Surviving and Understanding Meningitis

Jan. 29, 2007— -- I could never forget what happened when I was 8 years old. It's been nearly 10 years, and I'm still scared when I realize how close I was to facing my own death. I hope I never have to experience that feeling again as long as I live.

On the morning of May 12, I woke with a sore throat, fever and an upset stomach. I remember my fever was low, but I still had chills. The chills were so bad that my bed shook, and I was unable to hold my teddy bear or favorite toy. I began to hallucinate -- as I were watching TV. It seemed as though I was a part of the action.

I wasn't thinking straight at the time, and had trouble seeing clearly. My mother took me to the doctor's office, where I was told I had a virus. The doctors instructed me to take some Tylenol and to come back later.

As we were leaving my mom showed the doctor that I had developed spots on my legs. That was when my normally easygoing doctor became panic stricken. I heard him say, "She needs to go to the closest hospital now!"

My mother talked to another doctor who specialized in infectious diseases. He told her I had meningococcal meningitis. I was rushed to the hospital and given high-dose steroids and an antibiotic.

The last thing I remember was seeing the needle for the spinal tap.

At the time, I didn't realize I had come close to being another victim of a disease that kills hundreds of thousands of children worldwide every year.

--Kaeley Hamilton, meningitis survivor

Earlier this month, an outbreak of meningitis swept across the Northeast, sparking fear and concern among parents and health officials.

While there have been no additional reports of infection, the incident underscores the importance of understanding this potentially deadly disease and identifying the symptoms as soon as they appear.

What is Meningitis?

Meningitis is a result of an inflammation of the membranes and fluid around the brain and spinal cord. This is usually the result of some type of infection, either bacterial or viral. The first symptoms resemble the flu -- severe headache and fever, vomiting and lethargy.

Because many common and less-dangerous infections also start this way, it is difficult to diagnose meningitis in its early stage.Specific symptoms -- such as stiff neck and sensitivity to bright lights -- help doctors identify meningitis.

Once the doctor determines meningitis as a possibility, it is extremely important to perform a spinal tap immediately. Using the spinal fluid that is drawn out, the doctor can determine whether the infection is bacterial or viral.

If it is bacterial, doctors must identify the type of bacteria causing the the infection so they can administer antibiotics directly into the bloodstream. If it is viral, no specific medications are needed except to alleviate symptoms like headache or fever.

Bacterial vs. Viral

Bacterial meningitis is the most serious form of meningitis -- 15 percent of people who get bacterial meningitis die. Those who survive may be left deaf, with learning disabilities and permanent brain damage. The three most common and deadly causes of bacterial meningitis are the meningococcus germ, the pneumococcus germ and the hib germ. Luckily, effective vaccines are available for all these.

Protection Through Vaccination

Children should be vaccinated against hib and pneumococcus before their first birthday. A different type of pneumococcus vaccine is given to adults over 65 years old. The meningococcus vaccine is usually given during the teenage years or before college.

Vaccines can greatly reduce the risk of getting bacterial meningitis. For example, since the hib vaccine was introduced in 1990, hib meningitis has decreased by 95 percent. Hib meningitis used to be a major cause of death in childhood.

The pneumococcus and meningococcus vaccines have reduced meningitis in children, young adults and the elderly.

If you are in contact with someone who contracts contagious meningitis, you will need to take antibiotics to prevent getting meningitis yourself. The hib and meningococcus forms are extremely contagious, and potentially deadly. The pneumococcus form is not.

In viral meningitis, about 90 percent of the cases are caused by enteroviruses, which are most common in the summer and fall. These viruses are spread when people do not wash hands after sneezing, blowing their nose or using the toilet.

There are no vaccines against these viruses. The viruses are moderately contagious, but most people who get infected do not know they are sick and never develop meningitis.

People who do get sick from a virus will usually recover completely in one to two weeks without treatment. Since there no vaccines, washing hands is the best defense.

Young and Old Most at Risk

Children, the elderly and people living in crowded conditions are the most likely to get meningitis.

Children are most susceptible because they have not yet built up their immune systems. Additionally, it is easy to spread bacteria and viruses in close quarters such as dorms, military housing and institutions. The best protection for them is getting vaccinations on time.

The elderly are at risk because immune systems weaken with age. People with chronic illnesses are not able to fight off infections as well as healthy patients.

Dr. Charurut Somboonwit is an assistant professor in the division of infectious disease and international medicine of the University of South Florida and is the clinical research and communicable diseases director at the Hillsborough County Health Department.

Dr. Daniel Haight is an associate professor in the division of infectious disease and international medicine of the University of South Florida and director of the Polk County Health Department.