Breaking News
January 21, 2019 - FDA Advisory Committee Votes on Zynquista (sotagliflozin) as Treatment for Adults with Type 1 Diabetes
January 21, 2019 - The causes and complications of snoring
January 21, 2019 - Placenta adapts and compensates when pregnant mothers have poor diets or low oxygen
January 21, 2019 - New implant could restore the transmission of electrical signals in injured central nervous system
January 21, 2019 - Rapid-acting fentanyl test strips found to be effective at reducing overdose risk
January 21, 2019 - Coronary Artery Calcium May Help Predict CVD in South Asians
January 21, 2019 - The mystery of the super-ager
January 21, 2019 - Scientists develop smart microrobots that can change shape depending on their surroundings
January 21, 2019 - Keep Moving to Keep Brain Sharp in Old Age
January 21, 2019 - Despite progress, gay fathers and their children still structurally stigmatized
January 21, 2019 - Merck recognized with 2018 Life Science Industry Award for best use of social media
January 21, 2019 - Coeur Wallis equips the canton of Valais with 260 SCHILLER defibrillators
January 21, 2019 - Scientists propose quick and pain-free method for diagnosing kidney cancer
January 21, 2019 - Signs of memory loss could point to hearing issues
January 21, 2019 - HeartFlow Analysis shows highest diagnostic performance for detecting coronary artery disease
January 21, 2019 - How Much Caffeine is Too Much?
January 21, 2019 - Take a timeout before you force your child to apologize
January 21, 2019 - Scientists design two AI algorithms to improve early detection of cognitive impairment
January 21, 2019 - Novel therapy for children with chronic hormone deficiency provides lifeline for parents
January 21, 2019 - Bioethicists call for oversight of poorly regulated, consumer-grade neurotechnology products
January 21, 2019 - Study shows hereditary hemochromatosis behind many cancers and joint diseases
January 21, 2019 - Short bouts of stairclimbing throughout the day can improve cardiovascular health
January 20, 2019 - Liver Transplant Survival May Improve With Race Matching
January 20, 2019 - Study implicates hyperactive immune system in aging brain disorders
January 20, 2019 - Cancer Diagnosis May Quadruple Suicide Risk
January 20, 2019 - Parkinson’s disease experts devise a roadmap
January 20, 2019 - Research brings new hope to treating degenerative brain diseases
January 20, 2019 - Scientists pinpoint a set of molecules that wire the body weight center of the brain
January 20, 2019 - Researchers get close to developing elusive blood test for Alzheimer’s disease
January 20, 2019 - UCLA researchers demonstrate new technique to develop cancer-fighting T cells
January 20, 2019 - Researchers discover how cancer cells avoid genetic meltdown
January 20, 2019 - Exercise makes even the ‘still overweight’ healthier: study
January 20, 2019 - University of Utah to establish first-of-its-kind dark sky studies minor in the US
January 20, 2019 - School-based nutritional programs reduce student obesity
January 20, 2019 - Improved maternity care practices in the southern U.S. reduce racial inequities in breastfeeding
January 20, 2019 - New enzyme biomarker test indicates diseases and bacterial contamination
January 20, 2019 - Republican and Democratic governors have different visions to transform health care, say researchers
January 20, 2019 - Researchers discover that spin flips happen in only half a picosecond in the course of a chemical reaction
January 20, 2019 - Suicide Risk Up More Than Fourfold for Cancer Patients
January 20, 2019 - Doctors find 122 nails in Ethiopian’s stomach
January 20, 2019 - UV disinfection technology eliminates up to 97.7% of pathogens in operating rooms
January 20, 2019 - Researchers discover mechanism which drives leukemia cell growth
January 20, 2019 - AHA: Infection as a Baby Led to Heart Valve Surgery for Teen
January 20, 2019 - Injection improves vision in a form of childhood blindness
January 20, 2019 - Multiple sclerosis therapies delay progression of disability
January 20, 2019 - New study finds infrequent helmet use among bike share riders
January 20, 2019 - Clearing up information about corneal dystrophies
January 20, 2019 - Researchers describe new behavior in energy metabolism that refutes existing evidence
January 20, 2019 - New study takes first step toward treating endometriosis
January 20, 2019 - Researchers find how GREB1 gene promotes resistance to prostate cancer treatments
January 20, 2019 - Replacing Sitting Time With Activity Lowers Mortality Risk
January 20, 2019 - A simple, inexpensive intervention makes birth safer for moms and babies in parts of Africa
January 19, 2019 - New anti-inflammatory compound acts as ‘surge protector’ to reduce cancer growth
January 19, 2019 - Significant flaws found in recently released forensic software
January 19, 2019 - New Leash on Life? Staying Slim Keeps Pooches Happy, Healthy
January 19, 2019 - Men and women remember pain differently
January 19, 2019 - Rising air pollution linked with increased ER visits for breathing problems
January 19, 2019 - Study uses local data to model food consumption patterns among Seattle residents
January 19, 2019 - The brain’s cerebellum plays role in controlling reward and social behaviors, study shows
January 19, 2019 - Relationship between nurse work environment and patient safety
January 19, 2019 - Pioneering surgery restores movement to children paralyzed by acute flaccid myelitis
January 19, 2019 - Genetic variants linked with risk tolerance and risky behaviors
January 19, 2019 - New research provides better understanding of our early human ancestors
January 19, 2019 - First-ever tailored reporting guidance to improve patient care and outcomes
January 19, 2019 - 4.6 percent of Massachusetts residents have opioid use disorder
January 19, 2019 - New study suggests vital exhaustion as risk factor for dementia
January 19, 2019 - New antibiotic discovery heralds breakthrough in the fight against drug-resistant bacteria
January 19, 2019 - Ural Federal University scientists synthesize a group of multi-purpose fluorophores
January 19, 2019 - Researchers identify new therapeutic target in the fight against chronic liver diseases
January 19, 2019 - Preparation, characterization of Soyasapogenol B loaded onto functionalized MWCNTs
January 19, 2019 - FDA Approves Ontruzant (trastuzumab-dttb), a Biosimilar to Herceptin
January 19, 2019 - Tobacco use linked with higher use of opioids and sedatives
January 19, 2019 - Study delves deeper into developmental dyslexia
January 19, 2019 - Anti-vaccination movement one of the top health threats in 2019 says WHO
January 19, 2019 - Newly developed risk score more effective at identifying type 1 diabetes
January 19, 2019 - Highly effective protocol to prepare cannabis samples for THC/CBD analysis
January 19, 2019 - Prinston Pharmaceutical Inc. Issues Voluntary Nationwide Recall of Irbesartan and Irbesartan HCTZ Tablets Due to Detection of a Trace Amount of Unexpected Impurity, N-Nitrosodiethylamine (NDEA) in the Products
January 19, 2019 - How does solid stress from brain tumors cause neuronal loss, neurologic dysfunction?
January 19, 2019 - $14.7 million partnership to supercharge vaccine development
January 19, 2019 - Ian Fotheringham receives Charles Tennant Memorial Lecture award
What to Look Out For

