Meningococcal Meningitis

Meningococcal meningitis is an uncommon, serious bacterial infection of the meninges (membranes around the brain) and blood stream (septicaemia). Sporadic outbreaks occur worldwide, usually in winter, but up to 40% of the population carry the responsible bacteria in their nose and throat without any symptoms. Infection is more common in closed communities such as military camps and boarding schools. It affects about one person in 100,000 every year.

The infection is caused by the bacteria Neisseria meningitidis, which occur in 5 common strains (forms), and several dozen uncommon strains. The C strain is the most serious, while strains M, W and Y are probably next in severity, but this varies between patients.  It is spread by prolonged close contact with a person who has the disease by inhaling their sputum or phlegm in coughs and sneezes.

Symptoms include a high fever, severe headache, vomiting, neck and back stiffness, limb pains, confusion, convulsions and a rapidly spreading bruise like rash that starts on the arms and legs. The rash does not go white with pressure under a glass slide, a symptom that is critical in differentiating Meningococcal infections from other rashes, although there are some other infective rashes that do the same thing.

In terminal stages the patient becomes delirious, and goes into a coma. Rarely, abscesses may form in the brain, and pneumonia may develop.

Cultures of blood and/or spinal fluid from the lower back can confirm the presence of the responsible bacteria, then penicillin, or more potent antibiotics, are given by injection as soon as the diagnosis is suspected. The patient should be admitted to hospital for confirmation of the diagnosis, and continuation of antibiotics given through a drip into a vein. Life support in an intensive care unit may be necessary. The infection may be rapidly progressive causing death within hours, but overall 80 to 90% of all cases survive, with only 5% of survivors developing longterm consequences such as epilepsy.

Two vaccines are available. One is against strain C only, but lasts long-term, the other prevents four strains of the bacteria, but lasts for only two years. The former can be given to infants, and is now part of most routine vaccination schedules. This form of meningitis is particularly common in the Sahel region of Africa (South of the Sahara Desert) and travellers to this region should consider vaccination.

Meningococcal : “Meningo” is related to the brain covering and “Coccal” means cause by cocci bacteria.

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