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Meningitis

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.  It can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency. 

The inflammation may lead to abnormalities of the cranial nerves, a group of nerves arising from the brain stem that supply the head and neck area and control eye movement, facial muscles and hearing, among other functions.  Meningitis can thus lead to serious long-term consequences such as deafness, epilepsy, hydrocephalus and cognitive deficits.

Source:  Huffington Post

Sub-Saharan Africa has been plagued by large epidemics of meningococcal meningitis for over a century, leading to it being labeled the "meningitis belt". An epidemic wave can last two to three years.  Attack rates of 100–800 cases per 100,000 are encountered in this area. These cases are predominantly caused by meningococci. The largest epidemic ever recorded in history swept across the entire region in 1996–1997, causing over 250,000 cases and 25,000 deaths. 

 

 

 

Symptoms

The main causes of meningitis are viruses, bacteria, or other microorganisms such as parasites and fungi, toxins and pharmaceuticals.

Untreated, bacterial meningitis is almost always fatal. Viral meningitis, in contrast, tends to resolve spontaneously and is rarely fatal. With treatment, mortality (risk of death) from bacterial meningitis depends on the age of the patient and the underlying cause. Of the newborn patients, 20–30% may die from an episode of bacterial meningitis. This risk is much lower in older children, whose mortality is about 2%, but rises again to about 19–37% in adults.

The symptoms of meningitis are : 

  • headache  - an excruciatingly severe headache is the most common symptom of meningitis – occurring in almost 90% of cases of bacterial meningitis 
  •  
    neck stiffness  - Or ‘nuchal rigidity’ which is an inability to flex the neck forward passively due to increased neck muscle tone and stiffness.  Nuchal rigidity occurs in 70% of adult cases of bacterial meningitis 
  • fever – a sudden high fever 
  • an altered mental state which may include confusion or altered consciousness.  The brain tissue may swell, with increasing pressure inside the skull – this is responsible in part for the headache but can also cause a decreasing level of consciousness, loss of the pupillary light reflex, and abnormal posturing 
  • vomiting 
  • photophobia - an inability to tolerate light (photophobia) or loud noises (phonophobia) 
  • rash - a rash indicates a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria.  The rash consists of numerous small, irregular purple or red spots ("petechiae") on the trunk, lower extremities, mucous membranes, conjuctiva, and (occasionally) the palms of the hands or soles of the feet. 
  •  
    Hypotension - The infection may trigger sepsis, falling blood pressure, fast heart rate, high or abnormally low temperature and rapid breathing. Very low blood pressure may occur early, especially but not exclusively in meningococcal illness; this may lead to insufficient blood supply to other organs.  In meningococcal disease, gangrene of limbs can occur 
  • Increased bleeding - Disseminated intravascular coagulation, the excessive activation of blood clotting, may cause both the obstruction of blood flow to organs and a paradoxical increase of bleeding risk. Severe meningococcal and pneumococcal infections may result in hemorrhaging of the adrenal glands, leading to Waterhouse-Friderichsen syndrome, which is often lethal 
  • Hydrocephalus - Inflammation of the brain tissue may also obstruct the normal flow of CSF around the brain (hydrocephalus). 
  •  
    Seizures -  may occur for various reasons; in children, seizures are common in the early stages of meningitis (30% of cases).  Seizures may result from increased pressure and from areas of inflammation in the brain tissue. Focal seizures (seizures that involve one limb or part of the body), persistent seizures, late-onset seizures and those that are difficult to control with medication are “indicators of a poorer long-term outcome”

Small children may not exhibit the aforementioned symptoms, and may only be irritable and look unwell. In infants up to 6 months of age, bulging of the fontanelle (the soft spot on top of a baby's head) may be present. Other features that might distinguish meningitis from less severe illnesses in young children are leg pain, cold extremities, and an abnormal skin colour.

What is happening

The meninges comprise three membranes that, together with the cerebrospinal fluid, enclose and protect the brain and spinal cord (the central nervous system). 

  • The pia mater is a very delicate impermeable membrane that firmly adheres to the surface of the brain, following all the minor contours.
  • The arachnoid mater (so named because of its spider-web-like appearance) is a loosely fitting sac on top of the pia mater. The subarachnoid space separates the arachnoid and pia mater membranes, and is filled with cerebrospinal fluid.
  • The outermost membrane, the dura mater, is a thick durable membrane, which is attached to both the arachnoid membrane and the skull.


