Meningitis – Be aware of the early signs and symptoms
Meningococcal disease or meningitis commonly refers to any illness which is caused by the bacteria Neisseria meningitidis. More often that not, meningococcal illnesses are often very severe and can be deadly, resulting in infections of the lining of the brain, spinal cord and bloodstream (1). There are several different types of meningococcal disease, including serotypes A, B, C, W135 and Y. Groups B and C are the most common forms seen in Ireland (2).
Early symptoms of meningococcal disease include fever, headaches, vomiting, diarrhea, muscle pain, stomach cramps and a fever (2). Those infected with this illness often appear confused or disorientated. This infection is often linked to children with babies and infants often disliking bright lights and suffering from stiffness in the neck. If the bacteria enter the bloodstream, this may often result in a rash, due to the release of toxins which can damage the walls of blood vessels, resulting in a rash (2).
What causes meningococcal disease?
The bacteria that cause the meningococcal meningitis and meningococcal septicaemia are common and can live naturally in the back of the nose and throat. It is spread by respiratory droplets, most efficiently produced by coughing, sneezing and mouth kissing. Depending on the age group, up to 1 in 10 people may carry this bacterium, of the 15–19-year-old age group, 25% are carriers. Only a small minority of carriers will develop meningitis or septicaemia after an incubation period of 2-3 days as carriers typically develop immunity. Why some people develop meningitis and others don't is not fully known but it is believed that on occasion the bacteria can overcome the body's immune system and cause meningitis and meningococcal septicaemia.
Ireland has one of the highest notification rates on invasive meningococcal disease (IMD) in Europe, with an incidence rate of ~1.5 cases per 100,000 population (4). Recently the Department of Public Health has launched an investigation in Ireland, due to the recent cases of this fatal infection. A total of two young people have died as a result of this outbreak, with a number of cases detected in young adults or children (3). Close contacts are being identified and will be provided with antibiotics to prevent infection and will also be offered vaccine if appropriate. The HSE has urged vigilance, with any suspected carriers to seek medical attention immediately. If you see or suspect a rash, this can be an early sign of infection.
Remember: Meningitis and septicaemia often happen together. Symptoms can appear in any order. Some may not appear at all.
Early symptoms can include:
• Fever
• Headache
• Neck stiffness
• Vomiting
• Drowsiness
• Discomfort from bright light
• Diarrhoea
• Muscle pain
• Stomach cramps
• Fever with cold hands and feet
• A rash may appear (pin-prick type marks which if untreated can spread to form bruises or blood blisters). DO NOT WAIT FOR A RASH. If someone is ill and getting worse, get medical help immediately.
(1) https://www.cdc.gov/meningococcal/index.html
(2) https://www.hpsc.ie/a-z/vaccinepreventable/bacterialmeningitis/factsheets/
(3) https://www.thesun.ie/news/9528222/tributes-young-galway-man-meningitis/
(4) https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/chapter13.pdf