Meningitis is an infection affecting the meninges, the envelopes surrounding the brain. It can be caused by bacteria, called meningococci. This infection is very serious and must be treated immediately.
Bacterial meningitis is caused by bacteria. According to’Pastor Institute of Paris, they affect 500,000 people a year worldwide. If there are 12 serogroups of meningococci, serogroups A, B, C, W, X and Y are the cause of almost all cases of infection. In France, according to data from Public Health France as of December 31, 2022, 322 cases have been listed. In 2022, there was a resumption of meningococcal circulation, particularly in the east of the country. Bacterial meningitis is a disease that can be very serious. It’s a medical emergency. In 2022, it was responsible for the deaths of 33 people. “This recovery continues in 2023“, remarks Dr. Catherine Weil-Olivier, Professor of Pediatrics whom we interviewed.
Definition: what is bacterial meningitis?
Bacterial meningitis is caused by bacteria. “In the newborn, group B streptococci, Escherichia coli and Listeria monocytogenesdominate, says Dr. Weil-Olivier. In both children and adults, the most common bacteria are meningococcus (Neisseria meningitidis), pneumococcus (Steptococcus pneumoniae) and very rarely l’Haemophilus influenzae de type b. When it occurs, most often unpredictably, this disease can be very serious and leave lifelong sequelae. It most often occurs in babies, children, adolescents and young adults under the age of 24.“. It is more common in winter.
“Bacterial meningitis occurs by passing through the blood or directly through the meninges to the cerebrospinal fluid that surrounds the brain, from bacteria present in the nasopharynx“, explains Dr. Weil-Olivier.
Is bacterial meningitis contagious?
Meningococci are contagious. They are transmitted by direct, close air contact (less than one meter) and facilitated by contaminated nasopharyngeal secretions. “If, in the vast majority of cases, this contamination will only cause a simple colonization of the nose and pharynx by the bacteria, in rare cases we describe grouped cases of meningitis“, remarks our expert.
Is it serious in young children?
Yes, bacterial meningitis, especially meningococcal, which develops in these age groups can be serious. “Even rapid medical treatment, which is necessary, is not always enough to avoid often serious sequelae, even the death of the child“, laments the pediatrician.
A stiff neck is suggestive of bacterial meningitis
Is it serious in adults?
Yes, bacterial meningitis in adults is a serious disease. “It often comes in the form of a lung infection, invasive infection without meningitissays Dr. Weil-Olivier. Meningitis and invasive infection are all the more serious as they develop in people who are already weakened (a certain number of factors favor the occurrence less than the severity of invasive meningococcal infections)“. Here again, to avoid serious sequelae, even death, as much as possible, they require rapid treatment.
What are the symptoms of bacterial meningitis?
They are non-specific. The most frequent, often associated, are:
- Fever and headache sometimes violent
- Of the vomiting
- A lethargy even disturbances of consciousness
- A stiff neck is evocative
- Of the bleeding spots on the skin (which do not disappear when pressed, signing a purpura). Their existence, extent and progression is a sure marker of disease severity.
In newborns and infants, a change in behavior, refusal of food in the context of fever, a fortiori in the presence of convulsions alert. Neck stiffness is often replaced by neck hypotonia. The bulging of the fontanelle in infants too.
What is the average duration of bacterial meningitis?
“Depending on the case and the germ in question, bacterial meningitis may require between three and ten days of hospital stay, sometimes more in the presence of complications“, says Dr. Weil-Olivier.
What is the treatment for bacterial meningitis?
The diagnosis is made on clinical history, clinical examination and performance of a lumbar puncture (sampling of cerebrospinal fluid) supplemented by a blood culture (blood sample in search of bacteria present there). “A suspected meningitis patient is still hospitalized and receives as soon as possible intravenous antibiotic treatment. Depending on the results of the tests (sensitivity of the germ to antibiotics and possible resistance to them), this treatment may be adapted. The average duration of treatment is one to three weeks. Some subjects, because of their general condition (state of septic shock, visceral failure) must spend a few days in intensive care“says the pediatrician.
Is there a risk of sequelae?
“Despite a diagnosis that is as rapid as possible, facilitating immediate management, thehe risk of neurological, auditory or visual sequelae still exists in 20 to 40% of cases of meningitis according to recent studies“, laments Dr. Weil-Olivier. Some brain damage is irreversible and can cause hearing loss, speech, language, memory and communication disordersdevelopmental delay in children and psychological disorders.
Is there a vaccine to prevent the risk of bacterial meningitis?
Prevention through vaccination is very effective. In France, theThe Meningococcal C vaccine has been mandatory since 2018 (it is one of the 11 compulsory vaccines). The first dose is administered at the age of 5 months, followed by a booster at 12 months. All subjects between 1 and 24 years old, not vaccinated, can receive a catch-up dose.
Vaccination against meningococcal B infections is recommended and reimbursed for people with risk factors and since 2022 in all infants up to two years of age. It requires 3 doses, according to the following schedule: a dose at the age of 3 months and 5 months, and a booster dose at 12 months. Remedial measures are also possible. The vaccine against Meningococci A, C, W and Y is recommended if you are a contact case of a person with meningitis linked to a serogroup W or Y, for laboratory workers working specifically on meningococci and people who have received a bone marrow transplant or who have certain immune deficiencies. In people planning to travel to an endemic areathe vaccine is recommended but not reimbursed.
Thanks to Dr. Catherine Weil-Olivier, Professor of Pediatrics at the University of Pari-Cité, specialist in meningitis.
Source: Epidemiological situation of invasive meningococcal infections in France, December 31, 2022, Public Health France