Post on 13-Dec-2015
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
Maxim
um
Perc
enta
ge o
f C
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.