Meningitis

Illustration shows meningitis - brain inflammation

Bacterium Neisseria meningitidis

The bacterium Neisseria meningitidis, which causes meningococcal infection and its dangerous consequences - meningitis, meningoencephalitis and sepsis - is transmitted from one infected to another and colonizes the lining of the tonsils and pharyngeal walls. Read more here.

Types of meningitis: A, B, C

Several strains of meningococcus are known. For example, subspecies A is "responsible" for the largest outbreaks of meningitis in the 20th century - all such cases between 1914 and 1945 were caused by them. By 2024, meningococcus type B and C provide a stable incidence around the world.

Generalized meningococcal disease (GFMI)

The generalized form of meningococcal infection is very dangerous: every fifth patient (19%) died in 2023. Doctors warn parents to see a doctor immediately at the first warning signs. High fever, which is seriously confused by antipyretic agents, pallor of the skin and an unusual rash on the body, should be alerted. In these cases, it is impossible to self-medicate - it is necessary to urgently call an ambulance.

"GFMI is developing rapidly. The daily mortality rate with it is 67% - most of the sick die in less than 24 hours. Among them there are adults, but most often, these are children. Unfortunately, we still cannot understand why in some children the infection is mild, some do not even get sick, but remain carriers, and others it starts rapidly, moreover, alas, often with a fatal outcome, despite all the efforts of doctors, Alla Vilnitz, Doctor of Medical Sciences, neurologist, leading researcher of the Department of Vaccine Prophylaxis and Post-Vaccination Pathology of the Federal State Budgetary Institution "Children's Scientific and Clinical Center for Infectious Diseases of the FMBA," said in June 2024. - And no, there is no prevention other than vaccination. "

Vaccination against meningitis

Infection with a bacterial infection can lead to inflammation not only of the lining of the brain, but also of the brain itself (meningoencephalitis), as well as blood infection (sepsis). In severe form, the disease is lightning fast and can kill in just a few hours. And patients who can be saved often face serious long-term consequences - from impaired vision and hearing to amputation of limbs. In addition, therapy does not always manage to start quickly. This is due to the fact that bacterial meningitis can be difficult to diagnose, because its symptoms are similar to the manifestations of other diseases - from colds to banal poisoning.

Modern vaccines protect against several strains of meningococcal infection at once - they cover the main serogroups of meningococcal, which are present in most regions, and prevent even more cases of the disease.

2023: Death of two Ozon employees who contracted meningococcal disease in Yekaterinburg

On July 6, 2023, it became known about the death of two Ozon employees infected with meningococcus in Yekaterinburg. In total, Rospotrebnadzor in the Sverdlovsk region recorded seven cases of the development of such an infection in the company. Read more here.

2022: An outbreak of infectious meningitis occurred at the Ozon warehouse in the Moscow region

At the end of November 2022, 11 people working at the Ozon warehouse in Istra near Moscow were hospitalized with infectious meningitis. At the same time, more than 15 people with signs of ARVI were identified in the foci, they were placed in medical institutions for treatment, observation and laboratory examination. Read more here.

2019: Global meningitis deaths drop by one and a half times in the last 30 years

In 2019, 2.51 million cases of meningitis were recorded globally, and the number of deaths due to this disease amounted to approximately 236 thousand. Such figures are given in a study, the results of which were published in mid-August 2023 in the journal The Lancet: Neurology.

As the World Health Organization (WHO) notes, meningitis is a severe disease with high mortality, which can cause serious long-term complications. The ailment is associated with inflammation of the membranes of the brain and spinal cord. Meningitis remains one of the most important health problems in the world. At the same time, as a new study sponsored by the Bill and Melinda Gates Foundation showed, between 1990 and 2019, deaths from meningitis around the world among all age groups decreased by 56%, that is, more than one and a half times.

Children under the age of five are most at risk of developing meningitis, the study says. In this group in 2019, about 1.28 million cases of the disease and about 112 thousand deaths were registered.

