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Meningitis
Meningitis is an infection of the meningitis (cover of the brain) which surround
the brain and the spinal cord.Viruses and bacteria can cause meningitis. It is important to know the cause
since the outcome is very different for different causes. Viral Meningitis is
generally less severe and resolves without specific treatment unlike bacterial
meningitis which requires antibiotic treatment for the specific bacterium
causing it. Bacterial meningitis, if the appropriate treatment is not given, can
lead to blindness, deafness, paralysis, mental retardation and death.
Signs and Symptoms
- High fever
- Headache
- Stiff neck
Early diagnosis of meningitis is very important so that when symptoms arise the
patient should contact the doctor immediately. The diagnosis is usually made by
lumbar puncture to test the spinal fluid for culture and sensitivity to identify
the causative agent and give antibiotics accordingly.Meningitis is very contagious. Rapid person to person transmission. Children are
very commonly effected. Common in overcrowding. Reservoir for micro-organism is
man. It is spread by droplet infection; micro-organisms lodged in the posterior
nasopharynx or by transfer of infected blood e.g. Blood transfusion, organ
transplant and contaminated syringes.
Control and Prevention
Bacterial
Haemophilus Meningitis:
Rifampicin should be given to;
- All household members irrespective of age where there is an index case of haemophilus disease, and a child less than 3 years, except pregnant women,
breastfeeding women, any person with severe impairment of hepatic function and
children under the age of 3 months.
- All room contacts where two or more cases of Hib disease have occurred in a
play group, nursery or cresche within 120 days (exceptions as above).
- Index cases of Hib disease prior to discharge from hospital, except children
under the age of 3 months.
Meningococcal Meningitis:
Rifampicin/Ciprofloxacin should given as prophylaxis to:
- Eliminate carriage of meningococci in household members and other close
contacts; thereby in turn reduce transmission to susceptible individuals who are not
carriers.
- Prevent susceptible contacts from acquiring infection by directly inhibiting
colonisation but it could only be effective for 2 days of prophylaxis.
- Treat the newly acquired nasopharyngeal or blood borne infection in contacts
who are non-immune and may be incubating the disease.
Viral
Quarantine is not required. Isolate as a precaution after 7 days of onset of
illness. Investigation of contacts/source of infection indicated. No special
need for concurrent disinfection is needed beyond routine sanitary practices.
Specific treatment: none for the usual causative viral agents.
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