Bacterial MeningitisBrie Noble

What is Meningitis? Infection of the Meninges (membranes around the brain and spinal cord)

It can be caused by bacteria, fungi or a virus

Bacterial Meningitis is the most common, accounting for nearly “80% of all cases are acute bacterial meningitis”

People with viral meningitis are much less likely to have permanent brain damage after the infection resolves

3 “Main Types” Meningococcal disease (Neisseria

meningitidis)

reside in the throats and nasal passages of approximately 10 percent of the general population

Pneumococcal disease (Streptococcus pneumoniae) Can cause meningitis and blood infection

Can cause otitis media (middle ear infection)

Hib (Haemophilus influenzae type b) disease

primarily attacks the very young

nearly eradicated in the U.S. since infant vaccination programs in 1980’s

Age Group Causes

Newborns Group B StreptococcusEscherichia coli

Listeria monocytogenes

Infants and Children Streptococcus pneumoniaNeisseria meningitides

Haemophilus influenzae type b

Adolescents and Young Adults

Neisseria meningitidesStreptococcus

pneumoniaeOlder Adults Streptococcus pneumonia

Neisseria meningitidesListeria monocytogenes

(eating contaminated food)

http://www.cdc.gov/meningitis/bacterial.html

Who is most affected? Children

Adults who abuse alcohol

Chronic nose and ear infections

Pregnant women

Corticosteroids

Brain or spinal surgery

Blood Infections

Immunocompromised

Living in close contact living situations

Travelers to the “meningitis belt” or those travelling to Mecca on Hajj and Umrah pilgrimage

http://www.drugfree.org/wp-content/uploads/2010/09/alcohol1-300x267.jpghttp://africanwomennetwork.org/wp-content/uploads/2013/09/pregnant-woman.jpghttp://images.nationalgeographic.com/wpf/media-live/photos/000/661/overrides/neurosurgery-for-bears_66160_600x450.jpghttp://housing.unca.edu/sites/housing.unca.edu/files/images/dorm2.jpghttp://www.cdc.gov/meningitis/lab-manual/chpt02-epi.html

http://www.who.int/immunization/monitoring_surveillance/burden/estimates/pneumo_hib/Hib_deaths_map.JPG?ua=1

6 June 2013 - From 1 January to 12 May 2013 (epidemiologic week 19)

9,249 suspected cases of meningitis

857 deaths

Case fatality ratio of 9.3 percent

Reported from 18 of the 19 African countries under enhanced surveillance for meningitis

Meningococcal disease: 2013 epidemic season in the African Meningitis Belt

http://www.who.int/csr/don/2013_06_06_menin/en/

http://www.cdc.gov/meningitis/lab-manual/chpt02-epi.html

http://media3.s-nbcnews.com/i/msnbc/Components/Art/HEALTH/050526/Chart_Meningitis1.gif

Symptoms

http://www.austincc.edu/microbio/2993q/nm.htm

http://www.corbyccg.nhs.uk/modules_site_specific/guide/printablePages/meningitis.html

Diagnosis Blood, urine and mucous samples from

the nose and throat

Physical exam looking for:

Purple or red rash on the skin

Stiffness in the neck

Hip and Knee Flexion

A spinal tap will be ordered to determine if it is fungal, viral or bacterial

A spinal tap is also called a lumbar puncture

a hollow needle is inserted into the subarachnoid space (canal in that carries cerebrospinal fluid) in the lower back region of the spinal column

http://www.uspharmacist.com/continuing_education/ceviewtest/lessonid/108112/

Treatment

Prognosis Mortality rate for meningitis of all causes: between 4% -14%

Mortality rates for meningococcal meningitis: 4% - 8% in children and up to 7% in adults

Mortality rate for GBS meningitis: 7% - 27% in neonates and up to 30% in adults

Complications/other effects:

Neurologic sequelae in up to 50% of pneumococcal meningitis survivors

Hearing loss is present in up to 30% of pneumococcal meningitis survivors and 1% - 8% of meningococcal meningitis survivors

Long-term sequelae: present in up to 30% of children

Among those who survive, approximately 20% suffer long-term consequences

Mortality Rate Long term Squelae0

10

20

30

40

50

60

70

80

90

100

1420

8

2027

255

50

The Devastation of Meningitis

All Meningococcal GBS Hib

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ase

s

http://www.dailymail.co.uk/health/article-2547055/New-meningitis-vaccine-NHS-says-children-Meningitis-B-kills-hours-cost-survivors-limbs-So-arent-families-spared-heartbreak.htmlhttp://trialx.com/curetalk/wp-content/blogs.dir/7/files/2011/05/diseases/Memory_Loss-3.jpghttp://i1.ytimg.com/vi/xpVu-quhUCM/maxresdefault.jpghttp://manuprem.com/images/sideld.jpghttp://theaslproject.files.wordpress.com/2010/06/deaf-sign-language.jpghttp://www.timeslive.co.za/incoming/2013/05/05/epilepsy.jpg/ALTERNATES/crop_630x400/epilepsy.jpghttp://www.dramming.com/wp-content/uploads/2012/02/blind.jpghttp://forward.com/workspace/assets/images/articles/story-philologos-090711.jpg

Prevention VACCINATIONS for Neisseria meningitidis (meningococcus), Streptococcus

pneumoniae (pneumococcus), and Haemophilus influenzae type b (Hib)

Not smoking and avoiding cigarette smoke

http://www.houstontx.gov/health/Environmental/No_smoking_sign.jpghttp://www.who.int/features/2010/meningitis_vaccine/meningitis_vaccine_05.jpg

http://www.nature.com/nrmicro/journal/v10/n3/images/nrmicro2713-f2.jpg

PorB

PorB Continued

Works Cited

http://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/lumbar_puncture_lp_92,P07666/

http://www.uspharmacist.com/continuing_education/ceviewtest/lessonid/108112/ (tables)

http://www.who.int/csr/don/2013_06_06_menin/en/

http://www.cdc.gov/meningitis/lab-manual/chpt02-epi.html

http://my.clevelandclinic.org/disorders/meningitis/hic_bacterial_meningitis.aspx

Criss, A. K., & Seifert, H. S. (2012). A bacterial siren song: intimate interactions between Neisseria and neutrophils. Nature Reviews Microbiology, 10(3), 178+.

Jarvis, G.A., & Vedros, N.A. (1987). Sialic Acid of Group B Neisseria meningitides Regulates Alternative Complement Pathway Activation. Infection and Immunity. 174-180.

Massari, P., King, C.A., Ho, A.Y., & Wetzler, L.M. (2002). Neisserial PorB is translocated to the mitochondria of HeLa cells infected with Neisseria meningitides and protects cells from apoptosis. Cellular Microbiology, 5(2), 99-109.