Perspective

Infection of brain’s coverings

The scene

TKK has been residing in the northern part of the country all his life. He is a food crop farmer and usually look forward to the dry season for two reasons. Firstly, it signals the maturation of some of his crops, Secondly, he enjoys the cold/hamarttan associated with the season but the last harvest season was one like no other, he almost lost his life! He woke up on a particular day hoping to go through his usual routine but had to cope with a thunderous headache which made him retire home early. Then came this uncontrollable fever, neck stiffness and irrational talk/behavior before he passed out. He ended up spending 4 weeks in a secondary health facility. Over 800 Nigerians were lost to meningitis in the 2017 outbreak, recently, 9 children were lost to same in a Northern state year ago.

What it is

Meningitis is an inflammation (swelling) of the delicate membranes (meninges) surrounding the brain and spinal cord. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck.

Risk factors

Risk factors for meningitis include: • Skipping vaccinations. Risk rises for anyone who hasn’t completed the recommended childhood or adult vaccination schedule. • Age. Most cases of viral meningitis occur in children younger than age 5. Bacterial meningitis is common in those under age 20. • Living in a community setting. College students living in dormitories, personnel on military bases, and children in boarding schools and child care facilities are at greater risk of meningococcal meningitis. This is probably because the bacterium is spread by the respiratory route, and spreads quickly through large groups. • Pregnancy. Pregnancy increases the risk of listeriosis — an infection caused by listeria bacteria, which also may cause meningitis. Listeriosis increases the risk of miscarriage, stillbirth and premature delivery.
• Compromised immune system. AIDS, alcoholism, diabetes, use of immunosuppressant drugs and other factors that affect the immune system can also make one more susceptible to meningitis. Having the spleen removed also increases one’s risk, and patients without a spleen should get vaccinated to minimize that risk.

Types/Causes Viral Meningitis

It is the most common type of meningitis. Viruses in the Enterovirus category cause 85 percent of cases. These are more common during the in the dry season and they include: coxsackievirus A, coxsackievirus B and echoviruses. Others include West Nile virus ,influenza ,mumps, HIV, measles, herpes viruses.

Bacterial Meningitis

The types of bacteria that cause bacterial meningitis vary according to the infected individual’s age group; • In premature babies and newborns up to three months old, common causes are group B streptococci and bacteria that normally inhabit the digestive tract such as Escherichia coli . Listeria monocytogenes is transmitted by the mother before birth and may cause meningitis in the newborn. • Older children are more commonly affected by Neisseria meningitidis (meningococcus) and Streptococcus pneumoniae and those under five by Haemophilus influenzae type B (in countries that do not offer vaccination). • In adults, Neisseria meningitidis and Streptococcus pneumoniae together cause 80% of bacterial meningitis cases. Recent skull injury potentially allows nasal cavity bacteria to enter the meningeal space. An infection in the head and neck area, such as otitis media (infection of the middle ear) can lead to meningitis in a small proportion of people.

Fungal

There are a number of risk factors for fungal meningitis, including the use of immunosuppressants (such as after organ transplantation), HIV/AIDS, and the loss of immunity associated with aging.

Non-infectious

Meningitis may occur as the result of several non-infectious causes: spread of cancer to the meninges (malignant or neoplastic meningitis) and certain drugs (mainly nonsteroidal anti-inflammatory drugs, antibiotics and connective tissue disorders.

What gives it away

Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days. Possible signs and symptoms in anyone older than the age of 2 include: Sudden high fever, Stiff neck, Severe headache that seems different from the usual, Headache with nausea or vomiting, Confusion or difficulty concentrating, Seizures, Sleepiness or difficulty waking, Intolerance to light (photophobia), Intolerance to loud noise (phonophobia), No appetite or thirst, Skin rash (sometimes, such as in meningococcal meningitis), The fontanelle (the soft spot on the top of a baby’s head) can bulge in infants aged up to 6 months.

Treatment

For viral; supportive therapy. For bacterial;Antibiotics, For Fungal; antifungal. All these after the appropriate tests have been carried out by the doctor.

Prevention

Common bacteria or viruses that can cause meningitis can spread through coughing, sneezing, kissing, or sharing eating utensils, a toothbrush or a cigarette. These steps can help prevent meningitis: • Wash your hands. Careful handwashing helps prevent germs. Teach children to wash their hands often, especially before eating and after using the toilet, spending time in a crowded public place or petting animals. Show them how to vigorously and thoroughly wash and rinse their hands.

• Practice good hygiene. Don’t share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone else. Teach children and teens to avoid sharing these items too.

• Stay healthy. Maintain your immune system by getting enough rest, exercising regularly, and eating a healthy diet with plenty of fresh fruits, vegetables and whole grains.

• Cover your mouth. When you need to cough or sneeze, be sure to cover your mouth and nose.

• If you’re pregnant, take care with food. Avoid cheeses made from unpasteurized milk. Choose cheeses that are clearly labeled as being made with pasteurized milk cook meat properly

• Immunization; Some form of bacterial meningitis are preventable with immunization

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