The Meningococcal Meningitis - Essay Example

Meningitis Hearing Loss CONTENT Introduction to Meningococcal Meningitis 3 Meningitis Hearing Loss 4 Disease Transmission 6 Symptoms 6 Diagnosis and Treatment 6 Epidemiology of Meningococcal Meningitis 7 Prevention and Vaccination 7 Outline 9 Summary 10 References 11 MENINGITIS HEARING LOSS Neisseria meningitidis (N. meningitidis) Haemophilus influenzae (H. influenzae) Streptococcus pneumoniae (S. pneumoniae) Meningococcal disease (meningitis) was first described in 1805 when an outbreak swept through Geneva, Switzerland. The causative agent, Neisseria meningitidis, a meningococcus, gram-negative, aerobic, nonmotile diplococcus, was identified in 1887. Meningitis is inflammation of the meninges, which consist of three membranes that cover the brain and spinal cord: the dura mater, and the arachoid membrane, and the pia mater. Often referred to it as spinal meningitis, it is frequently caused by a viral or bacterial infection. Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability. Meningitis hearing loss typically appears after a bout with meningitis. Before the 1990s, Haemophilus influenzae Type B (Hib) was the leading cause of bacterial meningitis, but with new vaccines as part of routine immunizations, the occurrence of this invasive disease has reduced. Today, Streptococcus pneumoniae and N. meningitidis are the leading causes of bacterial meningitis. It can be caused by various infectious agents, including viruses, fungi, and protozoa, but bacteria produce the most life-threatening infection. Factors such as age, history of head trauma cerebrospinal fluid leaks, and immune status may help determine the causative agent. The bacteria that is responsible for meningitis are the meningococcus (N. meningitidis), most important because of its potential to cause epidemics; influenza bacillus (H. influenzae); and various strains of pneumococci, streptococci, or staphylococci. H. influenzae occurs in infants and young children but only rarely in the elderly, and its course and symptoms resemble those of N. meningitidis. In adults, the bacterium pneumococcus (S. pneumoniae) is a common cause of meningitis. Meningitis hearing loss can range in varying degrees, mild, moderate, severe, profound or total. Though meningitis is a cause of hearing loss, there are others which are congenital or acquired. Hearing loss can be classified by the auditory system that is defective. The causes can be divided into two basic types: conductive and sensorineural hearing loss. Conductive hearing loss is caused by anything that interferes with the transmission of sound from the outer to the inner ear. Possible causes include: middle ear infections (otitis media); collection of fluid in the middle ear ("glue ear" in children); blockage of the outer ear (wax); damage to the eardrum by infection or an injury; otosclerosis, a condition in which the ossicles of the middle ear become immobile, birth defect or abnormal rumor. Conductive hearing loss results from abnormalities or diseases of the outer or middle ear; sensorineural hearing loss results from abnormalities or diseases of the inner ear or auditory nerve; and central hearing impairment results from abnormalities or diseases of the auditory portions of the central nervous system. Sensorineural hearing loss is due to damage to the pathway for sound impulses from the hair cells of the inner ear to the auditory nerve and the brain. Possible causes include: age-related hearing loss; acoustic trauma (injury caused by loud noise) to the hair cells; viral infections of the inner ear (viruses such as mumps or measles); Menieres disease (abnormal pressure in the inner ear); certain drugs, such as aspirin, quinine and some antibiotics can affect the hair cells; a benign (non-cancerous) tumor affecting the auditory nerve; viral infections of the auditory nerve (such as mumps and rubella); and infections or inflammation of the brain or brain covering such as meningitis. Meningitis, the inflammation of the meninges of the brain or spinal cord, is an infection of Central Nervous System (CNS). Reported by some studies, a leading cause of morbidity from bacterial meningitis is an irreversible, usually profound sensorineural hearing loss, with an incidence as high as 30%. Bacterial meningitis remains the most common cause of acquired postnatal sensorineural deafness. Hearing loss is the most common after-effect of meningitis. It results from a board range of causes, some reversible, temporary or permanent. Damage to the inner ear can also result in balance problems and tinnitus (ringing in the ears). How common is meningitis as a cause of hearing loss? According to the Gallaudet Research Institutes Regional and National Summary of Report Data from the 1999-2000 Annual Survey of Deaf and Hard of Hearing Youth, meningitis is