Bacterial Meningitis : Etiology, Treatment and Societal Impacts

Bacterial Meningitis

Introduction:

 Bacterial Meningitis has many factors that contribute to the disease being easily contracted and potentially deadly. This paper will also explain an in-depth history that will help further explain the knowledge that society has currently available about the illness that can sometimes be fatal if not recognized soon enough. Some common acronyms in this paper include “CDC”, “CSF”, and “UK.” The term “CDC” stands for Centers for Disease Control and Prevention, “CSF” stands for cerebrospinal fluid and the term “UK” stands for United Kingdom.

Etiology:

 The origin of Bacterial Meningitis dates to the sixteenth century. Bacterial Meningitis comes in two forms, standard and complicated. The standard form does not affect the brain in its entirety; whereas the complicated form deals with the brain and spinal cord. According to The Cleveland Clinic, this illness is caused by bacteria that already exist in our bodies; however, the bacteria becomes active after the immune system has become weakened (para.9). The immune system being weakened is typically the result of an infection or another minor illness.

History:

Bacterial Meningitis was first discovered in the early eighteen-hundreds by a researcher named Mr. Vieusseux who first took notice when an unfamiliar sickness broke out amongst the community in Geneva, Switzerland. Approximately eighty-two years later, a pathologist, who specialized in studying bacteria, by the name of Anton Weichselbaum “…first isolated the bacterium from the cerebrospinal fluid (CSF) of a patient and identified it as the cause of meningitis in 1887; he called the organism Diplococcus intracellularis (Weichselbaum, 1887) (Yazdankhah & Caugant, 2004, pg. 821).”  During the time that Weichselbaum was researching, he found that about three quarters of patients that were tested had the bacteria that causes meningitis in the fluid surrounding the brain and spine. Mr. Weichselbaum also noticed about thirty-three people became ill from the disease and eventually died. Early researchers also noticed that most individuals carry the bacteria without ever being affected by it. It is noted that “…colonization of the respiratory tract, a phenomenon commonly referred to as carriage, represents a successful commensal relationship between the host and the bacterium, with the host experiencing no detectable pathology (Caugant and Maiden, 2004, para. 2).”

Epidemiology:

 This disease is prevalent all over the world; however, it is even more prevalent in housing environments where a lot of people live. Such examples of these environments include college dormitories or military barracks. For instance, Yazdankhah and Caugant (2004) noted that:

The study, performed at the University of Nottingham, UK, showed the carriage rate increased in the first week of term from 6. 9 % on day 1, to 11. 2 % on day 2, to 19. 0 % on day 3 and to 23. 1 % on day 4. High social mixing probably caused this increase (pg.824).

Another place in which the rate of contracting Bacterial Meningitis is high is Africa. Researchers have recently discovered that:

The incidence of Bacterial Meningitis varies throughout the world. In the UK and western Europe, the incidence is 1–2 cases per 100 000 people per year, whereas it can reach 1000 cases per 100 000 people per year in the Sahel region of Africa. (McGill, F., Heyderman, R. S., Pangiotou, S., Tunkel, A. R., & Soloman, T., 2016, para. 2)

It is not yet a widely known fact that “Approximately 600 – 1,000 people contract meningococcal disease in the U.S. each year” (Statistics and Disease Facts, pg. 1). However, on a much bigger scale the CDC (2016) notes that about 1.2 million cases of Bacterial Meningitis occur all over the world every year. Another study completed recently by researchers in the National Meningitis Association (2018) noted that while it does seem like a rather small number, about ten to fifteen percent of the individuals who are affected by the disease end up dying shortly after contracting it. A factor to consider when analyzing the disease, is how fast it can spread from individual to individual within just one community. An article written by The World Health Organization describes the spreading of disease being linked to people traveling while being ill (Impact of the Problem, 2015, para. 10). Other common ways this disease can spread is through mothers passing it on to the fetus in which is currently being carried in the mother’s womb. Another possible way to contract Bacterial Meningitis that is slightly more common than passing it from mother to child, is through saliva exchange. People typically experience an exchange of saliva through kissing one another.

Pathology:

 Bacterial Meningitis starts in the nose region of the body which is more commonly known as the nasopharynx region. Once the bacteria start to grow and multiply, it never ceases. Shortly after growing in the nasopharynx region, the bacteria move into the body’s blood stream. Once in the blood stream, the bacteria interact with the epithelial cells, the bacteria continue to move with the help of white blood cells. Researchers are under the impression that “The CSF is an ideal medium for the spread of bacteria because it provides enough nutrients for their multiplication and has few phagocytic cells, and low levels of antibodies and complement” (Agamanolis, 2016, para. 6). Before any inflammation occurs, it is possible to figure out if meningitis has already been contracted by an individual. Though health care teams have the ability to diagnose a patient early on, it is sometimes rare that the bacteria haven’t already taken over the brain. If the bacteria have already started spreading rapidly it can be difficult to take measures that could been used in a preventative matter.