Source: Wikipedia

Bacteria, for example, reach the meninges by one of two main routes: through the bloodstream or through direct contact between the meninges and either the nasal cavity or the skin.

In most cases, meningitis follows invasion of the bloodstream by organisms that live upon mucous surfaces such as the nasal cavity. This is often in turn preceded by viral infections, which break down the normal barrier provided by the mucous surfaces [note that unwise use of pharmaceuticals can do the same, such as anti-histamines].

Tilly Lockey lost her hands after contracting meningitis B

Once bacteria have entered the bloodstream, they enter the subarachnoid space in places where the blood-brain barrier is vulnerable.

Once the bacteria have invaded the subarachnoid space, the immune system reacts and the inflammation that occurs is not therefore a direct result of bacterial infection but can rather largely be attributed to the response of the immune system to the entrance of bacteria into the central nervous system.

As the immune system kicks in, blood vessels swell in order that those white blood cells needed to fight the infection can travel to the site more easily.  But this of course leads to pressure within the brain and, if we can imagine it,  the sort of inflammation we see if we get stung  - swelling and pain as well as heat [to kill the bacteria].  The response is actually the best the body can do in the circumstances, but of course it leads to immense pain and may not always work.

Causes

The following are the main causes:

Bacteria 

Several types of bacteria can cause meningitis.   In premature babies and newborns up to three months old, common causes are  group B streptococci, Escherichia coli and  Listeria monocytogenes. Older children are more commonly affected by Neisseria meningitidis (meningococcus), Streptococcus pneumoniae and those under five by Haemophilus influenzae type B.   In adults, N. meningitidis and S. pneumoniae together cause 80% of all cases of bacterial meningitis, with increased risk of L. monocytogenes in those over 50 years old.  Other bacteria that can cause the disease include pseudomonas and other Gram-negative bacilli and  Mycobacterium tuberculosis.  Meningitis may also result from infection with spirochetes, a type of bacteria that includes Treponema pallidum (the cause of syphilis) and Borrelia burgdorferi (known for causing Lyme disease).  Endocarditis (infection of the heart valves with spread of small clusters of bacteria through the bloodstream) may cause meningitis.  Meningitis can also arise from infections of the nasopharynx or the nasal sinuses.  Bacteria can pass from the mother to the baby .

Group B streptococci (GBS) are the leading cause of life-threatening neonatal bacterial infections in developed countries. The newborn is initially colonised during passage through the birth canal. Maternal vaginal carriage is usually asymptomatic. PMID: 21648230

 

 

Viruses  

Viruses that can cause meningitis include enteroviruses, herpes simplex virus type 2 (and less commonly type 1), varicella zoster virus (known for causing chickenpox and shingles), mumps virus, HIV, and LCMV.  It is worth noting that this is a gradually growing list as more viruses implicated in cases are identified.

Parasites

A parasitic cause is often assumed when there is a predominance of eosinophils (a type of white blood cell) in the CSF. The most common parasites implicated are Angiostrongylus cantonensis, Gnathostoma spinigerum, Schistosoma, as well as the conditions cysticercosis, toxocariasis, baylisascariasis, paragonimiasis, and a number of rarer infections and noninfective conditions". 
Amoebic meningitis – is  meningitis due to infection with amoebae such as Naegleria fowleri and  is contracted from freshwater sources. 

Angiostrongylus cantonensis, the rat lungworm, is a major cause of eosinophilic meningitis in humans. Rats are the definitive hosts. People can become infected by eating, both deliberately and inadvertently, raw or under-cooked intermediate hosts (snails or slugs) or paratenic hosts such as freshwater shrimp, crabs and frogs. It may be possible to become infected by consuming snail/slug slime (mucus) on produce or by transferring mucus from hands to mouth after handling snails/slugs. Infection from consuming drinking water contaminated by snails/slugs and infection via open wounds may be theoretically possible but no cases have been reported. The severity of the disease is probably related to the number of infective larvae ingested as well as to the precise location of the worms in the host and the host's inflammatory response. PMID: 23901388

Fungal meningitis

for example  cryptococcal meningitis, commonly produces raised intracranial pressure, and frequent lumbar punctures are often used to relieve the pressure. And now some food for thought....