responsible for 5.9% of hearing loss. It is the leading post-natal cause of hearing loss. N. meningitidis is associated with the least amount and degree of hearing loss. However, before the discovery of the H. influenzae type B conjugate vaccines, bacterial meningitis accounted for close to 10% of acquired deafness in children. Major Portions of the Ear Disease Transmission An internal bacterial infection elsewhere in the body may be carried to the meninges through the bloodstream itself or from an adjacent infected organ, such as the middle ear or the nasal sinuses. While external bacteria are transmitted from person to person through droplets of respiratory or throat secretions. Close and prolonged contact such as kissing, sneezing, and coughing; living in close quarters or dormitories such as military recruits, college students, sharing eating or drinking utensil, facilitate the spread of the meningitis. With average incubation period is four days, ranging between two and ten days, N. meningitidis only infects humans; there is no other animal reservoir. Symptoms Bacterial meningitis usually has three main stages. At first, the bacteria multiply in the nasal passages and throat, often causing no painful symptoms. Next, they invade the blood, introducing toxic substances into the circulation and causing fever. If the infection is caused by N. meningitidis, a rash may appear and develop into hemorrhagic spots (petechiae) in severe cases. In the third stage, meningitis develops when the bacteria multiply in the meninges, where they produce intense inflammatory changes and an exudate of pus. The classical symptoms of meningitis are headache, neck stiffness and photophobia (intolerance of bright light), this trio is called meningism. Fever and chills are often present, along with myalgia. An altered state of consciousness or other neurological deficits may be present depending on the severity of the disease. In meningococcal meningitis or septicaemia, a petechial rash may appear. Convulsions and hydrocephalus are known complications of meningitis. Diagnosis and Treatment Most important in the diagnosis of meningitis is examination of the cerebrospinal fluid. A fluid sample is obtained by lumbar puncture or a spinal tap should be performed promptly whenever the diagnosis of meningitis is suspected. Less commonly used, the ventricular tap requires a passage of a needle into the brain tissue. The opening pressure is recorded and the cerebrospinal fluid sample is taken for microscopic examination (complete blood count with differential), chemical analysis (glucose and protein) and microbiology (gram staining and bacterial cultures). A diagnosis is of meningitis is made on the basis of CSF abnormalities….changes in number and type of cells present, a decrease in glucose content of the CSF, and recovery of the harmful bacterial from the fluid. In treatment for bacterial meningitis, it is important to know which type of bacteria is causing the meningitis because antibiotics can prevent spreading and infecting others. Epidemiology of Meningococcal Meningitis There are nearly 3,000 cases every year in the U.S. According to the Centers for Disease Control and Prevention (CDC), between 10-12 % of the cases are fatal. Among those who survive meningococcal meningitis, approximately 20% suffer long-term consequences, such as brain damage, kidney disease, hearing loss or limb amputations. Meningococcal meningitis occurs sporadically in small clusters throughout the world with seasonal variations and accounts for a variable proportion of endemic bacterial meningitis. Adolescent and young adults may be at an increased risk of infection due to certain lifestyle factors, such as: crowded living conditions (such as dormitories, boarding schools and sleep-away camps), moving to a new residence, attendance at a new school with students from geographically diverse areas, sharing beverages or utensils, going to bars, active or passive smoking, and irregular sleeping patterns. Other risk groups include infants and young children, refugees, household contacts of case patients and military personnel. Prevention and Vaccination The ideal way of preventing deafness due to bacterial meningitis is to eliminate this infection altogether. Several vaccines are available to prevent the disease. Polysaccharide vaccines, which have been available for over 30 years, exist against serogroups A, C, Y, and W135 in various combinations. A monovalent conjugate vaccine against serogroup C has recently been licensed in developed countries for use in children and adolescents. The pneumococcal polysaccharide vaccine is recommended for all persons over 65 years of age and younger persons at least two years old with certain chronic medical problems. These vaccines have been proven to be safe and effective with infrequent and mild side