Overcoming the A, B, and C’s of Meningitis

2011-01-06 | |
Last updated: 2011-01-06

Meningitis is one those relatively rare destructive conditions that come at you like a freight train offering few easily-recognizable symptoms and very little time for reaction. Because of this, it is not surprising that the mention of the condition often evokes some level of fear. Although it is never wise to underestimate such dangerous conditions, medical science is working hard to turn Meningitis into something of interest more for medical historians rather than the rest of us.

The name Meningitis does not describe a single disease, but rather a group of conditions with different causes that all result in swelling of the lining surrounding the brain and spinal cord. Among the many causes of Meningitis, the viral form is the most common and least dangerous. However, more dangerous forms of the condition including types caused by bacterial, fungal and parasitic infection can also occur. Among these, the bacterial form is the most common and the greatest threat to public health.

Although bacterial meningitis is rare in most first world countries, it is still very dangerous for those who develop the infection. For those in the third world, however, the condition has far more widespread effects and has been a documented cause of serious illness for more than 100 years with as many as 1 in 100 people affected in some outbreaks. Worldwide, the World Health Organization estimates that some 500,000 people contract bacterial meningitis each year. Vaccine use in the first world has been largely responsible for reducing the rates of infection there.

Among those who develop Meningitis, as many as 30% of infants and roughly 40% of adults will die even with rigorous antibiotic treatment. Part of the problem is that the condition can develop so rapidly as to cause death within 4 hours in the worst cases. Generally, however, more than 70% of cases will come on more slowly offering some chance for the use of antibiotics. Among those who survive the infection, 20% will have long term health effects including blindness, deafness, paralysis, seizures, cerebral palsy and learning disabilities.

For the various bacterial causes of Meningitis, vaccines have been developed and enhanced for most during the last 35 years. The first of these vaccines was for the pneumonia-causing pneumococcus bacteria back in 1977. A vaccine against some forms of the meningitidis bacteria was developed in 1978. In 1985, a vaccine against the Haemophilus influenzae type B virus was developed. Despite the existence of these vaccines from that time, in many first world countries, the use of these vaccines in the general population was not implemented until the late 1990s and early 2000’s.

When these vaccines were finally put to use, remarkable results were seen in many cases. In the UK, the general introduction of a vaccine for type C Meningitis in 1999 reduced the rates of that infection by 99% over the subsequent decade. In the US, introduction of a similar vaccine reduced rates of type C Meningitis infection by 80% compared to rates in 2002.

Over the last 8 years, an effort to develop a more cost effective type A Meningitis vaccine has also produced results. The vaccine, targeted toward the African variant of the infection, is to be administered to more than 430 million Africans located in the “Meningitis Belt” of Northern Africa. The hope is that this mass inoculation will drastically reduce the number of infected from the 88,000 that were affected in 2009. Given that 80% of the Meningitis cases in Africa are the result of type A infection, such a reduction would diminish the burden of Meningitis on the population significantly.

Now, most recently, a type B Meningitis vaccine, first developed in 2008, has completed trials showing it to be 77% effective in preventing illness from this strain of bacteria. While this version of a type B vaccine is new, a version was originally developed in Cuba in 1987. Unfortunately, bad international politics prevented it from being used outside of the country. In any case, this new vaccine targets the most common form of Meningitis in the first world responsible for more than 90% of meningococcal Meningitis cases. Although this specific vaccine is not highly effective, it will certainly put a dent in the frequency of the disease.

Overall, medical science has made great strides in limiting the ability of Meningitis to harm the population. The collective achievements in the development of vaccines against the various forms of the disease now mean that a growing number of people are being spared from the ravages of such infections. Once national health programs take the necessary steps to get these vaccines to the population, we will finally be able to describe Bacterial Meningitis as a “condition once feared”.

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