Understanding Meningitis: What You Need to Know on World Meningitis Day

The three membranes comprising the dura mater, arachnoid mater, and pia mater together form the meninges. The Meninges are primarily responsible for protecting the brain and the spinal cord by forming a shield around them. They are therefore crucial for the stable working of the central nervous system (CNS). CNS, as we all know, is responsible for receiving, processing, and responding to sensory information and is critical for one’s well-being. Any hampering, inflammation or infection of the brain or the spinal cord results in life-threatening consequences, such as brain or spinal cord injury, encephalitis, neuropathy, tumours, epilepsy, haemorrhage, Parkinson’s, and Alzheimer’s diseases as well as meningitis. Therefore, we must be aware of the symptoms, complications, and management of such conditions for a healthy and long life.

What is Meningitis?

Meningitis is the inflammation of protective membranes, the meninges which essentially cover the brain and the spinal cord (CNS). The swelling is primarily caused by viral or bacterial infection of the fluids and the membranes surrounding the CNS. In rare cases, it is also caused by fungal or parasitic pathogens. Meningitis is prevalent in kids and teenagers but is also common in adults. If not diagnosed early, meningitis could be dangerous and even life-threatening. Every year, meningitis affects 2.5 million people globally and a lack of awareness about the disease makes the situation more dreadful with people losing their loved ones due to limited support and knowledge about its symptoms, prevention, and cure. 

A Brief History of Meningitis

The first report of a medical observation that might signify meningitis came from the famous Greek scholar Hippocrates (370 BC) who described the condition as an inflammation of the linings of the brain. 

Later, in 1661, Thomas Willis observed patients with inflammation of the meninges exhibiting continual fever, which became the earliest description of meningitis. 

In the early 1800s, the term meningitis was coined by combining the word meninges (outer covering of the brain) with ‘itis’, which refers to inflammation. 

How Does Meningitis Occur?

Meningitis is caused by various infections of the fluid and membranes surrounding the brain and spinal cord; however, bacterial and viral infections are the most common causes. Bacteria that are responsible for the infection, such as meningococcal, pneumococcal, and Hib, thrive naturally in the nose and throat. Unfortunately, every 1 in 10 people might suffer from meningococcal meningitis which occurs when the bacteria thriving harmlessly is carried in the back of their nose or throat. Although less infectious than flu, the bacteria can spread easily to close family members and friends through mouth and nose droplets via coughing, sneezing, or intimate kissing. 

Group B streptococcus (GBS), a type of bacteria that lives in the vagina and intestines, also causes meningitis, especially in newborn babies during the time of birth. 

Viral meningitis, on the other hand, spreads through enteroviruses and coxsackieviruses which also live in the nose, throat, and intestines. Spread is usually through faecal contamination, through droplets from the nose and mouth, or from the mother to her child during birth.

Signs and Symptoms of Meningitis

Meningitis is a global public emergency. Combined with neonatal sepsis, meningitis is the leading cause of intellectual disability (learning disability due to problems in the brain)  worldwide. We lose 1 in 10 people to meningitis, whereas 1 out of 5 survivors are left disabled due to the infection. 

Meningitis is easy to misdiagnose and difficult to detect. As a result, healthcare providers are left with little time to act owing to the aggressive nature of the infection. 

Signs of Meningitis in Babies and Toddlers:

Meningitis is prevalent in kids, toddlers, and teenagers. This is particularly because of their weak immune system to fight off bacteria and viruses in the body. Although viral meningitis is not life-threatening, recovery is slow. Bacterial meningitis can be fatal and requires immediate hospitalisation. Therefore, We must keep an extra eye on these signs and symptoms for early detection and care. 

• Fever, cold hands and feet
• Drowsy and unresponsive
• Rapid breathing 
• Throwing up food
• Pale blotchy skin
• Stiff neck
• Convulsions and seizures 
• Spots or rashes on the skin

Types of Meningitis

Meningitis is caused by various bacteria, viruses, fungi, and other parasites. Globally, meningitis is primarily caused by bacteria and viruses, whereas skull fracture or head and neck injury could also lead to meningitis.

