Bacterial Meningitis
On January 26, my 19-year-old son
awoke with what I thought was a stomach virus. He had been treated for a stomach virus just 2 months earlier, so I felt comfortable taking care of him at home since we still had medicine available. By that afternoon, he experienced some abdominal cramping and diarrhoea, which I contributed to the virus... Soon after [I had checked on] him, my son walked into our living room and sat down. His face was covered with bruises, and his extremities were blue. I immediately called 112 and waited for help to arrive. My son was conscious on our arrival to the ER at the for more health news hospital where I work. click on http://chaniapost.gr Within minutes, he was in full arrest. The ER doctor told me he suspected meningococcal meningitis, and that there had already been several cases in our area in the last month. I had no idea, since I had never come in contact with this deadly disease. My son died within 1 hour of serious symptoms presenting. Imagine my shock only 2 days later to learn that there is a vaccine available. I have talked with many people, including doctors and nurses, who were not aware that a vaccine existed.
A Deadly but Preventable Disease
by Miltiades Markatos Pneumonologist
p.26
health & nutrition
Saturday, September 11 started the same as any other. At around 9 AM, I was on the phone when [my son] Aaron said his shoulder hurt and he had a headache. He climbed into bed. . . . His temperature began to rise and he vomited. . . . His temperature had risen to 39C. . . . At the hospital, I told the admitting nurse each symptom and said I was worried that it was meningitis. . . . We went in to see the doctor. Again, I said meningitis. He did a general examination. He ordered blood tests and a chest x-ray, for pneumonia. . . . When the results came back, he told us it was a virus and to come back in 3 days. . . . As the evening wore on, I again started to worry. He was still vomiting occasionally but was able to drink water. The fear started to set in when he had a bowel movement and didn’t seem to notice. Then I noticed a bruise on his neck -not a pinprick rash, a bruise. . . . That
was it, we woke up our other son and went to the local ER. . . . All I had to do was move the sheet and show the bruise on his neck. We were rushed through immediately. I laid Aaron gently on the bed, keeping hold of his hand. That was the last time I saw him alive. . . . I truly believe that Aaron died not just from meningitis but also from ignorance. We have to get the message out. This is real, it is killing and maiming our children. I thought I was protected because I knew the symptoms. That only helps if the doctors know them, too. These scenarios -- heartbreakingly similar to hundreds of thousands of other meningitis cases with fatal outcomes -are devastating. Adding to the tragedy is the fact that these deaths could have been avoided -- either through vaccination or by accurate diagnosis and rapid intervention. According to a World Health Organization estimate, about 171,000 people worldwide die from bacterial meningitis each year. Even with antimicrobial treatment, fatality rates are as high as 5% to 10% in the developed world. Meningitis is a viral or bacterial infection of the meninges (membranes that surround the brain and spinal cord)
that enters through the bloodstream from other parts of the body. The meninges have no host defences to fight off invading bacteria. The classic presentations of meningitis are fever, headache, meningismus (nuchal rigidity), and signs of cerebral dysfunction such as confusion, delirium, or impaired consciousness. However, in the vast majority of cases, only 1 or 2 of these symptoms will be present, so the diagnosis is not always so clear-cut. Additional presenting symptoms include nausea, confusion, sleepiness, stupor, visual discomfort, and seizure activity. All of the above-mentioned characteristics are harder to detect in infants -- signs to look for in the very young include lethargy, irritability, vomiting, and poor appetite. Symptoms may have a sudden onset, whereby the patient becomes severely ill within a matter of hours, or they may develop more gradually (over the course of 1 to 2 days). Early diagnosis of meningitis is crucial. In many cases, a missed diagnosis can have fatal consequences. The germs that cause bacterial meningitis are very common and live naturally in the back of the nose and throat. At any given time, 10% of the population are carri-
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ers of the disease but never actually become ill. In fact, most cases of meningitis are acquired through exposure to asymptomatic carriers. Meningitis can be spread via nose and throat secretions (eg, coughing, sneezing, and kissing); however, meningitis is not considered to be a highly contagious disease; casual contact or breathing in the air where a person with meningitis has been normally would not expose someone to meningitis because the causative organisms cannot live outside the body for very long. By identifying the causative agent, the appropriate antibiotic can be administered. If antibiotics are started when the patient is already in an advanced stage of the disease, the patient’s chance for survival is poor. Vaccination is the only known way to protect against meningitis. Unfortunately, there is no single vaccine available that can prevent all forms of meningitis. Worldwide efforts to develop new vaccines in the fight against meningitis continue. Vaccination efforts can go a long way in minimizing the impact of this disease and reducing the number of deaths in its wake.