Meningitis
by Takehisa Ikeda, M.D.
A disease that begins with a headache, fever, and fatigue can sometimes progress to a stiff neck or unsettling rash, and can sometimes end with permanent scarring, disfiguring amputations, or even death.
This disease can run its course with devastating speed, taking just a few hours, or it can last a few days.
It can be viral or bacterial, harmless or fatal, transmitted by a kiss or launched by an underlying disease.
It is meningitis, an inflammation of the membranes that cover the brain and spinal cord.
Of the three most common forms of the bacterial types, meningococcal meningitis is probably the one parents fear the most.
It’s a rare disease, but its sheer ferocity tends to make headlines. It makes us want to lock up our kids at home instead of sending them off to school or college.
Spread through person-to-person contact, meningococcal meningitis is most common in adolescents and young adults, the very people who tend to gather in large groups within close quarters most often.
Meningococcal meningitis is fatal up to 15 percent of the time, but there is a vaccine for it—a vaccine that offers protection from the four serogroups of meningococcal meningitis responsible for approximately 70 percent of cases in the U.S.
The Centers for Disease Control and Prevention recommends that all 11 – 12-year-olds be vaccinated, along with receiving a booster shot at 16. Those who received the shot at 13 – 15 years old should receive a booster shot between 16 and 18, but adolescents who received the first dose at age 16 or older will not require a booster shot.
Texas state law currently requires college students living on campus and schoolkids entering seventh or eighth grade to be vaccinated against meningococcal meningitis.
While adolescents and young adults are most at risk, it’s important to recognize symptoms in all ages.
Children can tell you they have a sore neck and headache, whereas infants may appear irritable, inactive, and uninterested in feeding.
It’s also important to note that symptoms of meningitis are usually collective. In other words, a sore neck on its own might be caused by sleeping in an awkward position or sitting at the computer for too long. But if your child has a sore neck that is so stiff it’s hard to touch chin to chest, plus a fever, plus a headache, get to the doctor immediately.
Bad bugs and various viruses
Pneumococcal meningitis, also spread by respiratory secretions, is most common in infants and the elderly. More than 20 percent die and approximately half of all pneumococcal meningitis patients experience long-term complications, including paralysis and deafness. In Texas, pneumococcal vaccination is required and is therefore already a component of childhood immunizations.
Haemophilus meningitis is most common in kids under the age of 5. It is caused by a bacterium called Haemophilus influenzae type b, more commonly known to parents as Hib. Since Texas requires Hib immunization in children, there’s been a decrease in the number of Haemophilus meningitis cases. Left untreated, Haemophilus meningitis may result in seizures and speech or hearing problems.
Viral meningitis can also be caused by underlying viruses, such as measles, mumps, and chickenpox, but again, state law requires children be immunized for MMR and varicella.
Viral meningitis is not usually serious, and most people recover within two weeks. The problem is that early symptoms of viral meningitis can mimic early symptoms of bacterial meningitis.
If in doubt, head out
The only way to know what’s going on for sure is a lumbar puncture, sometimes called a spinal tap, in the care of a physician.
If the spinal fluid sample confirms the presence of bacterial meningitis, doctors must determine which bacterium is responsible before beginning antibiotic treatment.
I’ve seen infants, children, tweens, and teens arrive at the hospital completely unresponsive but go on to recover. With prompt medical attention, proper diagnosis, and swift treatment, the risk of dying from bacterial meningitis can be kept to a minimum.
It’s also important to remember that more than 80 percent of combined cases can be prevented in the first place simply through vaccination.
Ask your family doctor or pediatrician about the steps you can take to keep your kids safe…from cradle to classroom to campus.
Fast facts
Common types of bacterial meningitis and who’s most at risk:
- pneumococcal: infants and the elderly
- meningococcal: adolescents and young adults
- Haemophilus: children under the age of 5
Classic bacterial meningitis symptoms:
- Children 2 years and older – high fever, stiff neck, headache
- Infants – feeding poorly, inactive, irritable, vomiting
How to prevent meningitis:
- meningitis vaccinations
- childhood vaccinations
- good hygiene
How to prevent meningitis:
- people 16-21 are most at risk
- spread through respiratory droplets
- rare but can be fatal
- more than 80 percent of cases can be prevented through vaccination
For more information:
www.dshs.state.tx.us/immunize/
www.cdc.gov/meningitis/