In September 2012, a single case report sparked an investigation into a nationwide outbreak of fungal meningitis due to contaminated injectable drugs. The source of the contamination, New England Compounding Center (NECC), was in violation of several state and federal laws and had a history of such violations. The regulation of compounding pharmacies has historically been left to the states, while manufacturing fell under the jurisdiction of the Food and Drug Administration. However, as more compounders took part in large-scale interstate distribution of drugs, the current state-based regulatory system became less equipped to provide oversight. The lack of a clear definition of "compounding pharmacy" further obscures proper oversight and regulation. ……While the current compounding regulation changes are a necessary step forward, it remains to be seen how effective they will be in safeguarding the public.  PMID:  25063265

'Injectable drugs' includes vaccines.

Pharmaceutical Drugs

Tommy Brown was left severely disabled after contracting Meningitis B

Pharmaceuticals  can cause meningitis including  non-steroidal anti-inflammatory drugs, antibiotics and intravenous immunoglobulins.  The list of pharmaceuticals that are implicated in meningitis is growing, so this LINK takes you to the eHealthme website where an up-to-date list of each drug together with the number of cases caused by the drug is provided.  This list is not anecdotal, it is compiled from the Adverse Drug Reports submitted to the FDA and SEDA.

There is a separate entry for pharmaceuticals that could cause bacterial meningitis - LINK.  And another LINK for cryptococcal meningitis.

A cause often overlooked, but nevertheless an exremely serious one is so called 'herbal medicines'.  The following should strike fear in the hearts of all sane people:

The aim of this overview of systematic reviews is to summarise and critically evaluate the evidence from systematic reviews of the adulteration and contamination of herbal medicinal products (HMPs)…… Twenty-six systematic reviews met our inclusion criteria. The most commonly HMPs were adulterated or contaminated with dust, pollens, insects, rodents, parasites, microbes, fungi, mould, toxins, pesticides, toxic heavy metals and/or prescription drugs. The most severe adverse effects caused by these adulterations were agranulocytosis, meningitis, multi-organ failure, perinatal stroke, arsenic, lead or mercury poisoning, malignancies or carcinomas, hepatic encephalopathy, hepatorenal syndrome, nephrotoxicity, rhabdomyolysis, metabolic acidosis, renal or liver failure, cerebral edema, coma, intracerebral haemorrhage, and death. Adulteration and contamination of HMPs were most commonly noted for traditional Indian and Chinese remedies, respectively. PMID:  22843016

Physical damage

Direct contamination of the cerebrospinal fluid can also arise from indwelling devices, and skull fractures; occasionally, congenital defects of the dura mater can be identified. The most common cause of recurrent meningitis is skull fracture,  particularly fractures that affect the base of the skull or extend towards the sinuses and petrous pyramids.  A literature review of 363 reported cases of recurrent meningitis showed that

  • 59% of cases were due to such anatomical abnormalities
  • 36% due to immune deficiencies (such as complement deficiency, which predisposes especially to recurrent meningococcal meningitis)
  • and 5% due to ongoing infections in areas adjacent to the meninges.



Nutritional deprivation

Vitamin imbalance - both overload and deficiency as well as Mineral imbalance - overload and deficiency do not cause meningitis, but they can be a contributory factor in enabling the disease to take hold.  Children and adults whose immune system is compromised by a mineral or vitamin deficiency, for example, may develop meningitis.  One vitamin which appears to be key to immune system response is Vitamin D.

Meningitis and meningoencephalitis caused by Escherichia coli are associated with high rates of mortality and neurological sequelae. A high prevalence of neurological disorders has been observed in geriatric populations at risk of hypovitaminosis D. Vitamin D has potent effects on human immunity……. Our observations suggest that vitamin D deficiency may impair the resistance of the brain against bacterial infections.   PMID:  24686054

But overloading the system and getting it out of balance can have much the same effect.  The heavy dosing of children with vitamin tablets instead of providing them with a balanced natural food intake can affect the immune system and lay them open to meningitis.  The following comes from eHealtme:

On Sep, 4, 2014: 38,361 people reported to have side effects when taking Vitamins. Among them, 24 people (0.06%) have Meningitis.

Trend of Meningitis in Vitamins reports

 Toxins and heavy metals

Paul Challis' daughter Ellie May, 9, developed
meningitis at 16 months, Paul took Ellie to A&E
with a temperature, but was told she had 'a urine
infection'
 
 

Toxins such as insecticides, pesticides, fungicides and so on as well as heavy metals such as lead and mercury can cause meningitis.  And lest we think that this does not affect us because we are in an area of clean air and free from factory farming methods or pollutants - think again, we are, I am afraid, all in this together - one planet, one ecosysytem....

