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Mentigitis - the silent devil

Mentigitis - the silent devil

Meningococcal infections are serious bacterial diseases causing meningitis or general febrile illness, poisoning and death. Meningococcal diseases often have a dramatic rapid onset and course, with a danger of organism sepsis. In the Czech Republic, meningococcus type B dominates (up to 60% of cases), but in recent years there has been an increased incidence of type C. The most endangered groups are children under 5 years and young people aged 15-25 years.

What causes meningitis

There are two basic types of meningitis. Among the most well-known bacterial causes of meningitis is the bacterium Neisseria meningitidis, which infects only humans. Transmission of meningitis occurs by droplet infection (sneezing, kissing, sharing food) and is a cause of epidemics. People with weak immunity are most at risk. If meningococcus enters the brain, it can lead to meningococcal meningitis, and if it enters the bloodstream, it causes the sepsis. Further infection it causes are pneumonia, bronchitis and others.

Second type is a viral meningitis, which is usually less severe than bacterial meningitis. It is caused by various types of viruses (eg. Enteroviruses, Herpes simplex virus type 1 or 2, Varicella zoster virus (the cause of chickenpox), mumps virus or also HIV). For the full list there are altogether 12 types of meningitis.

 

What meningococcus actually does in my body

Meningococcus causes increased blood clotting, and the clots subsequently clog small blood vessels, causing ischemia (bleeding) and death of tissues and organs. It is also manifested by bleeding under the skin, a strange rash appears, (which does not disappear when pushed through the glass, which is one of the ways how to test this disease). There is a toxin on the surface of meningococci called endotoxin, which is the cause of the disease. The multiplication of meningococci in the blood leads to a greater release of dangerous endotoxin, which has a direct negative effect on the heart function, anc cen result in failure of vital organs such as kidneys and lungs.  

 

How can you recognize meningitis?

Meningitis in children

Meningitis often threatens young children because the immune mechanism in children is not yet sufficiently developed. The highest incidence has bee recorded in children aged 0-11 months, then 1-4 years, followed by adolescents aged 15-19 years. The morbidity of infants is 20 times higher than in other age groups.

Children tend to have different symptoms than those of adults. Meningitis can manifest itself in:

  • Irritability
  • Restlessness, sleep problems
  • Refusal to eat, loss of appetite, vomiting
  • Breathing problems
  • Pale limbs or abnormal skin color
  • In infants, sometimes due to increased intracranial pressure, the fontanelle also rises

In the youngest children, symptoms such as fever, restlessness, refusal to eat can be easily confused with the symptoms of growing teeth, and they are often not given proper attention and may underestimate the situation.

 

Meningitis in adults

In adult patients, these are main symptoms:

  • Sudden high fever
  • Often and long-lasting headache
  • Stiff neck
  • Nausea, vomiting
  • Muscle and joint pain
  • Tingling in the fingers
  • Confusion, disorders of consciousness
  • Photophobia - inability to tolerate light
  • Phonophobia - inability to tolerate loud sounds
  • Petechial rash - if the meningitis is caused by the bacterium Neisseria meningitidis. A large number of small, irregular purple or red spots (petechiae) appear on the patient's body. The most affected are the torso, lower limbs, mucous membranes, conjunctiva and palms. Stains usually do not disappear even when pushed into place by a finger or glass.

 

Risk factors

Age. The most common are children under 4 years and the elderly over 60 years of age. In the youngest children the most common source of infection is often a family member - an asymptomatic carrier of the bacteria - tt can be one of the parents, grandparents or an older sibling.

Smoking: The possibility of infection increases with active and passive smoking. In children under the age of 15 this risk increases 3x times higher - if one of the parents smokes, and 8x times higher  - if both parents smoke.

Season: The risk of infection is higher in colder seasons when people spend more time indoors.

Inflammation of the middle ear: Common disease in children. The ear area is where the bacteria can easily pass into the meninges. In addition, otitis media is very often caused by pneumococcus.

Meningitis in past: Even if it was caused by another agent, the brain-blood barrier is broken and it is easier for the infection to switch to the meninges.

Missing spleen: You can live very well without the spleen (a person can be born without it or you can lose your spleen, for example in an accident). The spleen is an organ that is heavily involved in the immune system, and an individual without the spleen is much more susceptible to bacterial infections, including the dangerous pneumococcal ones.

Open head injuries: When the skull protection is compromised, the entry of any infection into the brain and meninges is greatly facilitated.

Diabetes mellitus: Diabetes significantly weakens a person's immunity and then he/she is much more prone to various infections, including pneumococcal meningitis.

Alcohol: Alcoholics have a compromised immune system, and in general have poor health, therefore the infection is more severe in them.

 

How meningitis is treated

The doctor will make the correct diagnosis by a medical examination, by testing the stiff neck or by a lumbar puncture (collection of cerebrospinal fluid). Untreated meningitis can be life-threatening. Therefore patients are given broad-spectrum antibiotics, such as third-generation cephalosporins or penicillin as soon as possible after diagnosis. Antivirals are used for viral infection. Adjunctive therapy with corticosteroids is also recommended to prevent complications of extensive inflammation. Viral meningitis usually requires only basic care, when antivirals are given and having rest is important. In contrast, tuberculous meningitis must in most cases be treated with antituberculosis drugs for more than a year. Fungal meningitis requires treatment with fungicides.

 

Meningitis vaccination available

Vaccination is an effective prevention against meningitis. Because meningococcal diseases have a higher incidence in the children’s first 6 months of life, the Czech Vaccinological Society recommends including vaccination as early as 2 months of the child. A quadrivalent vaccine is currently used to protect against meningococci in groups A, C, W135 and Y (vaccination recommend for children from 2 years of age), but there has also been a separate vaccination against the most dangerous type B (vaccination in children from 2 months of age). In Unicare we vaccinate against both types of meningococci. 

 

If you are interested in the vaccine, please make an appointment with your paediatrician. To make an appointment, please call Unicare at +420 235 356 553