private vaccination separate to the normal schedule. I am not currently aware of any plans to vaccinate those children who were born before the vaccine was introduced in 2016 so if you want your child vaccinated please speak with your GP. As it is not covered under the childhood scheme you will have to pay for this vaccination and costs can vary but including administration can be between 140-170 euro per dose. Children born before the vaccine was introduced will need two doses with at least one month between each dose.
Bexsero is suitable from two months of age. You can see the doses needed below as described in the product SPC .(http://www.medicines.ie/medicine/15903/SPC/Bexsero+Meningococcal+Group+B+vaccine+suspension+for+injection+in+pre-filled+syringe/)
Meningococcal Group A,C,W and Y bacteria
There’s also a quadruple vaccine that provides protection against group A, C, W and Y meningococcal bacteria. This is not routinely offered in Ireland as cases from groups A, W and Y are rare in Ireland. Brands include Menveo and Nimenrix
Treatment of meningitis
You should always see a doctor if you suspect your child has meningitis. Seek medical attention immediately. Your baby may need tests to find out if it is bacterial or viral meningitis and their treatment choices will result from the diagnosis.
As www.actformeningitis.ie say – Trust your insticts and ACT now!
I hope you have found this article helpful and if you have any questions at all please don’t hesitate to contact me by sending a private message to the WonderBaba facebook page (www.facebook.com/wonderbabacare) or by calling me (Sheena) at Milltown totalhealth Pharmacy in Dublin 6 on 012600262. I’m always happy to help!
This post was updated on 28/1/19