Meningitis in sub Saharan Africa kills 1670 people in 2 months...

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Meningitis has infected nearly 16,000 people and killed 1,670 in sub-Saharan Africa in the last two months, the World Health Organization (WHO) said on Friday.

The United Nations agency said it was working with Medicins Sans Frontieres (Doctors Without Borders) to contain the outbreak with vaccinations in Burkina Faso, the Democratic Republic of Congo, Sudan and Uganda.

Some 1.5 million people in the four affected countries have been targeted by mass vaccination campaigns so far, though large numbers of displaced people and those living in hard-to-access areas have presented a challenge, the WHO said.

Outbreaks are worse during the dry season in the meningitis belt that runs from East to West Africa.

Transmitted by coughing or sneezing, meningitis is an infection of the thin lining that surrounds the brain and spinal cord. It can cause brain damage and deafness, and kills between 5 and 10 percent of those infected.

Meningitis in Africa kills 1,670 in two months: UN on Yahoo! Health

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most cases of meningitis are caused by microorganisms (such as viruses, bacteria, fungi, or parasites) that spread into the blood and into the cerebrospinal fluid (CSF). Non-infectious causes include cancers and certain drugs. Although the most common cause of meningitis is viral, bacterial meningitis (the second most frequent cause) can be very serious and life-threatening. Anyone suspected of having meningitis should have prompt medical evaluation. Meningitis can affect anyone in any age group, from the newborn to the elderly.

Meningitis usually presents with these symptoms:

High fever, sometimes with chills , sometimes SUDDEN high fever.
Severe headache
Nausea
Vomiting
Light sensitivity (called "photophobia")
Sound sensitivity
Neurological signs such as drowsiness or confusion
Twitching
Opisthotonus
Delirium (particularly in children[1])
Seizures (occurs in about 20 to 40% of patients).
Nuchal rigidity (stiff neck) (occurs in less than 50% of cases, but if seen, it is considered pathognomon.




Treatment
Bacterial meningitis
Bacterial meningitis is a medical emergency and has a high mortality rate if untreated.[3] All suspected cases, however mild, need emergency medical attention. Empiric antibiotics must be started immediately, even before the results of the lumbar puncture and CSF analysis are known. Antibiotics started within 4 hours of lumbar puncture will not significantly affect lab results.

The choice of antibiotic depends on local advice. In most of the developed world, the most common organisms involved are Streptococcus pneumoniae and Neisseria meningitidis: first line treatment in the UK is a third-generation cephalosporin (such as ceftriaxone or cefotaxime). In those under 3 years of age, over 50 years of age, or immunocompromised, ampicillin should be added to cover Listeria monocytogenes. In the U.S. and other countries with high levels of penicillin resistance, the first line choice of antibiotics is vancomycin and a carbapenem (such as meropenem). In sub-Saharan Africa, oily chloramphenicol or ceftriaxone are often used because only a single dose is needed in most cases.

Staphylococci and gram-negative bacilli are common infective agents in patients who have just had a neurosurgical procedure. Again, the choice of antibiotic depends on local patterns of infection: cefotaxime and ceftriaxone remain good choices in many situations, but ceftazidime is used when Pseudomonas aeruginosa is a problem, and intraventricular vancomycin is used for those patients with intraventricular shunts because of high rates of staphylococcal infection. In patients with intracerebral prosthetic material (metal plates, electrodes or implants, etc.) then sometimes chloramphenicol is the only antibiotic that will adequately cover infection by Staphylococcus aureus (cephalosporins and carbapenems are inadequate under these circumstances).

Once the results of the CSF analysis are known along with the Gram-stain and culture, empiric therapy may be switched to therapy targeted to the specific causative organisms. Because antibiotic-resistance is a prevalent problem, information from drug susceptibility testing should also be gathered.

Neisseria meningitidis (Meningococcus) can usually be treated with a 7-day course of IV antibiotics:
Penicillin-sensitive -- penicillin G or ampicillin
Penicillin-resistant -- ceftriaxone or cefotaxime
Prophylaxis for close contacts (contact with oral secretions) -- rifampin 600 mg bid for 2 days (adults) or 10 mg/kg bid (children). Rifampin is not recommended in pregnancy and as such, these patients should be treated with single doses of ciprofloxacin, azithromycin, or ceftriaxone
Streptococcus pneumoniae (Pneumococcus) can usually be treated with a 2-week course of IV antibiotics:
Penicillin-sensitive -- penicillin G
Penicillin-intermediate -- ceftriaxone or cefotaxime
Penicillin-resistant -- ceftriaxone or cefotaxime + vancomycin
Listeria monocytogenes is treated with a 3-week course of IV ampicillin + gentamicin.
Gram negative bacilli -- ceftriaxone or cefotaxime
Pseudomonas aeruginosa -- ceftazidime
Staphylococcus aureus
Methicillin-sensitive -- nafcillin
Methicillin-resistant -- vancomycin
Streptococcus agalactiae -- penicillin G or ampicillin
Haemophilus influenzae -- ceftriaxone or cefotaxime

Viral meningitis
Unlike bacteria, viruses cannot be killed by antibiotics. Patients with very mild viral meningitis may only have to spend a few hours in hospital, while those who have a more serious infection may be hospitalised for many more days for supportive care. Patients with mild cases, which often cause only flu-like symptoms, may be treated with fluids, bed rest (preferably in a quiet, dark room), and analgesics for pain and fever. The physician may prescribe anticonvulsants such as phenytoin to prevent seizures and corticosteroids to reduce brain inflammation. If inflammation is severe, pain medicine and sedatives may be prescribed to make the patient more comfortable. However, this type of meningitis is highly contagious during its early stages, so patients must be kept isolated for at least several days.

Fungal meningitis
This form of meningitis is rare in healthy people, but is a higher risk in those who have AIDS. Antifungals to combat the infection are usually administered, as well as fluids and medicine to control pain and fever


Kids often get vaccinations against it.