major role of bacterial meningitis

Bacterial Meningitis

Bacteria have played a major role on the development of the modern world. On the other hand it is also being a life threatening disease causing organisms for humans. Meningitis caused by bacterial infection was and is a dangerous disease which attacks the human central nervous system.

The central nervous system (brain & spinal cord) is lined by thin membranes called Meninges. The brain and the spinal cord is surrounded by the cerebral spinal fluid (CSF). When the CSF gets infected, it causes the meninges to inflame. This is called meningitis.

Meningitis could be caused by various factors, such as bacteria, virus, fungi and etc. This essay will elaborate on meningitis caused by bacteria which is known as bacterial meningitis (BM). BM is more dangerous than the meningitis caused by other factors. There are many types of bacteria that cause meningitis but only three of them are most commonly found to infect. They are Streptococcus pneumonia, Neisseria meningitides, and Haemophilus influenza type b (Hib).

Meningitis caused by the bacteria Neisseria meningitides (N.Meningitis) is also known commonly as Meningococcal meningitis. N.meningitis mostly infects children than the adults.[1] It is the first most common cause of bacterial meningitis in children where it is the second most common cause in adults. In contrast Streptococcal pneumonia is the first most common factor to cause meningitis in adults and the second most common in children. The infection by these bacteria is also known as pneumococcal meningitis. Even though these two bacteria are the most infection causing bacteria in current period, Hib was the type of bacteria which infected children highly in early days. Hib was controlled and the risk of infection by this was reduced after the introduction of a vaccine. [2] Even if it causes the 5% - 10% of infection in adults; it occurs in less than 2 in 100,000 populations of children.

Even though bacterial meningitis isn't particular in certain age group, infants and children are found to be infected by theses bacteria more than any other age group.

Fortunately, the bacteria that are responsible for this infection are not very contagious. A person does not get meningitis just by breathing the same air breathed by an infected person or by being in a place where the person was. These bacteria are carried by the respiratory secretions of a primary carrier (infected person). After the bacteria reaches a person's nose or throat it stays harmless. In rare instances they can cross the mucosal barrier, cross the nasopharyngeal epithelium, break through the body's natural immune system and enter the CSF where they begin to increase in number rapidly. When the cerebral spinal fluid gets infected, the meninges get swollen and inflamed which leads to the first symptoms of the meningitis.

The common symptoms of bacterial meningitis could develop in several hours or one/ two days. The most common symptoms are high fever, head ache, sore throat, respiratory illness and a stiff neck. These could be associated with one or more of the other symptoms such as confusion, nausea, vomiting, sensitive to light, drowsiness and lethargy. In the advanced stage it is also possible to develop bruises that would quickly spread under the skin. These symptoms could be in persons over age 2 only, it would be impossible to spot these symptoms in newborns and infants. But some other signs, such as inactivity, irritability, poor feeding, vomiting lethargic, high fever and high-pitched cry could be seen.

Bacterial meningitis could be fatal if it is not diagnosed at its early stage. Identifying the type of bacteria that is responsible for the infection is very important for the selection of the type of antibiotic, which should be started as soon as soon as possible. Different types of tests are been done to diagnose the infection. They are gram and stain culture test (of blood) and rapid tests for bacteria in the CSF. The gram and stain culture tests will help the doctor to identify the type of bacteria (gram negative or gram positive). I suggest that this test should be done immediately after suspecting the information, because it will help to start a suitable antibiotic treatment immediately, therefore the infection will be controlled and prevented from spreading to the others till the more specific and accurate results come from the other complicated tests.

The next test and a very important test is the rapid test for the bacteria in the CSF. The CSF is obtained from the suspected patient by medical personnel by a method called the Lumbar puncture or the spinal tap. While doing this test, the person would be asked to be seated in a chair in a curled position. A sterile spinal needle will be inserted between the 3rd and the 4th lumbar vertebrae in the lower spine. The taken sample will be observed under the microscope and would be studied for its colour, glucose level, WBC counts, proteins, and bacteria or any abnormal cell. The results would inform the doctor of the cause of bacterial meningitis from which he would be able to treat the patient with more specific medicines.

The doctor normally prescribes an antibiotic as soon as he suspects meningitis. Then he would arranged one or more of the tests mentioned above to confirm the cause of the bacterial infection and then he would prescribe a more powerful antibiotic such as [3] ceftraixone, which would be given through the arm with IV fluid. Sometimes steroid medication would also be used in children to reduce hearing loss, which is a common complication of bacterial meningitis in them.

Bacterial meningitis could be prevented by two ways, which are by vaccination and by maintaining cleanliness and hygienic condition. Vaccines are available for all three types of bacteria mentioned. Hib vaccines are given to prevent H.influenza. It is recommended for children under 2 years, adults over 65 years, and children over 2 years who are a high risk. Pneumococcal meningitis could be prevented by polysaccharide vaccine and conjugate vaccine. This is given for children under 5 years starting from 2 months. Meningococcal polysaccharide vaccine and Meningococcal conjugate vaccine are available to prevent Meningococcal meningitis. Bacterial meningitis vaccines are advisable for university first years who stay in dormant, people working at day care centres and travellers who visit countries which have a high rate of meningitis infection.

The other way is prevention is by being hygiene. As this infection spreads via tiny droplets which come out from their nose or mouth, sharing food, drinking glasses, eating utensils, tissues or towels have a high risk of transmitting the bacteria. It is always better not to share the above items and also to wash hands before eating and after using the toilet. These habits could avoid the risk of transmitting the bacteria.

Bacterial meningitis might have many complications which might require further and advanced treatment. Some children might develop neurological problems such as hearing loss, visual problems, seizures, and difficulty in learning. And also some organs such as heart, kidneys and adrenal glands also could be affected as a result. Therefore these children would require further treatment even after recovery.

Bacterial meningitis is one of the major reasons of morbidity and death in most of the developing countries. It effects these countries' economic in a large scale and upraise many social problems. As the vaccines and medicines are highly expensive, they require a substantial amount of funds for which the government would have to strive. Lack of vaccine would result in a major number of people attacked by BM. As a result labours and staff would be unable to turn up to work which would eventually cause a plunge in the country's economy.

[4]The civilians of the African continent are being affected by BM for about 100years. The rate of attack in these countries is from 100 to 800/ 100,000 population. But it is only 1 to 3/ 100,000 population in industrialised nations.

BM is a contagious disease, therefore there is a risk of the virus spreading in large populated places. [5] For example, in tear 2000/2001 several hundred pilgrims who attended the Hajj were infected by N.meningitidis. In an economically and socially developing country many reasons increase the rate of infection and death by Meningitis. Firstly, major group of people are uneducated, hence are unaware of the disease, its symptoms and the medical treatments. Therefore, even before they realise that they are affected by a dangerous disease and reach the medication centre many people die. Secondly, due to economical problems vaccine, medicines and treatment are unable to reach the poor. Thirdly, poor living conditions, lack of nutrition and overcrowding of the houses, enable the bacteria to spread easily.

Even though the BM is very dangerous and life threatening it is less contagious comparing to many other bacterial infections. The risk of this infection is decreased by various vaccines that have been developed, but unfortunately has not reached some countries. This could be controlled and prevented with the help of the government and also by health and cleanliness consciousness among the people.

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