What to Look Out For

image_pdfDownload PDFimage_print

An interview with Claire Wright on behalf of World Meningitis Day 2018, conducted by Alina Shrourou, BSc

What are the different types of meningitis?

Meningitis is the inflammation of the lining around the brain and spinal cord and it can be caused by either viruses or bacteria.

Credit: SailanaLT/Shutterstock.com

Viral meningitis can be very unpleasant but it is almost never life threatening and most people make a full recovery. Whereas bacterial meningitis is a serious illness and the bacteria that cause it can also cause sepsis (blood poisoning) – both life-threatening conditions.

Meningococcal bacteria are a major cause of bacterial meningitis. There are several strains or ‘serogroups’ of meningococcal bacteria. Serogroups A, B, C, W, X and Y account for the majority of cases around the world.

Other major causes of bacterial meningitis are:

  • Pneumococcal bacteria
  • Haemophilus infuenzae type b (Hib) bacteria

Bacterial forms that mostly, though not exclusively, affect newborn babies are:

  • Group B Streptococcal (GBS)
  • E. coli
  • Listeria

Are there vaccinations available to prevent all types of meningitis? Are these vaccinations available to everyone?

There are licenced vaccines protecting against meningococci A, B, C, W and Y, some of the most common strains of pneumococcal bacteria, as well as Haemophilus infuenzae b (Hib). Although the use of vaccines within routine vaccination schedules vary from country to country, we always encourage everyone to take up the offer of the vaccines that are included in their routine immunisation schedule to protect themselves and their families.  

Vaccination is one of the most effective public health interventions in the world for saving lives and promoting good health. Only clean water, which is considered to be a basic human right, performs better.

However, there are not yet vaccines available to prevent all causes of meningitis, particularly amongst newborns. That’s why it’s important to know the symptoms of meningitis and sepsis. Early recognition and treatment provide the best chance of a good recovery.

What are the risk factors associated with morbidity and mortality in infants with bacterial meningitis?

Meningitis affects more than 2.8 million people globally each year, but it is babies, young children and teenagers who are most at risk of bacterial meningitis. In the UK, babies under three months of age are 70 times more likely to get bacterial meningitis than adults – with newborns being at the highest risk of all.

Bacterial meningitis and sepsis are deadly diseases that can kill in hours and rapid diagnosis and prompt treatment with antibiotics provide the best chance of survival.

Unfortunately, we still face a mortality rate of 1 in 10, in individuals affected by meningitis and associated sepsis. The seriousness of the condition can also be seen in survivors, as 1/3 of them are left with after-effects, such as brain damage, amputations, blindness or hearing loss.

Collectively, meningitis and neonatal sepsis are the second biggest infectious killers of children aged under five globally and kill more under-fives than malaria, AIDS, measles and tetanus combined.