Overall, age-standardized death rates from meningitis decreased from 7.5 per 100,000 residents in 1990 to 3.3 per 100,000 population in 2019. Among children under the age of 5, the mortality rate in 2019 was 16.9 per 100,000 population, compared with 45 per 100,000 people in 1990: thus, a fall of 62.3% was recorded. Among newborns, deaths from meningitis during the specified period decreased from 296.7 to 137.2 per 1000 000 people, which corresponds to a decrease of 53.8%.

The most common cause of fatal meningitis among all ages in 2019 was Streptococcus pneumoniae (18.1%). Next come Neisseria meningitidis (13.6%) and Klebsiella pneumoniae (12.2%).^[1]

1960s: Meningococcal vaccine

The first vaccines capable of protecting against meningitis began to be developed in the early 1900s. In the 1930s, safe and effective vaccines against pneumococcal disease were first created, and in the 1960s, against meningococcal disease. These developments have produced incredible results - worldwide, the incidence of bacterial meningitis has decreased by 25%.

1941: Successful use of penicillin

A couple of decades later, the standard of care for meningococcal meningitis was the antibacterial drug sulfanilamide, a cheaper and safer remedy than antiserum. By 1941, after the discovery of penicillin by Alexander Fleming, immune serums were completely out of use - the era of antibiotics began. During World War II, several outbreaks of meningococcal meningitis were reported, especially among the military, and it was the American Army that first recorded cases of successful cure of entire groups of patients with penicillin. One report described an outbreak that affected 71 soldiers and only one died after treatment.

Creating immune serum with equine antibodies

During epidemics in the early 20th century, Georg Johmann and Simon Flexner created an immune serum containing antibodies obtained from animals injected with bacteria that cause meningitis. It turned out that this helps not only to prevent the disease, but also to treat it. The introduction of equine antiserum into the cerebrospinal fluid has become the main method of therapy for meningococcal meningitis. During the First World War, many lives were saved.

1840: Outbreak in Africa

In 1840, an outbreak of meningitis was recorded in Africa. Large epidemics of meningococcal meningitis (up to 500 cases per 100,000 inhabitants) occur in the so-called "meningitis belt" - Africa, south of the Sahara - and in the 2020s.

19th century: The emergence of the term "meningitis"

The 19th century was a truly breakthrough in the treatment of meningitis. At this time, the Scottish physician John Abercrombie (1780-1844) in his textbook on neuropathology was one of the first to use the term "meningitis" (from the Latin word meningis - "braincase" and the suffix -itis "inflammation"), after which this designation became widespread. By the end of the 19th century, it was known about bacteria provoking meningitis, but they could only be determined after the death of the patient. The situation at the root was changed by the discovery of Heinrich Quinke, who first performed a lumbar puncture - the collection of cerebrospinal fluid through the insertion of a needle into the spinal cord. This made it possible to diagnose the disease during the patient's lifetime. However, it was too early to talk about a complete understanding of the mechanisms of the disease.

1805: Meningococcal meningitis outbreak in Geneva kills 33

An outbreak of meningococcal meningitis was recorded in Geneva: it arose in January 1805 and killed 33 people in three months. The then popular "miasma theory" attributed the spread of the disease to "bad air," so it was not thought to be transmitted from person to person.

During the Geneva epidemic of 1805, patients were treated with vomiting agents, quinine wine and leeches. It was thought that reducing the amount of fluid in the body by bloodletting and vomiting would relieve the pressure of inflammation.

5th century BC: Mention of meningitis symptoms in Hippocratic writings

Ancient civilizations were already familiar with many infectious diseases affecting the central nervous system (CNS). Evidence of this is found in archaeological artifacts and anthropological specimens dating even earlier than written documents. In some cases, today you can even make a "modern" diagnosis of the characters of ancient images.

Due to the fact that the main clinical manifestations of meningitis are quite uncharacteristic (this may be headache fever, rash, confusion), it is consciousnesses not difficult to recognize it in early historical records. For example, in the works of Hippocrates, you can find many descriptions of the disease accompanied by symptoms similar to the signs of meningitis. At the same time, tracing the history of bacterial meningitis helps to understand how other bacterial neuroinfections developed.

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