effects. However, a vaccines may not provide adequate protection for 10 to 14 days following injection. OUTLINE Introduction to Meningococcal Meningitis A. Brief History B. Bacteria 1. Neisseria meningitidis (N. meningitidis) 2. Haemophilus influenzae (H. influenzae) 3. Streptococcus pneumoniae (S. pneumoniae) Meningitis Hearing Loss A. Conductive Hearing Loss B. Senorineural Hearing Loss C. Central Nervous System Disease Transmission A. Internal Bacteria B. External Bacteria Symptoms A. Bacteria Multiplies B. Bacteria Invade C. Meningitis Develops D. Classic Symptoms 1. Headache 2. Neck stiffness 3. Convulsions Diagnosis and Treatment A. Examination of Cerebrospinal Fluid B. Lumbar Tap or Spinal Tap C. Microscopic Examination D. Antibodies Epidemiology of Meningococcal Meningitis A. Prevalence B. Cases Annual in US 1. Survival Rate 2. Risk of Infection Prevention and Vaccination A. Eliminate Infection B. Vaccination 1. Polysaccharide Vaccine 2. Monovalent Conjugate Vaccine 3. Pneumoccocal Polysaccharide Vaccine SUMMARY Meningitis is the serious disease that affects the membranes covering the brain and the cerebrospinal fluid (CSF) which surrounds the brain and the spinal cord. Meningitis occurs when the CSF in overwhelmed with infection organism such as bacteria, viruses, fungi or parasites. The most life threatening types of meningitis are caused by bacteria and viruses. Though the immunization has greatly reduced the occurrence, meningitis is the most feared human infectious disease. The disease has no preference because it attacks all age groups but infants and children are more likely to be afflicted than others. The organisms which are more apt to cause meningitis and result in hearing loss include: Neisseria meningitidis (N. meningitidis), Haemophilus influenzae (H. influenzae), and Streptococcus pneumoniae (S. pneumoniae). Meningitis is extremely contagious. It appears that a carrier can transmit it with much ease….a cough, utensil, basic human contact. The symptoms are similar to those of many other acute diseases; therefore, detection, an accurate diagnosis and the immediate treatment are all the difference between life and death. Vaccines have adequately reduced meningitis but it would be better if it were completely eliminated. REFERENCES Bell, William E. "Meningitis". (2000). In AccessScience@McGraw-Hill. 12 March 2006. . DOI 10.1036/1097-8542.414700. Last modified: 10 April 2000. Berke, Jamie. (2006). "Cause of Hearing Loss – Meningitis: To Survive and Be Deaf is a Miracle". About, Incorporation. The New York Times Company. 12 March 2006 . "Dont Be Silent About Hearing Loss". (2001). Harvard Womens Health Watch. Volume 8 Issue 12, Page 4. 12 March 2006 http://library.troy.edu:2051/ login.aspx?direct=true&db=hch&an=5720571. "Ear Disease". Encyclopedia Britannica. (2006). Encyclopedia Britannica Online. 12 March 2006 . President and Fellows of Harvard College. (2001). "Dont be Silent About Hearing Loss". Harvard Medical School Health. Harvard Health Publications. Kaplan, Sheldon L. (1997). "Prevention of Hearing Loss From Meningitis". The Lancet. 19 July 1997. Volume 350. Number 9072. Page 158. 12 March 2006   .   Kesser, Bradley W. and Hashisaki, George T., et al. (1999). "Time Course of Hearing loss in an Animal Model of Pneumococcal Meningitis". Otolaryngology - Head and Neck Surgery. Volume 120. Issue 5. May 1999. Pages 628-637. 12 March . McCance, Kathryn and Huether E. (1998). Pathothysiology: The Biologic Basis for Disease in Adults and Children. 3rd Edition. St. Louis, Missouri: Mosby. Page 610-12. "Meningitis" (2006). From Wikipedia, the Free Encyclopedia.12 March 2006 . "Meningitis". Encyclopedia Britannica. (2006). Encyclopedia Britannica Online. 8 Mar. 2006 . "Meningococcal Disease". (2005). Centers for Disease Control and Prevention. National Center for Infectious Diseases/Division of Bacterial and Mycotic Diseases. 12 March 2006 . "Meningococcal Meningitis". World Health Organization. (2006). 12 March 2006 http://www.who.int/mediacentre/factsheets/fs141/en/. "Neurologic Disorders". The Merck Manual of Diagnosis and Therapy. Section 14. Chapter 176. Central Nervous System Infections. 12 March 2006. http://www. merck.com/mrkshared/mmanual/section14/chapter176/176a.jsp. Parker, James N. and Parker, Philip M. (2003). Meningitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References (eBook). San Diego, CA: Icon Group International, Incorporation. 12 March 2006 . Parker, James N. and Parker, Philip M. (2002). The Official Patients Sourcebook On Meningitis (eBook). San Diego, California: Icon Group International, Incorporation. 12 March 2006 < http://library.troy.edu:2136/Reader/>. Popelka, Gerald R. (2002). "Hearing impairment". In AccessScience@McGraw-Hill. 12 March 2006. http://www.accessscience.com, DOI 10.1036/1097-8542.309750. Last modified: 21 August 2002. Read More