Meningitis
Meningitis is an inflammation of the meninges--the three layers of protective membranes that line the spinal cord and the brain. Meningitis can occur when there is an infection near the brain or spinal cord, such as a respiratory infection in the sinuses, the mastoids, or the cavities around the ear.Disease organisms can also travel to the meninges through the bloodstream. The first signs may be a severe headache and neck stiffness followed by fever,vomiting, a rash, then convulsions leading to loss of consciousness.
To diagnose meningitis, a sample of spinal fluid must be drawn from the lumbar region of the spine, a procedure known as a spinal tap. The spinal fluid isexamined to reveal the microorganisms present in it. A diagnosis of bacterial meningitis requires immediate treatment with antibiotics.
The meningococcus bacteria, Neisseria meningitides, is a diplococcus that cannot move on its own. The bacteria spread from person to person in droplets in the air. Untreated, the disease advances quickly. It is fatal in about 15% of cases--significantly higher in infants and adults over sixty. In theUnited States, it affects between 2,000 and 5,000 young people each year, 70% of whom are under five years of age. Those who recover may suffer from somebrain damage. Another type of bacterial meningitis, tuberculous meningitis,affects young children in third world countries where tuberculosis is common.Meningitis can also be caused by a virus. Viral meningitis usually requireslittle treatment and subsides within a week or two. It occurs most often in winter time. While data indicate that between 9,000 and 12,000 young people each year in the United States are affected with viral meningitis, many more cases may actually occur because people with mild forms of viral meningitis often do not see a physician.
Before antibiotics were available, bacterial meningitis was a dreaded disease, taking a toll on the young and leaving those who survived blind, deaf, or mentally retarded. A pioneer in the research of this disease and its cure wasDr. Sara Elizabeth Branham (1888-1962), who worked at the National Instituteof Health in the early part of the twentieth century. Initially she did someresearch on bacterially caused food poisoning; but after the epidemic years of World War I she worked on the specific antiserum to combat meningitis. During World War I, cases of the disease ran rampant among soldiers, often leading to lengthy quarantines to prevent its further spread. Knowing that many strains of infectious bacteria could be responsible, Dr. Branham developed laboratory procedures that enabled technicians to determine which type of infection was present. At that time, the only treatment for meningitis was an antiserum (developed from horses) which had been losing its power over the years. Branham substituted a more effective serum extracted from rabbits. In 1937, Dr.Branham and a coworker discovered that the newly developed sulfonamide drugs( sulfonamides) were effective in treating meningitis. Sulfadiazine was thenused along with antiserum as an effective treatment and was responsible forkeeping meningitis at bay during World War II. Dr. Branham wrote widely aboutthe disease and was recognized for her dedicated work with awards and honorary degrees.
Today bacterial meningitis is curable if treated promptly with antibiotics, usually administered intravenously. Vaccines against meningitis are sometimesadministered during epidemics. A vaccine against haemophilus influenzae typeb (Hib), which was a major cause of bacterial meningitis, has reduced Hib meningitis cases by as much as 95 percent. However, because of the variety of disease organisms that can cause meningitis, this vaccine is not effective against other types of meningitis, and vaccines are generally of limited use forprevention.