What is meningitis?

Meningitis is an inflammation of the tissues covering the brain, called meninges. The brain and spinal cord are wrapped around by the meninges, with fluid, the cerebro-spinal fluid, in between. The surrounding meninges and the cerebro-spinal fluid provide protection for the brain and the spinal cord.

There are many types of meningitis. These are:

* Bacterial meningitis: This is caused by infections of the meninges with bacteria, of which there are many types. For example Meningococci, Haemophilus Influenzae and Streptococcus Pneumoneae (or Pneumococci).

Infections with Meningococcus (the most dangerous of the bacterial infections) occur throughout the year, with peaks in the incidence starting in May through to August and September.

Bacterial meningitis can be fatal if not diagnosed and treated. Meningitis caused by Meningococci can be spread from person to person in situations such as close contacts in a home or between babies in the same room within a nursery.

All bacterial meningitis is treatable with antibiotics. Where Meningococcal meningitis is confirmed or suspected, chemo-prophylaxis with oral antibiotics is administered to all close contacts.

* Viral meningitis: This is due to infection caused by viruses like HIV, mumps, herpes and chicken pox. These types of meningitis do not cause the rapid deterioration as occurs with bacterial meningitis, but there is generally no effective treatment to eliminate viral infections.

* Fungal meningitis: This is caused by fungi like Cryptococus, usually in immune-compromised patients, such as those with HIV infection, diabetes, etc. Fungal meningitis is treatable.

How do we get meningitis?

Bacteria and viruses are found everywhere in the environment, in our digestive systems, on objects we come into contact with and in the air we breathe. In general our immune systems keep control of the bacteria so that they do not invade the body to cause illness.

However situations occur when our tissues are vulnerable and the bacteria or viruses are able to overcome our resistance to cause illness. Eating healthy food, and staying away from smoking and excessive drinking are effective ways to maintain high degrees of resistance. However, even when living healthy lifestyles, infections can occur.

What are the symptoms of meningitis?

In adults and older children, like with many infections, people feel unwell, and have fever. One suspects meningitis when, in addition, this is associated with:

* Severe headache

* Nausea and vomiting

* Photophobia (when one cannot tolerate any light)

* Neck stiffness

It needs to be noted that infections of the throat and ears can cause similar illnesses, and it is important that people are examined to establish an underlying cause of the symptoms.

In untreated cases of meningitis, this can go onto confusion, convulsions, loss of consciousness and skin rashes and bruising.

For younger children (less than two years of age), diagnosing meningitis can be difficult, as they have symptoms of any infection, including:

* Fever

* Irritability

* Drowsiness and the child is generally unwell

* Refusing to eat and drink

* Continuous crying

* Neck stiffness

How is the diagnosis of meningitis confirmed?

A sample of the cerebro-spinal fluid is obtained by inserting a needle between the spaces of the spine and through the meninges.

The fluid is examined for evidence of infection and is cultured to grow the invading organism.

This provides guidance to institute appropriate treatment.

What is the provincial trend of meningitis?

Meningitis cases are seen throughout the year round. The Gauteng Department of Health (GDoH) keeps record of all meningococcal meningitis cases as it is the most serious of the bacterial meningitis and can cause death.

Issued by: Department of Health, Gauteng Provincial Government
14 March 2009
Source: Gauteng Provincial Government (http://www.health.gpg.gov.za