Dust storms may originate in many of the world's drylands and have an effect not only on human health in the drylands themselves but also in downwind environments, including some major urban centres, such as Phoenix, Kano, Athens, Madrid, Dubai, Jedda, Tehran, Jaipur, Beijing, Shanghai, Seoul, Taipei, Tokyo, Sydney, Brisbane and Melbourne. In some parts of the world dust storms occur frequently throughout the year. They can transport particulate material, pollutants, and potential allergens over thousands of km from source. The main sources include the Sahara, central and eastern Asia, the Middle East, and parts of the western USA. In some parts of the world, though not all, the frequency of dust storms is changing in response to land use and climatic changes, and in such locations the health implications may become more severe. Data on the PM10 and P2.5 loadings of dust events are discussed, as are various pollutants (heavy metals, pesticides, etc.) and biological components (spores, fungi, bacteria, etc.). Particulate loadings can far exceed healthy levels. Among the human health effects of dust storms are respiratory disorders (including asthma, tracheitis, pneumonia, allergic rhinitis and silicosis) cardiovascular disorders (including stroke), conjunctivitis, skin irritations, meningococcal meningitis, valley fever, diseases associated with toxic algal blooms and mortality and injuries related to transport accidents. PMID:  24275707

Heavy metals can be passed from the mother to the baby leaving the little soul vulnerable to subsequent infection.   Both lead and mercury are particularly dangerous in this respect.  In this we should not forget the role of dental amalgam fillings, as they are mercury based.  Where a filling is leaking or poor dental work has been undertaken, then the mercury may be the cause - leaking from the mother to the baby.  Another source of mercury is the Thiomersal in some Vaccines.  Tattoo inks are another.

 Ellie May

Another area of increasing concern is the indiscriminate and uncontrolled use of nanoparticles - invented by scientists and being released into the environment by scientists in the belief that they do no harm, except that yet other researchers have realised they do a lot of harm......

....DNA damage occurs chemically or physically by nanomaterials. Chemical and physical damage are associated with point mutation by free radicals and double strand brake, respectively. The failure of DNA repair and accumulation of mutations might occur when inflammation is prolonged, and finally normal cells could become malignant. These free radicals can not only damage cells but also induce signaling molecules containing immunoreaction. Nanoparticles and asbestos also induce the production of free radicals. .... Taken together,... a variety of diseases [may be] induced by nanomaterials. PMID: 25097864

 Vaccines

A subject to cause arguments in every camp.  But there are proven cases where vaccines can cause meningitis.
Where the vaccine used in the injection is a live virus, there are instances where it, although apparently vanquished by the immune system, lays low and continues to attack, albeit at a much reduced rate.  One example is the herpes virus, read on:

Herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2) are human neurotropic viruses that establish latent infection in dorsal root ganglia (DRG) for the entire life of the host. From the DRG they can reactivate to cause human morbidity and mortality. Although they vary, in part, in the clinical disorders they cause, and in their molecular structure, they share several features that govern the biology of their infection of the human nervous system.
HSV-1 is the causative agent of encephalitis, corneal blindness, and several peripheral nervous system disorders;
HSV-2 is responsible for meningoencephalitis in neonates and meningitis in adults. The biology of their ability to establish latency, maintain it for the entire life of the host, reactivate, and cause primary and recurrent disease is being studied in animal models and in humans.  PMID: 24142852

This is not the only virus to do this, any vaccine containing a live virus carries great risk with it.

To describe the spectrum of central nervous system complications of varicella-zoster virus (VZV) in children admitted to The Hospital for Sick Children between January 1999 and December 2012…. Clinical syndromes included acute cerebellar ataxia (n = 26), encephalitis (n = 17), isolated seizures (n = 16), stroke (n = 10), meningitis (n = 10), Guillain-Barré syndrome (n = 2), acute disseminated encephalomyelitis (n = 2), and Ramsay Hunt syndrome (n = 1). …Three children with encephalitis died. …. 4 children were reported to have received the varicella vaccine….. Neurologic complications of VZV infection continue to occur despite the availability of an effective vaccine.  PMID:  25063723

Some vaccines contain Thiomersal, which is mercury based.  For a full list see this LINK.  As a consequence, there is the risk of mercury poisoning and mercury poisoning can cause meningitis.

