SUNDAY MAGAZINE

Deal with meningitis

IN 1985 India last had a spate of meningitis cases caused by the bacterium, Neisseria meningitidis. Strangely this is an organism that lives peacefully in the noses and throats. But once in a way, for reasons we do not know yet, it can infect the blood stream or the coverings of the brain (meninges) and cause trouble.

Whether it does so first in carriers and then affects others who breathe in the organism or ingest it due to close contact, or whether carriers get spared, like the proverbial Typhoid Mary who spread typhoid but never caught it herself is not known. But when meningitis breaks out all hell breaks loose.

It affects children under one year and under five the most, though teens and the elderly are also vulnerable. It spreads rapidly in closed communities. So much so the American Academy of Paediatrics recommended that all freshmen joining college be vaccinated against meningococcal meningitis. About seven strains of meningococci are known; fortunately the one responsible for the recent outbreak was type A one, which responds well to antibiotics.

Fever, headaches, nausea, inability to tolerate bright light, neck pain and stiffness, blotchy skin rashes, drowsiness, fits and irritability may be symptoms. A whimpering infant who feeds poorly, has fever, has a stiff neck, skin rash, or fits needs to be checked out. Blood tests, a CT scan and studying the cerebrospinal fluid help clinch the diagnosis.

Certain other bacterial and viral meningitides can mimic meningococcal meningitis but the blotchy skin rash that occurs when meningococci flood the blood is special for meningococcal infection.

World over, statistics say that once a decade or so one can expect an epidemic; and the mortality rate is roughly 10 per cent; be it in the U.S. or Asia. The highest incidence of disease is in sub-Saharan Africa. Inactivated vaccine prepared from the polysaccharide capsule of the organism given as a single shot protects against disease for around three years; but it is not routinely advocated for the public. During epidemics, contacts are vaccinated; but putting them on antibiotics to prevent disease is another option.

Any precautions to take? Eat well, drink adequate fluids; in case of an outbreak, avoid going to theatres and such places where crowds breathe the same air all the time; avoid eating out. If you have fever and headache or if anyone in your area has been diagnosed with meningitis; see your doctor. A prompt course of antibiotics could save you much trouble; or perhaps you may be advised a shot of the vaccine. In any case there is no need to panic.

DR. HIRAMALINI SESHADRI

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