Depending upon the pathogen involved, meningitis is divided into the following types:

1. Bacterial meningitis: It is deadly and requires immediate hospitalisation. Even though vaccines are available, they protect against only some kinds of bacterial meningitis. Pneumococcal, TB, Group B streptococcal, E. coli, and Hib meningitis are some of the bacterial meningitis that affect neonates, babies, and adults. 
2. Viral Meningitis: It is more common than bacterial meningitis, albeit less fatal, and can make anyone quite unwell. Individuals with healthy immune systems usually get better on their own. Vaccines are also available for some viral meningitis. Herpes Simplex virus 2 causes Mollaret’s meningitis which is a  rare, chronic, and recurrent lymphocytic meningitis. 
3. Fungal Meningitis: It is rare but people with compromised immune systems are susceptible to getting the infection by inhaling meningitis-causing fungal spores. Patients with HIV, diabetes, and cancer are vulnerable to this infection.
4. Parasitic Meningitis: Certain parasites found in uncooked raw freshwater fishes, snails, eels, and poultry can cause meningitis. Although extremely rare, parasitic meningitis is life-threatening. 
5. Non-infectious Meningitis: As the name suggests, this type of meningitis is not contagious but is caused by certain chemicals or cancers. 
6. Malignant Meningitis: Malignant meningitis is described as a serious medical condition when cancer cells spread to the meninges. 

Prevention and Vaccination

Prevention is always better than cure! Meningitis caused by bacteria and viruses are highly contagious and as a result, it is difficult to prevent their spread. The best practice to contain its spread involves isolating the infected person from others. However, this is not always 

possible due to lack of resources. We can follow these guidelines to help prevent its spread and do our part:

• Quit Smoking: Individuals who smoke cigarettes carry the meningococcal bacteria in their throat; therefore, quitting smoking can prevent its spread. 
• Maintaining Personal Hygiene: Meningitis viruses and bacteria can be present in the saliva. Hence it is recommended to avoid sharing bottles, glasses, and cups. 
• Practise Healthy Hand Hygiene: Washing hands regularly, especially after coming in contact with an infected person or after going out in public places.
• Antibiotics: As a preventive measure, antibiotics are also given to people with close contact with the patient.
• Cover mouth: Covering the mouth while coughing or sneezing is a basic hygiene measure that one should practise to help contain the spread of the infection. 
• Avoid Raw/Uncooked Meat and Poultry: Parasitic meningitis can spread through uncooked and raw fish, snails, and poultry. 
• Early Diagnosis: Early diagnosis can help prevent its spread to healthy individuals in the family and among close contacts. Immediately see a healthcare provider if you exhibit meningitis symptoms.
• Robust Immunity: Individuals with weak immunity can easily get infected. Also, in infections caused by a virus, the person's immune system is responsible to fight off the infection. Therefore, having a robust immune system is no doubt the best way to prevent infection and quicken recovery.

Vaccination

Although vaccines are available, they prevent only some kinds of meningitis. These vaccines are part of the immunisation schedule in some countries like the UK. Meningitis vaccines can be broadly divided into 3 groups:

Meningococcal vaccines:Meningococcal bacteria have 5 groups, namely A, B, C, W, X, and Y which commonly cause meningitis and septicaemia. 

1. MenB Vaccine: Formulated against the most common bacterial meningitis caused by Meningococcal group B bacteria. 
2. This is given to babies at 2, 4, and 12 months.
3. MenC Vaccine: This is also designed to combat common bacterial meningitis and given to infants along with Hib at 12–13 months of age.
4. MenACWY Vaccine: Offered to children at 14 years of age, it protects against four main bacterial groups causing meningitis, namely A, C, W, and Y. Anyone who missed this vaccine can take it up to the age of 25 years. 

Pneumococcal Vaccines:

As many as 95 Pneumococcal strains are present but not all cause meningitis. Some can cause meningitis as well as septicemia.

