The simple facts on a deadly virus

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LIZ HUNT

Health Editor

What is meningitis?

The word meningitis means inflammation of the meninges, the delicate membranes that cover the brain and spinal cord. It is caused by a viral infection, usually mild, or a bacterial (menin- gococcal) infection which can be life-threatening.

A bacterium which lives harmlessly in the nose and throat of about 10 to 25 per cent of the population is responsible for most cases of meningococcal meningitis. Doctors do not know why the microbes move from the nose/throat to cause a systemic infection in carriers, or why non-carriers should become vulnerable.

Have there been more cases this winter than in previous winters?

Not according to the Public Health Laboratory Service which monitors reports of bacterial meningitis. However, cases may have peaked earlierthan normal. A number of clusters of cases in the pre- Christmas period heightened perception of a meningitis epidemic. GPs are also much more aware of meningitis now and inclined to refer suspected cases to hospital as a precaution. Some of these will not be due to meningitis. Provisional figures for 1995 from the laboratory show there were 1,361 cases of meningococcal disease and 185 deaths. In 1994, there were 1,129 cases reported and 148 deaths (provisional).

What treatments are available for meningitis?

Treatment for meningococcal meningitis is the prompt administration of large doses of intravenous antibiotic drugs. Antibiotics may also be prescribed to contacts of a meningitis victim although there is no guarantee of protection.

Vaccine development is problematic but some progress has been made. A vaccine against the bacterium hamophilus influenzae b, has controlled one type of bacterial meningitis and it is now included in the NHS immunisation programme.Researchers are close to developing a vaccine for meningococcal strain C. An experimental C vaccine is available and has been used in some clusters this year.

How is the infection transmitted?

In droplets produced in coughs and sneezes, and by nose- blowing.

How infectious is it?

Not very infectious, which is why on average of only 2,000 people out of the total UK population contract the disease each year.

What are the symptoms?

The classic symptoms of bacterial meningitis are fever, a severe headache, nausea, vomiting, a dislike of light and a stiff neck. The symptoms develop rapidly, in many cases within a few hours, and are followed by drowsiness and there may be loss of conscious.

A characteristic red rash which spreads very quickly and is due to leaking capillaries appears in about half of all cases. Prompt diagnosis and treatment with antibiotics are crucial to maximising chances of survival, and limiting spread of the infection in the body.

9 The National Meningitis Trust Helpline is 0345 538118.

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