Radiation

All radiation whether 'cosmic' or electromagnetic impacts our bodies and depending on its frequency it resonates different parts of us.  The reason that nuclear radiation is so dangerous is that it impacts cells, but what we appear to have overlooked is that all radiation impacts some part of us.

Every aggregate in our bodies - organs, cells, the body itself, has natural ‘resonance’.  Resonance is a substance’s natural tendency to oscillate – vibrate – at maximum amplitude at certain frequencies, known as the thing’s resonant frequency.

I found it difficult to pin down which frequencies resonate the meninges.  At the moment, no clear picture has emerged, however, there are cases of meningitis having occurred after radiation therapy.

We report a case of fulminant meningitis without a CSF fistula in a 57-year-old woman who underwent TSS and multiple radiotherapies for a clival chordoma. She ....had an unexpected fatal outcome. She was diagnosed with meningitis based on CSF culture and blood culture. While treating clival chordomas with adjuvant radiotherapy, clinicians should be aware of the possibility of fulminant meningitis. PMID: 24904902

 

Treatment

Brad Pitt contracted 'a mild case' of
viral meningitis in July 2005 after having
visited Ethiopia

Prevention - Bacterial and viral meningitis are contagious. Both can be transmitted through droplets of respiratory secretions during close contact such as kissing, sneezing or coughing on someone, but cannot be spread by only breathing the air where a person with meningitis has been. Viral meningitis is typically caused by enteroviruses, and is most commonly spread through fecal contamination.  Thus the spread of meningitis can be prevented to a certain extent by the use of basic hygiene precautions.

Another easy to use preventative measure is to breast feed your baby.

 

Infant milk formula has been identified as a potential source of Enterobacter sakazakii, which has been implicated in neonatal meningitis and necrotizing enterocolitis. PMID:  18522026

It can also be prevented by understanding the causes of meningitis and ensuring that they are avoided.

There appears to be a campaign going at the moment to get people to vaccinate themselves against meningitis, but I urge you to read the vaccines section. 

Treatment - Emergency hospital treatment is needed for all cases of meningitis.

How it works

When he fell ill with meningitis in 1979, actor Donald Sutherland thought
he was done for. He said he remembers how all the pain and suffering
he was feeling suddenly vanished as he felt himself leave his body.
Like many other similar experiences, Sutherland experienced being taken
down a tunnel of light, but it was blue. Physicians later told him that he
had passed away for a very short time.

At the time the meningitis is experienced, the sorts of spiritual experience most frequently encountered tend to be hallucinations, visions, out of body and in exreme cases near death experiences.  There are multiple mechanisms by which meningitis can give you these sorts of experience 

But I want to put a positive slant on this.  One of my dear friends had meningitis as a child and he now has extraordinary capabilities spiritually.  He cannot hear well - it left him partially deaf, but the rest of him recovered well, so in effect this acted as a door opener and he is not brain damaged in any way.  He became permanently gifted spiritually from the meningitis.

So remember that if you survive or your child survives meningitis, you may have or be a very very special person.  Well worth cherishing and nurturing.

References and further reading

  • Eur J Clin Pharmacol. 2013 Mar;69(3):295-307. doi: 10.1007/s00228-012-1353-z. Epub 2012 Jul 29.  Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews.  Posadzki P1, Watson L, Ernst E.  Complementary Medicine, Peninsula Medical School, University of Exeter, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK. paul.posadzki@pcmd.ac.uk
  • Environ Int. 2014 Feb;63:101-13. doi: 10.1016/j.envint.2013.10.011. Epub 2013 Nov 26.  Desert dust and human health disorders.  Goudie AS.  School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, United Kingdom. Electronic address: Andrew.goudie@stx.ox.ac.uk
  • J Am Pharm Assoc (2003). 2014 Jul-Aug;54(4):441-5. doi: 10.1331/JAPhA.2014.14011.  How gaps in regulation of compounding pharmacy set the stage for a multistate fungal meningitis outbreak.  Teshome BF, Reveles KR, Lee GC, Ryan L, Frei CR.
  • J Pediatr. 2014 Jul 22. pii: S0022-3476(14)00531-9. doi: 10.1016/j.jpeds.2014.06.014. [Epub ahead of print]  Central Nervous System Complications of Varicella-Zoster Virus.  Science M1, MacGregor D2, Richardson SE3, Mahant S4, Tran D5, Bitnun A6. 

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