Meningitis



Meningitis is a disease that affects a lot of people, but is most common with children under the age of 5years old. It is important for parents to be aware of the dangers and how to prevent the spread of the disease because it can be fatal when not given appropriate attention to the signs and symptoms of the disease, but if it’s treated early most children make a full recovery.
Meningitis is mainly a seasonal disease but can occur throughout the year, and about two-third of the bacteria is found to occur during the winter months and people living in overcrowded houses are at risk of contracting the disease through prolonged contact with the person affected by the disease. People carry the meningitis germs without being aware that they have the germs because it is situated at the back of the nose and throat, the germs can be carried for days, weeks and even months without actually becoming ill. 10% of the population and 25% of the students carry these germs and can be contracted from person to person through cough, sneeze, and kiss, but cannot be contracted through swimming, building, clothes or toys and the incubation period is between two to ten days.

Meningitis can be caused by Viruses, Bacteria, Fungi or Amoebae

VIRAL MENINGITIS
These are the most common form of meningitis and commonly affect children, it is mostly common around the summer time and this type of meningitis are relatively mild, they are not life threatening and cannot be treated by antibiotics only by having plenty of rest, fluids and a good nursing care and this usually lasts for about four to ten days. Viral meningitis can be transferred from one person to another through coughing, sneezing kissing, poor hygiene and sewage polluted water.
The following are the causes of viral meningitis
·         Enteroviruse
·         Herp simplex type 2 [ are less common]
·         Varicella Zoster virus[ also known to cause chicken pox and shingles]
·         Mumps virus
·         HIV
·         Cold Sore and
·         Measles


Signs and Symptoms of Viral Meningitis
·         Headache
·         Fever and general ill feeling
Sometimes the symptoms could include
·         Nausea
·         Vomiting
·         Abdominal pain
·         Muscle pain
·         Photophobia
·        Altered consciousness [which are usual], with additional symptoms this illness can be life threatening and may cause long-term after effect and is not usually associated with scepticaemia


BACTERIA MENINGITIS
According to the magazine Childcare.ie this type of meningitis can be fatal and has caused approximately fifteen deaths in Ireland in 2001and can also be contracted through coughing, sneezing and kissing and can be treated by antibiotics.
The most common types of bacterial meningitis are
·         Meningococcal A; this type of meningitis are rarely found in Ireland, but are commonly found in sub-saharan Africa, Middle East and India.
·         Meningococcal B; this are common in Ireland and approximately 60% of cases are accounted for.
·         Meningococcal C; this type of meningitis was responsible for about 30% of cases before the introduction of new vaccines into the childhood immunization schedule in October 2000. This is according to the childcare. i.e. magazine.
·         Pneumococcal meningitis; with this type of meningitis there  is a risk of neurological damage, Hib [ haemophillus influenza type B] and this damage can be permanent when it affects a person or a child. It is found to affect adults and growing babies and can have high death rate, and up until 1992 before vaccines were introduced, it is found to be the biggest killer of children under the age of 5years old and in 1992 Hib vaccine was introduce and is given to children at 2, 4, and 4 months on routine basis.
·         Tuberculosis: it is a rare disease and mostly affects countries like India and sub-continent. Meningitis caused by TB is due to infections with mycobacterium tuberculosis, and people with low immune system can be affected.
·         E. Coli and Streptococcal: are bacteria that can cause meningitis and are common cause of meningitis in pre-mature babies or new born up to three months. This can be transferred from mother to baby through the birth canal, naturally E. Coli which carry K1 antigens are found in the intestine or the digestive tract while the streptococcal is found in the vagina this disease occur in 25% of new born and infection is due to group B streptococci and is less common in adults.
·         Listeria Monocytogenes [Serotype Ivb] may affect new born and can be found in the skin [epidermis] and older children are affected by Neissria Meningitis [meningococcus].


  
Signs and Symptoms of Bacteria Meningitis in children

·         High pitched cry
·         Difficult to wake
·         Blank or staring expression Pale or blotchy completion
·         Refusing to feed
·         Vomiting and dislike of being held.


FUNGAL [Cryptococus]

These are rare type of fungi disease and only occur in patient with low immune system, drug therapy, Leukemia and people with organ transplant and HIV. Diagnosis can be difficult because not all signs are noticeable at the start and are mostly passed off as childhood illness and the patient’s condition can deteriorate very quickly.