Clinical Manifestations:

 There are many telling symptoms that can help healthcare professionals to determine if an individual is showings signs of contracting it soon or if the patient is currently ill from Bacterial Meningitis. A few of the most common symptoms include but are not limited to headaches, fever, and an individual’s inability to touch the chin to the chest region of the body. Other possible symptoms can include agitated moods, confusion, and showing signs of tiredness.  The Cleveland Clinic has noted that seizures and head swelling are two notable symptoms of Bacterial Meningitis that are noticeable with even just the naked eye.

Evaluation:

To properly diagnose an individual with Bacterial Meningitis, the individual would first need to seek medical attention. Once at a hospital or clinic, the patient would then need to be admitted for doctors to be able to properly treat the individual. Next, some lab tests must be ordered and completed. According to the CDC’s website, the most common tests ordered are those that require the patient’s blood or CSF to be drawn (para. 15). The doctors must then thoroughly review the lab results before giving the news to the patient. 

Treatment:

 To treat the patient as quickly and effectively as possible, doctors will give the individual an antibiotic to help start to kill the bacteria that is within the patient’s body. This will also help the bacteria to keep from continuing to grow, multiply, and spread. Depending on the severity of an individual’s case will help doctors to determine how long of a treatment period the patient will need.  This means that, per the U.S. National Library of Medicine, the standard cases require antibiotic treatments that can be completed in a week’s time; on the other hand, cases that are regarded as complicated take about three weeks to a month to be completed (para. 30). The most common way to prevent one from getting Bacterial Meningitis is to have the individual vaccinated. There are currently vaccinations available people can receive to stay protected against the potentially fatal disease. Researchers working for the CDC have found vaccinations currently exist that target the most common bacteria in which cause Bacterial Meningitis (CDC, 2017, para. 13).

Socio-Politico-Economic:

 With the onset of possibly contracting Bacterial Meningitis, individuals are faced with an even bigger problem. The new problem is trying to obtain the vaccine for Bacterial Meningitis in which could help to protect individuals from spreading the disease from one person to other individuals. Many researchers for the World Health Organization are under the impression that:

 The socioeconomic implications of epidemic meningococcal disease are serious. Control and prevention of the epidemic require a considerable amount of vaccine, medicines and logistical support from the national health authorities of the affected countries (Impact of the Problem, 2015, para. 9).

This means that the vaccine is highly sought after by healthcare professionals, yet it isn’t always readily available to administer to individuals who are currently suffering from Bacterial Meningitis. This also means that the medicine is only limited to those who can pay the often-hefty price for the vaccine. Many researchers report that people should have high hopes for one day being able to further spread the availability of Bacterial Meningitis vaccinations.

References

• Agamanolis, D. (2016). Chapter 5 INFECTIONS OF THE NERVOUS SYSTEM. Retrieved October 1, 2018, from http://neuropathologyweb.org/chapter5/chapter5aSuppurative.html
• Caugant, D. A., & Maiden, M. C. (2004). Meningococcal carriage and disease—Population biology and evolution. US National Library of Medicine National Institutes of Health Search Database. doi: 10.1016/j.vaccine.2009.04.061
• Clinic, C. (2018). Bacterial Meningitis Symptoms, Treatment & More. Retrieved October 02, 2018, from https://my.clevelandclinic.org/health/diseases/11039-bacterial-meningitis
• Hoffman, O., & Weber, R. J. (2009, November). Pathophysiology and Treatment of Bacterial Meningitis. Retrieved October 6, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002609/
• Impact of the problem. (2015, July 24). Retrieved October 8, 2018, from http://www.who.int/csr/disease/meningococcal/impact/en/
• McGill, F., Heyderman, R. S., Pangiotou, S., Tunkel, A. R., & Soloman, T. (2016, December 17). Acute Bacterial Meningitis in adults. Retrieved September 30, 2018, from https://www-sciencedirect-com.libproxy.estrellamountain.edu/science/article/pii/S0140673616306547
• Meningitis. (2017, January 25). Centers for Disease Control and Prevention. Retrieved October 6, 2018, from https://www.cdc.gov/meningitis/bacterial.html
• Meningitis. (2012, March 15). Centers for Disease Control and Prevention. Retrieved September 29, 2018, from https://www.cdc.gov/meningitis/lab-manual/chpt02-epi.html
• Statistics and Disease Facts. (2018). Retrieved September 29, 2018, from https://www.nmaus.org/disease-prevention-information/statistics-and-disease-facts/
• Yazdankhah, S. P., & . Caugant1, D. A. (2004). Neisseria meningitidis: An overview of the carriage state. Journal of Medical Microbiology, 821-832. doi:DOI 10.1099/jmm.0.45529-0