WHAT IS MENINGITIS?

What is meningitis?
Meningitis is an infection of the fluid and lining that surrounds the brain.

What causes meningitis?
Meningitis is usually caused by a viral or bacterial infection. Viral meningitis is generally mild and resolves without specific treatment.
Bacterial meningitis comes in two main forms : Meningococcal and Pneumococcal. Before the 1990s, Haemophilus was the leading cause of bacterial meningitis, but now all children are vaccinated (HIB) against this and the disease has almost vanished. Bacterial meningitis can be quite severe and may result in brain damage, hearing loss, learning disability or even death.

How common is the disease and the bacteria?
Bacterial meningitis is very rare. In Gibraltar we see about 1 or 2 cases a year or even less.
However, the bacteria which cause both meningococcal and pneumococcal meningitis are very common and live naturally in the back of the nose and throat. At any one time, around 20 per cent of the population are carrying the germ. That's more than 5,000 persons in Gibraltar.
People of any age can carry these germs for days, weeks or months without becoming ill. In fact, being a carrier helps boost natural immunity to the disease. Only rarely do the bacteria overcome the body's defences and cause meningitis.

Is meningitis contagious? How is the disease spread?
Yes. The bacteria are spread between people by coughing, kissing and sneezing. They cannot live outside the body for long, so they cannot be picked up from water supplies, swimming pools, buildings or factories. They also cannot be picked up by just breathing the air where a person with meningitis has been.

What are the signs and symptoms of meningitis?
High fever, headache, stiff neck and irritability to bright light are common symptoms of meningitis in anyone over the age of 2 years. New-borns and small infants may appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. A severe form of meningococcal infection occurs with a rash that does not fade when pressed under a glass plate, and the child will become ill very quickly.

What should be done?
Early diagnosis and treatment are very important.
If the above symptoms occur or if in doubt where a child is concerned, doctor's advice should be sought immediately. Bacterial meningitis can be treated with effective antibiotics provided if treatment is started early in the course of the disease.

How serious is the disease?
In most countries, the death rate is about 10-15% of the cases. We believe that our rate in Gibraltar is lower, but we cannot afford to be complacent.

Why are friends and relatives sometimes treated?
The bacteria that cause meningitis may have spread to the sick person from other people who have had close contact with him/her. These people may innocently spread the bacteria again. Hence they are treated with special antibiotics to prevent spread. Doctors have guidelines for deciding who should be treated.

Are there vaccines against meningococcal meningitis?
There is now a vaccine against Group C meningococcal disease which is being gradually introduced as part of the childhood immunisation programme. Unfortunately there is no vaccine against Group B meningococcal disease, and therefore parents and nursery carers will still need to be aware of the symptoms and early signs of meningitis so that they can seek medical advice urgently if necessary.