AMOEBIC MENINGITIS

These are due to infection with amoebae such as Naegleria Fowleri found in fresh water sources. Parents and people working with children must be vigilant as babies and young children are not able to explain themselves about their feelings, there knowing the signs and symptoms is very important to parents and early years workers.
Meningitis and Septicaemia can occur at the same time and are responsible for the majority of meningitis cases. Septicaemia sometimes causes bacteria meningitis as the bacteria rapidly increases in the blood, thereby poisoning the blood stream and infect the meninges [lining of the brain and spinal cord] which develops into a full blown meningitis

Signs and Symptoms of Septicaemia

Heamorrhagic rash, people infected with septicaemia usually develops rashes and it starts as a cluster of tiny blood spots and when not treated it gradually becomes bigger and looks like bleeding under the skin surface as fresh bruises which is obvious to the eyes these are then joined together to form a large area discolouring the skin making it look like a purple colour. The person becomes unwell, no appetite, fever with hands and feet becoming cold and the person might go into coma or possibly die. When a child’s body is covered in rash, parents or early years workers must first carry out a glass test to check if the child suffers from meningitis caused by septicaemia, if the rash disappears on placing the glass against the skin the child has no meningitis but if the rash remains the an ambulance must be called immediately.
TREATMENT
Many vaccines are now available to prevent or treat meningitis in children and those with high risk condition, though no vaccine can totally prevent all stains of meningitis.
MMR vaccines are given to children at 14months to prevent them against measles, mumps and rubella.
HIB vaccines are given to children at ages 2,4 and 6months to protect them against haemophillus influenza B
Pneumococcal vaccine are given people with high risk, whose spleen has been removed, low immune system head injury and those who have had major surgery.
Meningococcal A and C vaccine are given to people who travelled to meningitis belt countries and this lasts up to 3years but it is not effective in children under 18months Meningococcal C vaccine lasts a life time and is given to children as part of childhood vaccine programme at 2, 4, and 6months and cases of meningitis has reduced by 70% since it was introduced in October 2000.
Quadrivalent vaccine is given to people travelling to mecca for Hajj.
There are some after effect of viral meningitis for people who suffer from the disease and these includes
·         Depression
·         Recurring headaches
·         Short term memory loss
·         Tiredness or chronic fatigue
 There are also some after effect of bacterial meningitis they are
·         1 [physiological] memory loss, deafness, amputation, brain damage and learning difficulty.
·         2 [psychological] tiredness, poor concentration, epilepsy, stiff joint, headaches and short term eye sight problem Meningitis is a life threatening disease and the death is high if it is not treated or if treatment is delayed could lead to poor outcome.



     The glass test: 
     The glass test is a really useful way of spotting suspected meningitis. If your child has a cluster of red or purple spots, press the side of a clear drinking glass firmly against the rash. In this example the spots are still visible through the glass. Contact a doctor immediately (e.g. your own surgery or Walk-in/Urgent Care Centre). If you cannot get help straight away go to the Accident and Emergency Department. Go straight to the Accident and Emergency Department


PREVENTION

Contracting meningitis cannot be entirely prevented but some precautions can be taken to prevent the spread of the disease by parents and those working in the childcare settings. Parents and childcare workers should take all reasonable measures to ensure and safeguard the health and safety of children, as we know germs thrive in a place that is warm or hot, therefore any heat emitting surface should be thermostatically controlled so that the rooms both at home or in the childcare setting is not too warm to promote the growth of germs since the disease can be spread through coughing and sneezing.
In the home if there is a pond in the garden, parents should make sure that the pond is cleaned regularly and guarded to prevent children from falling into the pond and in child care settings staffs should make sure they prevent the spread of infection by following the hand washing procedures by washing their hands after every nappy change or after changing a child that has just vomited on his or her clothes .Always make use of safety equipment provided such as gloves, aprons, and sanitizers when changing a child’s nappy and to make sure that all surfaces that are contaminated such as door knobs and handles, television, remote control with hot soapy water and disinfectant to reduce the spread of germs [viruses] and also to clean the rooms and the toys at the end of the working day, this also applies to parents as health and safety measures at home.


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