Meningococcal meningitis is a severe bacterial infection of the bloodstream and meninges (a thin lining covering the brain and spinal cord). The microorganism that causes this condition is called meningococcus or Neisseria meningitidis (N. meningitidis).
The meningococcus bacteria is spread by direct close contact with nose or throat discharge of an infected person. Many people carry this particular bacteria in their nose and throat without any signs of illness, while others may develop serious symptoms.
Meningococcal meningitis occurs as a communicable disease between humans. It is often found in young military recruits living together, or among college students living in close quarters in dormitories.
When the cerebrospinal fluid is invaded by this blood-borne organism. Originating in the respiratory tract, the meningococcus bacteria travels, via the blood, into the cerebrospinal fluid (the watery liquid that surrounds the brain and spinal cord). During infection, the bacterium releases a toxin into the fluid causing an inflammatory reaction.
If the bacteria invades the blood it can lead to arthritis, heart infections and pneumonia. If it damages the nerves leading into the brain it could cause hearing loss, learning disabilities, motor impairment or mental retardation.
The most common symptoms of meningococcal meningitis are:
- Stiff neck
Symptoms may also include:
- Inability to completely extend the legs
- Stiffness in knees and hips
The symptoms may appear 2 to 10 days after exposure, but usually within 5 days.
A medical history and physical examination are useful but not specific enough to make the diagnosis. Typically a lumbar puncture (also called a spinal tap) must be done. This procedure is done by injecting local anesthetic (numbing medicine) into the skin of the lower back, then inserting a hollow needle into the lower part of the spinal canal and withdrawing some cerebrospinal fluid. The fluid is then stained and cultured to determine the causative organism and to look for signs of infection (white blood cells, bacteria, protein).
Cultures of blood, sputum and urine will also be obtained. In all patients with suspected meningitis, chest films and CT scans of the brain are done to look for other sources of infections and to rule out other diagnoses.
Bacterial meningitis is a medical emergency. Every hour of delay in starting antibacterial (antibiotic) therapy increases the risk of complications and permanent neurological damage. Treatment with intravenous antibiotics (such as penicillin G or ceftriaxone) should be started immediately, in some cases even before the lumbar puncture. The regimen of intravenous antibiotics may be continued for up to 7-10 days.
Household members, close friends at school and at home with intensive exposure, and - if the child attends child care - all preschool children who are cared for in the same room, should receive an antibiotic such as rifampin, ceftriaxone or ciprofloxacin as soon as possible (preferably within 24 hours of the diagnosis) as a preventive measure.
Is it contagious?
Can a person who was just "in the room" contract meningococcal meningitis?
Is there any permanent damage?
How long until the condition goes away?
Can a person get meningococcal meningitis again?
A vaccine called meningococcal polysaccharide is used to prevent infection by certain groups of meningococcal bacteria. The vaccine works by causing the body to produce its own antibodies against the disease. This vaccine only applies to the Groups A, C, Y and W-135 of the meningococcal bacteria. The vaccine will not protect against Group B. The vaccine is recommended for persons who:
- Are age two (2) or older
- Are susceptible to certain conditions that may cause meningococcal meningitis
- Are living in, working in, or visiting an area where there is a high incidence of meningococcal infection
- Are exposed to areas where the epidemic is occurring and the cases are due to Groups A, C, Y, and W-135
- Are military recruits
- Have no spleen