What are the current challenges in recognising and diagnosing meningitis, especially in newborns?

In the early stages it is very difficult to tell the difference between meningitis and a milder viral infection. Even a doctor may not be able to identify the seriousness of the illness at first. The diseases can be particularly difficult to detect in babies because they cannot tell us how they are feeling. However, a child who is unwell with meningitis or sepsis will deteriorate rapidly.  

Recent research funded by Meningitis Research Foundation (MRF), conducted by experts at St George’s University of London, found that only around 50% of babies under 3 months old who have bacterial meningitis display fever, which has for a long time been the trigger for further medical investigation.

The study involved 263 infants across the UK and Ireland and found the symptoms displayed by young infants when they are seen by doctors at first in hospital are often non-specific, such as poor feeding, lethargy and irritability – perhaps characteristics that you wouldn’t consider of anything other than purely being a newborn!

Fever (temperature above 38°C) was reported in only 54% of cases, seizures in 28%, bulging fontanelle in 22%, coma in 6% and neck stiffness in only 3%. Therefore, the research highlights that clinicians must consider bacterial meningitis in the diagnosis of an unwell infant that doesn’t present with fever.

The same research uncovered a lack of recognition of clinical features in primary and secondary care leading to delays from the onset of first symptoms to treatment, delays in starting antibiotics and the antibiotics chosen not being in conformity with national guidelines, delays in performing lumbar puncture and lack of consensus on long term follow up.

Credit: Photographee.eu/Shutterstock.com

Please outline the eTool created by the Meningitis Research Foundation following the recent research, which found that only around half of newborns with meningitis display fever.

Based on this research, the Meningitis Research Foundation, or MRF, collaborated with the study investigators to create a teaching package aimed at hospital doctors to aid rapid diagnosis, appropriate treatment and follow-up care.

An eTool to help clinicians recognise bacterial meningitis in young infants, a lumbar puncture information sheet to help explain the need for this diagnostic procedure to parents and an algorithm to aid management of bacterial meningitis in the hospital setting are all included within the teaching package.

The MRF have also refreshed the information available to parents about the symptoms of bacterial meningitis, so they know not to rely on fever alone as the main symptom to look out for in babies.

What does the Meningitis Research Foundation aim to achieve with the eTool?

Young babies are particularly vulnerable to bacterial meningitis, yet the disease is particularly difficult to spot in this age group. The MRF aims to better equip clinicians to recognise, diagnose and treat bacterial meningitis in young infants, ultimately improving outcomes for these infants and their families.

Completing this eTool should increase awareness of:

  • The epidemiology of bacterial meningitis in young infants
  • Risk factors and clinical indicators for infection in young infants
  • Which investigations should be carried out on young infants and when
  • The importance of giving appropriate antibiotics and when these should be given
  • Potential long-term effects of meningitis and appropriate follow up care for these infants

When will we start to see if it is successful?

We are already collecting some really positive feedback from users of the eTool, all of whom reported the structure of the eTool to be simple and easy to follow. 95% of users would recommend the course to a colleague and importantly 93% felt that they would be less likely to miss a case of meningitis in a young infant after completing the course.

Has the eTool been incorporated into standard clinician training procedures and is it available worldwide? Is there a cost associated with the tool?

The eTool has been endorsed by the Royal College of Paediatrics and Child Health in the UK, and health professionals in the UK can receive CPD points for completing the training. The tool is free and can be accessed by health professionals worldwide, although the content has been written in the context of the UK health system.  

In what other ways can clinicians help to educate themselves and their patients about meningitis?

MRF has a number of free, downloadable resources that can help clinicians to educate themselves and their patients about meningitis.

Why are awareness days important for meningitis research?

Awareness campaigns, such as World Meningitis Day on Tuesday 24th April run by the Confederation of Meningitis Organisations (CoMO), are vital if we are going to defeat meningitis and septicaemia. It raises awareness amongst the research community, prompting and encouraging advancements to be made surrounding the condition.

What’s the vision for the Meningitis Research Foundation moving forwards?

Meningitis Research Foundation is a leading UK and international charity working to defeat meningitis wherever it exists. Our vision is a world free from meningitis and septicaemia, and to help reach this we fund and support vital scientific research.

We campaign and provide information to the public, health professionals and researchers that promotes prevention, early diagnosis and treatment, and raises awareness of the diseases. We also provide direct support and ongoing personal help to individuals and families affected, whether they are living with impairment caused by the diseases or coping with the death of a loved one.

Where can readers find more information?

  • Find out more information on the MRF website.
  • MRF’s teaching package including the eTool and Babywatch card for parents can be accessed here.

About Claire Wright

Claire is Evidence & Policy Manager at the UK and international charity Meningitis Research Foundation (MRF). Her work involves developing the educational materials that MRF distributes to health professionals and the public, making sure that it is up to date with findings from current research.

She also answers specific medical questions the charity receives about meningitis and septicaemia and promotes the charity’s work at conferences around the UK.

About author

Related Articles