Posted 1 November 2017
With at least one million cases annually across the globe,
meningitis is a major concern, and its tendency to peak in the winter months
means now is the ideal time to review what we need to look out for. (1, 2)
What is meningitis?
Meningitis means inflammation of the
meninges, which are the linings that shield the brain and spinal cord. (3) It
occurs most commonly in children under the age of 5, teenagers and those in
their early twenties, and people with weakened immune systems. (3, 4)
Viral meningitis
Viral meningitis is the most
common form, but is not usually serious. People infected generally recover with
no complications, although this may take some time, several months in some
cases. (1, 5) Enteroviruses, which are usually involved in milder illnesses
such as colds and upset stomachs, are the most common cause. (6)
Bacterial meningitis
Bacterial meningitis is the most
severe form. The cause is often particular bacteria that live harmlessly in the
nose or throat of healthy individuals that can be passed to others through
coughing, sneezing or close contact. Equally, if a person’s immune system
becomes weaker for whatever reason, they can also be at risk if any bacteria associated
with meningitis live in their body, as their defences may not be enough to stop
them from invading the meninges. (1, 4) Neisseria
meningitidis is the most common type of bacteria which causes meningitis,
followed by Streptococcus pneumoniae and Haemophilus influenzae Type B. (1)
Affected individuals can go from
feeling perfectly healthy to seriously ill within hours. Up to a quarter of
people who contract bacterial meningitis die as a result, many of whom will
have only started showing symptoms 24 hours earlier. (1) This is why it is
essential that we know the signs listed below and act immediately if we suspect
meningitis.
Fungal meningitis
Fungal meningitis is uncommon,
occurring mainly in those with weakened immune systems. It is caused by
breathing in fungal spores present in the air. It may be severe if it develops.
(1)
Other causes
Occasionally, meningitis may arise
as a result of injury, surgery on the brain, medication, cancer or parasitic
organisms. However, this is very rare. (1)
Signs and symptoms of meningitis
Recognising the following signs of
meningitis is crucial to enable treatment to be started as early as possible,
as the progression of the illness is so rapid. However, note that not all of
these symptoms may appear and there is no set order:
These symptoms call for an urgent
visit to A&E, or if you or the person concerned is too ill to get to
A&E, dial 999 immediately for an ambulance. It is a common misconception that
the main symptom of meningitis is the characteristic rash - this does not
always appear. If you are in any doubt, call 111 for NHS Direct. (3)
Vaccinations against meningitis
There are several vaccines
available that protect against different types of meningitis, the latest being
introduced in 2015 in the UK.
MenB
vaccine – this protects against the strain of Neisseria meningitidis known as MenB. This vaccine is given to
babies at the ages of 2 months, 4 months and 12 months. Since its introduction
in 2015, the number of babies contracting MenB has dropped significantly. (7)
MenC
vaccine – introduced in 1999, this offers protection against the MenC
strain of Neisseria meningitidis. It
is administered at the age of 12 months in combination with the Hib vaccine
and, since 2015, at 14 years as part of the MenACWY vaccine. It has almost
eliminated MenC meningitis in the UK. (7)
MenACWY
vaccine –protecting against the
MenA, MenC, MenW and MenY strains of Neisseria
meningitidis, this vaccine was introduced in 2015 to be routinely given to
14 year olds as a result of the rise of MenW cases in the UK since 2009. MenW
is a particularly dangerous strain, leading to death in a third of teenagers
who contract it. However, since its introduction, no teenagers who have
received the vaccine have fallen ill with any of the four strains it offers
protection against. (7, 8)
Pneumococcal
vaccine – this protects against a different type of meningitis-causing
bacteria, Streptococcus pneumoniae.It is given to babies at the ages of 2
months, 4 months and 12 months. (7)
Hib
vaccine – protecting against meningitis caused by Haemophilus influenzae Type B, this vaccine has cut cases
dramatically to almost none since it was introduced in 1992. It is administered
to babies at the ages of 2 months, 3 months, 4 months and finally 12 months.
(7)
MMR
vaccine – this vaccine offers immunity against the measles, mumps and
rubella viruses. These viruses can lead to viral meningitis in some cases. It
is given to babies at 12 months. (7)
For further information on
vaccines to protect against meningitis, click here.
References
Confederation of Meningitis Organisations. Types
of meningitis [cited 30 October 2017]. Available from: http://www.comomeningitis.org/facts-about-meningitis/types-of-meningitis/
Oxford Vaccine Group. Meningococcal disease
[cited 30 October 2017]. Available from: http://vk.ovg.ox.ac.uk/meningococcal-disease
NHS Choices. Meningitis [cited 30 October 2017].
Available from: https://www.nhs.uk/conditions/Meningitis/Pages/Introduction.aspx#outlook
Patient. Meningitis [cited 30 October 2017].
Available from: https://patient.info/health/meningitis-leaflet
Meningitis Research Foundation. What are
meningitis and septicaemia? [cited 30 October 2017]. Available from: https://www.meningitis.org/meningitis/what-is-meningitis
Meningitis Research Foundation. Viral meningitis
[cited 30 October 2017]. Available from: https://www.meningitis.org/meningitis/what-is-meningitis/viral-meningitis
Meningitis Research Foundation. Vaccine
information [cited 31 October 2017]. Available from: https://www.meningitis.org/meningitis/vaccine-information
Oxford Vaccine Group. MenACWY Vaccine [cited 31
October 2017]. Available from: http://vk.ovg.ox.ac.uk/menacwy-vaccine
Author: Gabby Gallagher MPharm
Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 01/11/17
Posted in Men's Health, Womens health