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MENINGITIS The What, Where and How of this Misunderstood Condition Reported cases of meningitis strike fear in the public and stir media attention because certain forms of meningitis can strike suddenly, without warning - without a taste, without a smell, or seemingly without any cause whatsoever - and sometimes it kills. Meningitis is an infection of the fluid and lining surrounding a person's spinal cord and brain. Research shows that certain age groups are more susceptible to the disease than others: those under age five, those between the ages of sixteen to twenty five, and those over fifty five years of age. There are two common types of meningitis: viral and bacterial. Of these, viral meningitis is much more common, often being mistaken for flu and not even reported to family physicians. Bacterial meningitis, the rarer form, is the most dangerous by far. Lee County recorded fourteen cases of this form in 2001.
Both kinds are spread by coughing, sneezing and intimate contact such as kissing, sharing a drinking glass or sharing eating utensils with an infected person. But according to Judith Hartner, M.D., Director of the Lee County Health Department, "meningitis shouldn’t be considered as being air-borne. These viruses and bacteria can’t be blown in the wind. Meningitis cannot be spread be casual contact or by breathing the air where a person with meningitis has been." A spokesman for the Centers for Disease Control and Prevention (CDC), Tom Skinner, backs that statement with "You can't get meningitis by just being in the same room with an infected person." But proper hygiene practices are always critical, especially in preventing the viral form. "One route of infection is due to poor hygiene – what’s known as ‘oral-fecal’ transmission," explains Dr. Hartner, stressing that one of the major preventive actions we can take is also the simplest: "Wash your hands often and thoroughly with soap and warm water. By doing this, and avoiding drinking from the same glass as another or sharing their eating utensils, you greatly reduce your chance of being exposed to the organisms that can cause meningitis. Although the culprit in bacterial meningitis can be any of various strains of bacteria, the two leading causes are bacteria named Streptococcus pneumoniae and Neisseria meningitides. In what is universally considered to be a tremendous victory for public health, prior to the 1990’s Haemophilus influenzae type b, or "Hib" was the leading infectious agent, every year striking up to twenty thousand children, mostly under age five, in the United States. But vaccines now given to all children as part of their routine immunizations have lessened this threat by an incredible ninety nine per cent – only 144 cases were confirmed in the two year period 1996-1997.
The organisms that cause bacterial meningitis live in the back of the nose and throat, and at any given time are being carried by between ten and twenty five per cent of the population. Why they sometimes migrate to the bloodstream isn’t yet known. The actual condition of illness known as meningitis occurs when the bacteria gets into the bloodstream and travels to the meninges, a membrane lining the outer surface of the brain and spinal cord. Disease symptoms may not always be the same for everyone, according to the Centers for Disease Control and Prevention in Atlanta, but commonly include fever, severe headache, stiff neck, bright lights hurt the eyes, drowsiness or confusion, and nausea and vomiting. In babies, the symptoms are more difficult to identify, and may include fever, fretfulness or irritability, difficulty in awakening the baby, or the baby refusing to eat. Not all symptoms appears in every case, and not particularly in any order, which can make diagnosing meningitis difficult. But what will always be apparent is that at a certain point, the individual is becoming very sick, very quickly. A number of effective antibiotics are effective at treating bacterial meningitis. But treatment must be started early in the course of the disease. Antibiotic treatment of most common types of bacterial meningitis reduces the risk of death to less than fifteen per cent, although the risk is higher among the elderly.
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