1. PCV Vaccine: Pneumococcal conjugate vaccine prevents 13 strains that cause meningitis. Babies are given this vaccine at 12 weeks and 12–13 months.
2. PPV Vaccine: Pneumococcal polysaccharide vaccine is given to adults aged 65 years or above. It provides only a limited period of protection against 23 strains. The vaccine is not effective in children under 2 years of age.
3. Patients with chronic respiratory or heart diseases must seek immunisation.

Other Meningitis Vaccines:

1. Hib Vaccine: Protects against Haemophilus influenzae type B bacteria which commonly cause meningitis in children under five. It is a combined vaccine and prevents Hib, diphtheria, polio, tetanus, pertussis, and hepatitis B. It is given to babies at 2, 3, and 4 months.
2. MMR Vaccine: The Vaccine protects against measles, mumps, and rubella. It is given to infants at 12–13 months and again at 3–4 years of age. Mumps is the primary reason for viral meningitis among children.
3. BCG Vaccine: The vaccine protects against tuberculosis (TB) and TB meningitis. Offered to children and adults who are at higher risk of infection.
4. Men ACWY Vaccine: It is recommended to people who are travelling to parts of the world with high incidences of meningitis like Sub-Saharan and Saudi Arabia. 

Treatment Of Meningitis

• Physical examination to diagnose meningitis symptoms 
• Blood test to verify the causative pathogen
• Lumbar puncture in which fluid is taken from the spine 
• CT scan to check swelling in the brain and other complications

Depending on the severity of the infection, meningitis could be treated at home or in a hospital.

At the hospital, (All bacterial meningitis require immediate hospitalisation) 

• Patients are put on antibiotics course through IV
• To prevent dehydration, IV fluids are given
• A steroid medication may be given to prevent swelling 
• Oxygen support may be given to patients with breathing difficulties. 

At home,

• Recommended for mild meningitis caused by a virus
• Children with viral meningitis are also given treatment at home
• Plenty of rest is recommended 
• To alleviate the pain, painkillers are prescribed 
• Medicines for nausea may be prescribed by your healthcare provider. 
• Usually resolves within 7 to 10 days.

Meningitis Awareness and World Meningitis Day 2023

Every year “World Meningitis Day” is celebrated on October 5 to raise awareness about the life-threatening infection that devastates lives and families across the world. Its awareness is important because of its symptoms that at first seem like a normal flu but later develop into a full-blown infection damaging the brain and causing instant fatalities. The survivors are not spared either and may get life-long complications.  Therefore, we must spread as much awareness as possible which could help save 200,000 lives annually. The awareness could help bring down cases of meningitis and disabilities caused by the infection at a tremendous scale.  Every awareness counts and every person counts!

 

 

Why World Meningitis Day Matters?

Meningitis is a life-threatening disease that affects infants, teenagers, and adults. We lose approximately 250,000 individuals annually due to meningitis and the fatality rate is 21%. Individuals with bacterial meningitis die within just 24 hours if the diagnosis is late or complicated.

As a result, celebrating World Meningitis Day is crucial to make people aware of the preventive measures, symptoms, and vaccines to tackle this epidemic and eradicate the disease at the global level in the near future. 

How to be a Part of World Meningitis Day?

You can be a part of World Meningitis Day in various ways from taking part in awareness programmes to donations.

You can do your part by

• Creating awareness: Take part in a meningitis awareness drive happening in your city or council or you can also start your campaign locally. Discuss the symptoms and preventive measures with mothers, parents, and adults.
• Share your story: If you happen to be a survivor of a meningitis infection or know someone who gracefully survived the deadly infection, you can share the experience and let people understand the deadly infection in a more empathetic way.

• Donate: Create a charity programme or donate to forums available on the internet after verifying their goals and motives. This helps in providing resources to NGO-run meningitis drives and local hospitals across underprivileged areas. Even a small donation can help people tremendously. 
• Collaborate with influencers and politicians: This will help create awareness at an unprecedented level and tackle meningitis infections locally. 
• Get Vaccinated: Aware people about the available vaccines that protect against meningitis, especially how parents can take steps to protect their children and newborns with vaccination schemes. 

