Worrying times as Meningitis cases on the rise

Dr Dara Hume
 

Even the mere mention of the word Meningitis strikes fear in the heart of every parent. We have heard a lot about this recently in the media, and about immunisation against it, but what exactly is it?

 

 

Meningitis is inflammation due to infection, of the lining around the brain and spinal cord known as the Meninges. It can cause Septicaemia (or blood poisoning), which is the more life threatening form of the disease. The inflammation and swelling in these tissues can put dangerous pressure on the brain and spinal cord. Meningitis is an extremely serious disease that can also cause permanent damage to the brain and nervous system, loss of limbs, hearing or sight loss, and even death. It is caused by the invasion of bacteria or viruses into the bloodstream, and then travelling to the brain and spinal cord.

One in 10 people carry some strains of these bacteria in their nose or throat, unknown to them. Infection can be spread by coughing, sneezing, kissing or sharing cutlery/drinks.

There are different strains of meningococcal bacteria, but the main ones are A, B, C, W, X and Y.

There is no single vaccine that protects against all strains. Here in Ireland, group B and C cause the majority of infection. Viral Meningitis is the commonest form (and most people make a full recovery in up to two weeks ) but bacterial Meningitis is the most serious form.

The highest risk groups are children and babies under age five years, the second highest risk group is young people aged 16 to 21 years.

The trickiest thing about this infection is that the symptoms vary so much from person to person and can even mimic the common cold. Common symptoms are high temperature, dislike of bright lights (photophobia), vomiting, headache, stiff neck, confusion, seizures, fast breathing, cold or blue hands and feet, excessive sleepiness, muscle pains, and a red blotchy rash.

Symptoms can come on very quickly, often over just a few hours, or can progress over a day or two.

It can be even more difficult to diagnose in babies, but an unusual cry or severe distress, floppy or excessive drowsiness, refusing feeds, bulging fontanelle (the soft spot at the top of the head) are the most common. The rash that we regularly hear about is often a very late sign, or is not there at all.

If your child is unwell, with a high temperature and a rash, do the ‘glass test’. If you press a glass against the rash, it should disappear and reappear once you remove the glass. If the rash doesn’t disappear, this is the meningitis rash (which I hope no parent has to ever see), and is a medical emergency.

 

 

 

Prevention

 

 

Meningitis is contracted from other people. So cover your mouth and nose when coughing or sneezing, wash hands regularly, avoid sharing food, drinks etc, and make sure your child’s vaccinations are up to date. Some types of bacterial Meningitis can be prevented by immunisation.

All children receive neumococcal, HIB, Meningitis C, MMR, and six in one vaccine. Men C vaccination is given at six and 13 months, and all children born from October 2016 receive the Men B vaccination at two, four and 12 months of age.

The incidence of Meningitis is estimated at 1.4 cases per 100,000 people. In my own 22 years as a GP, I have come across three cases of Meningitis in total, but a higher number of suspected cases.

In my practice, we would have 80-100 babies born per year, and our nurses Margaret and Maura take great pride in ensuring that we have an almost 100% uptake in childhood immunisations.

If Meningitis is caught and treated early enough, a person can make a full recovery with few or no lingering effects. However it can also have detrimental consequences.

But the best prevention is immunisation and good hygiene practices.

 

 

 

Diagnosis and treatment

 

 

Meningitis is diagnosed (or outruled) by a test called a lumbar puncture (where a sample of spine fluid is taken and examined under a microscope). This is done in the hospital by a doctor. The first treatment in acute meningitis is antibiotics and sometimes antiviral medications.

We have had innumerable phone calls to our practice in the past two weeks from worried parents enquiring about getting Men B vaccine (Bexsero) for their children over two and a half (ie born before October 2016). In my opinion there certainly should be a ‘catch up’ programme, particularly up to age five years. However the Government doesn’t currently agree. In the meantime though, parents who want their children immunised, are scraping together the money to pay for this. This is so grossly unfair, as those who can afford the vaccine are getting it, and those that can’t afford it are not. It is an expensive vaccine and lots of parents seeking it cannot actually afford it. That is a disgrace of the highest order in my opinion. And it is causing enormous stress and worry for parents.

The key message that I want you to take from this about Meningitis is - make sure your children’s immunisations are up to date, take care with general hygiene measures, watch for the signs of Meningitis, and seek help from your GP if you are concerned. Above all, always trust your instinct with your child, as no one knows your child better than you.