Meningitis

Meningitis is inflammation of the meninges, the lining of the brain. It is a word that strikes fear into parents and doctors alike. It can be caused by bacteria, by viruses, by tuberculosis or by infiltration of meninges by malignant cells, when it is called aseptic, because there aren’t any germs present. Bacterial meningitis is by far the most serious. Different bacteria are responsible at different ages: in the very young child under the age of three months it may be due to infection by streptococcus; up to the age of six there may be involvement of the meningococcus or haemophilus influenzae, while in the older child and adult the germ usually responsible is the meningococcus. The classical story of headache, neck stiffness, dislike of light and a rapidly developing rash which does not blanch when pressed by a glass may not be present.

Meningococcal septicaemia can occur in the absence of meningeal infection, causing the rapid development of the rash and circulatory collapse without the headache. Since meningococcal infection is a dangerous disorder it requires vigorous emergency treatment and a high index of suspicion. Spread is by droplet infection - inhaling the saliva coughed or sneezed by an infected person, or someone who carries the germ in their nose or throat without being affected by it - as 1 in 4 of us do. It can also be spread in saliva shared while kissing, which is why there were routinely outbreaks among first year students at universities. Vaccination will prevent some infections - Meningococcus A and C (which has reduced University outbreaks), but not all. Close contacts of cases of meningococcal meningitis may require prophylactic antibiotics in order to prevent the development of the disease.

Viral meningitis, where the infection is by a virus rather a bacterium, is a much less severe disease and complete recovery may be expected.
 
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