Theme for World Meningitis Day.

The theme for World Meningitis Day 2023 is to “Light up the Road to Defeat Meningitis and Eradicate it by 2030”. 

You can help light up the road and contribute your part in eradicating meningitis by

• Creating Awareness: Create Awareness at a community level by collaborating with local healthcare professionals, politicians, and NGOs. 
• Support: Support local hospitals, clinics, and medical drives by raising funds for resources, vaccines, and medicines. Investing in research and technology could also be a vital support.  
• Get Involved: Light a candle, lantern, or earthen lamp at 8.30 PM (local time) on 5th October and show your support and enthusiasm.  

 

References

 

Making a Difference: World Meningitis Day Fundraising. Meningitis.org. 

https://www.meningitis.org/world-meningitis-day-fundraising#:~:text=Every%20year%2C%20people%20from%20all,to%20Defeat%20Meningitis%20by%202030.

Introducing World Meningitis Day: 5th October. Meningitis.org.

https://www.meningitis.org/blogs/introducing-world-meningitis-day

Treatment, Meningitis. NHS

https://www.nhs.uk/conditions/meningitis/treatment/

What is the Fatality Rate of Meningitis? Veazey K. Medical News Today. June 23, 2023

https://www.medicalnewstoday.com/articles/meningitis-fatality-rate#fatality-rate

Help us Light the way This World Meningitis Day. MeningitisNow.org. October 4, 2023.

https://www.meningitisnow.org/meningitis-now-stories/news-centre/news/help-us-light-the-way-this-world-meningitis-day/#:~:text=The%20theme%20of%20World%20Meningitis,of%20defeating%20meningitis%20by%202030.

Tell Your Story, Your Way and be one of 2030 Global Voices of Experience. Comomeningitis.org. 

https://www.comomeningitis.org/world-meningitis-day-tell-your-story

World Health Organisation.

https://www.who.int/news-room/fact-sheets/detail/meningitis

The History of Meningitis. October 2020. Meningitis.org

https://www.meningitis.org/blogs/the-history-of-meningitis

https://www.meningitisnow.org/meningitis-explained/meningitis-vaccines/

 

FAQs:

1) Can Meningitis cause death?

Yes, meningitis can be fatal, especially bacterial meningitis if not diagnosed and treated quickly.

2) Can Meningitis spread?

Meningitis is less contagious than flu but people in close contact with an infected person can catch the infection. It is recommended to avoid close contact and practise personal hygiene. 

3) How Meningitis occur?

Meningitis can be caused by bacterial and viral infection of the meninges (covering of brain and spinal cord). It is prevalent in immunocompromised individuals and babies. 

4) Can I recover from Meningitis on my own?

Viral meningitis is common and your body’s immune system can fight off the infection on its own. Bacterial meningitis requires immediate hospitalisation.  

5) How is Meningitis diagnosed?

Meningitis is usually diagnosed through blood tests and physical symptoms. Some cases require a CT scan and lumbar puncture. 

6) Which Meningitis is the worst?

Bacterial meningitis can be fatal and even the survivors are left with life-long complications. 

7) When can I take the Meningitis Vaccine?

Different vaccines are available that protect against some kinds of meningitis in babies, teens, and elderly people. Talk to your healthcare provider for a detailed list of vaccines and dosages.

8) When to seek medical help?

Seek medical help as soon as possible. Only early detection of meningitis can help save life and life-long complications. 

9) Does Meningitis require isolation?

Yes, isolating the infected person from family members and friends can help prevent its spread. 

10) Do antibiotics work against all types of Meningitis?

No, antibiotics will only work against meningitis caused by bacterial infection. Viral, fungal, and parasitic meningitis require different medications. Always consult your healthcare provider in case of an emergency. 

11) Does a robust immunity prevent meningitis infection?

Having a healthy and robust immunity is key fighting off infection early and easily. It is more evident in viral meningitis where the body's immune system has to fight off the infection on its own.