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Vaccination is critical

by Jodi DeLong

Dr. Joanne Langley is an infectious disease specialist and deputy director of the Canadian Centre for Vaccinology at the IWK in Halifax.

Photo credit: Calnen

Babies and toddlers cannot tell us how they are feeling, and sometimes there’s more going on than we as parents might think. Occasionally, a group of symptoms including sudden high fever, lethargy, stiff neck and headache, light sensitivity and other signs may suggest a form of meningitis. While not as common as they once were, infections of meningitis can be serious, with long-term damaging effects such as brain damage, deafness, learning challenges and seizures. Yet what we hear and read about meningitis can be very confusing. Happily, there are medical professionals who are expert in deconstructing the info out there for parents. 

What is meningitis?

Meningitis is an inflammation of the protective membranes, the meninges, that cover the brain and spinal cord. Infection by various bacteria, viruses, and more rarely, fungus, will trigger swelling of the meninges, but other, more rare causes of the inflammation can include reactions to certain drugs, injuries to the head or spine, and types of cancer.

Dr. Joanne Langley is an infectious disease specialist and deputy director of the Canadian Centre for Vaccinology at the IWK in Halifax. She explains that the two main types of meningitis are bacterial and viral pathogens.

“Bacterial meningitis is a serious and life-threatening infection,” she states. A number of different species of bacteria can cause meningitis, although “since the introduction of routine immunization programs against Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type B, the incidence of bacterial meningitis has greatly decreased and is now very uncommon in vaccinated children.” Before the vaccines were developed, bacterial meningitis was a cause of death (about 10 per cent of cases) and neurologic deficit (example, hearing loss) in patients.

There are also different types of viral meningitis. Dr. Langley says that some are very serious (example Herpes meningitis) and some are less serious and get better on their own over time. Due to vaccines against bacterial meningitis, viral meningitis is now more common in children than bacterial meningitis.

Dr. Langley also explains that some pathogens are more likely to cause illness at certain times of life. “For example, people less than two years of age and older than 65 years are more likely to get serious pneumococcal (Streptococcus pneumoniae) meningitis or blood infections. People of any age can get viral meningitis.” Occasionally, a newborn contracts the disease when it is exposed to bacteria that may cause meningitis as it exits through the birth canal.

Meningococcal disease is not exactly the same thing as meningitis; it is specifically caused by the Neisseria bacteria, and can result either in meningitis or septicemia, a serious infection in the bloodstream. The Centres for Disease Control indicates it can be spread by close contact with the saliva of others (coughing, sneezing or kissing) but is not normally as contagious as other forms. Many signs are the same as in meningitis, but if bacteria has spread into the bloodstream, symptoms such as cold chills, aches and pains in muscles and joints, and diarrhea may be present. If a dark purple rash develops, treatment is urgent. There are very effective antibiotics to treat the disease, and dedicated vaccines against the bacteria.

Prompt diagnosis

Normally, the pathogens that cause bacterial meningitis are spread from one person to another by a number of means—from food that has been contaminated, from other infected people coughing or sneezing in close proximity, or from carriers—who carry the bacteria in their bodies but do not get sick. Occasional outbreaks take place on university campuses, where large groups of people live and attend classes and other activities together.

Children who are not vaccinated or who have weak immune systems due to such conditions as immune deficiency, a recent transplant, or cancer treatments are more susceptible to meningitis than are healthy children.

Symptoms of bacterial meningitis generally appear three days to a week after exposure, although this is not easy to track timewise if there’s no knowledge of a prior exposure. Children with meningitis may be confused, bothered by light, be lethargic, have a headache, nausea and/or vomiting, or exhibit a stiff, sore neck and fever. If you are concerned that your child is unwell, you should take your child to a health care professional. Viral meningitis is the more common form of meninges inflammation, and people often recover without treatment. A number of common viruses can occasionally cause meningitis, including mumps, measles and influenza viruses. It’s still very important to see a health professional because the form needs to be diagnosed. Infants less than a month old and those with weakened immune systems are more apt to have illness from viral meningitis.

A health professional will take a history of the illness, do a physical examination, take blood tests, and do a lumbar puncture—removing some fluid from the area surrounding the spinal cord.

Treatment and prevention

Once diagnosis is confirmed, treatment can commence. “Depending on the cause of the meningitis, antibiotics or antiviral medications may be used,” Dr. Langley says. She adds that there are very few treatments for viral meningitis, and, of course, antibiotics do not work on viral diseases.

The most important way to prevent bacterial meningitis is to make sure your child receives all recommended vaccines. Dr. Langley says, “the vaccines routinely provided to children prevent more than 20 types of meningitis.” Before the MMR (measles, mumps and rubella) vaccine was developed, those diseases could lead to viral meningitis, so vaccinations have greatly reduced cases of meningitis.

Prevention is half the battle with many diseases: staying healthy with adequate sleep, exercise, good nutrition and excellent hygiene, especially around other people who are sick will, help prevent many infectious diseases.

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