Childhood illnesses

Meningitis in children. 10 things you should know about this disease

Meningitis in children. 10 things you should know about this disease

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Every April 24 the World Meningitis Day, a disease that, according to the World Health Organization (WHO), can cause significant brain damage and is fatal in 50% of cases it can become fatal without treatment, always being considered a medical emergency. What is meningitis? How is it spread? What symptoms do you ask? We answer all these questions!

Santiago García Blanco, president and one of the founding partners of the Spanish Association against meningitis. He knows this disease very well, because in January 2016 he took away his daughter Candela. Since then, he has fought to raise public awareness, spread prevention and support meningitis research. We have spoken with him to learn more about this terrible disease.

What is meningitis and what types are there?
Meningitis is an infection and inflammation of the membranes that surround the brain and spinal cord, the meninges. It can be of two types, viral and bacterial.

Are all types the same? What is the difference between them?
Viral meningitis, typically due to enterovirus, is usually more benign, although its potential cognitive sequelae are not negligible. Bacterial, for its part, is the most dangerous and can lead to sepsis, which is when the infection travels throughout the body through the blood.

Within the bacterial there is an additional variety. There are those caused by meningococcus, pneumococcus, Haemophilus (Hib), and streptococcus. And within the meningococcus are types A, B, C, W, X, Y to mention those that cause the majority of cases worldwide. Within these, the current highest number of annual cases in Spain is divided between B, W, C and Y, in that order.

Who are the people most at risk of contracting this disease?
The highest risk ages are 0-5 years and then there is a rebound in cases in adolescents aged 15 to 24 years, although meningitis can strike at any age. Meningitis affects 99% of healthy people, although there are also defined risk groups (people with asplenia, properdin or complement factor deficiency, etc.)

Why is it produced?
It is due to a combination of factors. The majority of the population lives with the causative bacteria and, even, a high percentage of us are carriers in the nasopharynx. Most of us are immune to infection, however, when a host with low defenses is combined (it is also the subject of study if there is any genetic predisposition, although there are no conclusions yet) and a particularly virulent strain of bacteria can be unleashed the infection.

How is contagion produced and can it be avoided?
Meningitis is not a particularly contagious disease and thanks to the successive introduction in the vaccination schedule of the different vaccines available, the chances of contracting it are currently low (0.8 cases per 100,000 inhabitants in Spain in 2018). Even so, meningococcus coexists with us without consequences and spreads through the respiratory secretions of a carrier or an infected person: by coughing, sneezing, sharing a glass, a cigarette ...

What symptoms does it present?
The big problem with meningitis is that it is a very fast-evolving disease and it is essential to get to the ICU of a hospital on time to receive treatment, and yet the symptoms are nonspecific and can easily be mistaken for a cold or flu. , making the diagnosis very difficult for primary care or pediatric professionals.

Symptoms include vomiting and high (and non-remitting) fever, chills, headache and joint pain, abnormal skin color, cold hands and feet, fast breathing, neck stiffness, fainting spells, and for their specificity and indication seriously, petechiae, which are pink / purple spots on the skin anywhere on the body that do not disappear when pressed with a glass.

How is meningitis treated?
Once the causative bacteria and strain have been identified in the hospital, thanks to lumbar puncture and culture, it is treated with the most appropriate and effective antibiotic.

What consequences can it have for a person with meningitis?
Meningitis can cause death in 24 hours. A percentage of more than 10% of deaths is calculated and around 20% of those affected are left with very serious consequences for the rest of their lives (amputations, deafness, blindness, cognitive retardation, etc.).

Post-traumatic stress and the personal and social cost for the affected person and their family is enormous and from the association we facilitate the accompaniment and all the psychological and social support available with our resources.

What to do if you have been in contact with a person with meningitis?
The Public Health action protocol in a case of meningitis includes chemoprophylaxis with antibiotics in the closest environment of the affected person, typically parents, siblings, classmates and teachers, to try to eliminate the carrier state and circulation of the causative bacteria.

Is there a vaccine? How is it acquired and how is it administered?

The diversity of causative agents of bacterial meningitis means that several vaccines are needed to protect the population. Vaccines are in fact the reason for the significant reduction in cases in Spain and Europe in the last 30 years. The vaccination schedule in Spain has included the Haemophilus (Hib) vaccine since the 1980s. In the early 2000s, the meningococcal C vaccine was introduced and in 2014 the pneumococcal vaccine was introduced.

In 2015, the first effective vaccine against meningococcus B, which causes the largest number of cases in Spain, was authorized, although for now it must be paid for in pharmacies by parents to be administered later in their health center. In infants, its recommended regimen is 2 + 1 at 3, 5 and 12-14 months (the regimen is only 2 doses for those over 2 years old) and each dose costs € 106.15. The vaccine is safe and effective, it has been on the calendar in the United Kingdom since 2015 where it has already prevented more than 250 cases of meningitis B, and more than 30 million doses have already been applied worldwide.

The growing epidemiology in Spain of meningococcal types W and Y from other areas of the world (cases have doubled from 2017 to 2018) has also led to the clear recommendation to replace the vaccine only against C with the tetravalent ACWY that protects against all 4 types at once. The Ministry and the Autonomous Communities recently agreed to replace the current dose of vaccine against C at 12 years of age with ACWY and to carry out a rescue campaign for all adolescents between 13 and 19 years of age.

For greater protection, we believe that it would also be advisable to apply the ACWY to 12-month-old infants, as if Castilla y León, the Canary Islands and Andalusia have decided for the moment. If you do not reside in these Autonomous Communities, it is also possible to purchase it in pharmacies, at a cost of € 54 per dose.

You can read more articles similar to Meningitis in children. 10 things you should know about this disease, in the category of Children's Diseases on site.

Video: Introduction to bacterial meningitis (May 2022).