It’s time to put pen to paper again and inspiration
eludes me as I battle with what I should write for the next
edition. May as well go to the net for a while, whilst I ponder
the next article. No need to look further than the home page,
and there it is. Meningococcal strikes again. A group of young
people in Australia have contracted the disease while at a
Sydney nightclub, where they shared cigarettes and drinking
glasses.
How could I forget, on a recent holiday to Australia, the
tears of a Mother who’s sixteen year old son had been
taken in less than 48 hrs by this horrifying disease; or the
face of the 4 year girl who had lost both feet, and most of
her fingers after surviving an almost fatal attack. What is
this menace with symptoms that read like something out of
a science fiction / germ warfare novel?
What is the difference between “Meningococcal”
and “Menigitis”
The term “meningitis” means “inflammation
of the brain”. There are many different kinds of Meningitis,
with equally as many causes (bacterial, viral, fungal, trauma).
The Meningoccocal Meningitis is what seems to be getting all
the attention these days, and is caused by a bacteria –
Neisseria Meningitidis. There are several different strains
of this bacteria, namely the types A, B, C, W135 & Y.
The Meningococcal can present it self as a brain infection
or a septicemia (general infection of the bloodstream). Once
the disease has progressed to septicemia, it may cause bleeding
into the tissues (purple / red spots under the skin) and eventually
cause death of the peripheral tissues (fingers, toes, feet).
This may result in amputation of the affected limbs and even
death of the victim. In 2000, 388 cases of Meningococcal were
reported in Australia, and 25 of those were fatal. No accurate
figures are available for Indonesia, but I imagine that the
figures are very similar. In this part of the world types
B (affecting mostly young adults) and C (affecting mostly
babies and young children) are of concern, and certainly cause
the most severe cases of the disease.
What are the symptoms of Menigococcal?
Early Meningococcal disease symptoms can be very similar
to a flu or heavy cold. This can be confusing and may potentially
delay a definitive diagnosis. The onset of Meningococcal is
very sudden (within hours to a few days) and symptoms in adults
may include:
Headache.
Fever.
Neck stiffness.
Nausea and vomiting.
Photophobia (light hurts the eyes).
Altered mental status.
A rash of purple red spots (not apparent in every case).
In babies and younger children you may expect to see all
of the above as well as:
Refusing feeds, loss of appetite.
High pitched cry or moan.
Difficult to rouse / drowsy.
Any one with the above symptoms should consult their Doctor
immediately as delay in diagnosis and treatment can worsen
the outcome.
How is Meningococcal spread?
Meningococcal is spread by bacteria found in the nose and
throat of healthy children and adults. 10 - 20% of thepopulation
carry the Niesseria bacteria and are unaffected by the disease.
The reason why some people develop or pass on the disease
is not clear. The bacteria are not able to survive for long
periods outside of the body, and die very quickly in an unfavorable
environment. It is spread by close contact such as kissing,
sharing drinks or eating utensils. It IS NOT spread by:
Swimming pools.
Water supplies.
Animals.
Air-conditioning vents etc.
How is Meningococcal treated?
Once Meningococcal is diagnosed with examination of the spinal
fluid (lumbar puncture), it is treated with very specific
antibiotics. The patient is generally very ill and will be
kept in an intensive care unit until their condition is stable.
Close contacts of the patient must also be treated with prophylactic
(preventative) antibiotics that will stop them from thedeveloping
the disease. The person affected by Meningoccocal will remain
infectious for as long as there are bacteria in the nose or
throat. This may be days or weeks after therapy has commenced.
What about a Vaccine?
A vaccine is available against Meningococcal Type C. In infants
3 doses of the vaccine are required to give life long immunity.
In Older children and adults, only one dose will give life
long protection. A combined vaccine against Types A,C,W135
&Y is available for adults and children over 2 years of
age. Only one dose of the vaccine is required initially, but
it does need to be boosted every 3 years. There is currently
no vaccine available against Meningococcal type B. Vaccination
with the Hib vaccine DOES NOT protect against the Meningococcal
meningitis. This vaccine gives immunity against the Hemophillus
Influenza Type B that can cause a different kind of meningitis
in children. No vaccine is 100% effective, so please have
your child assessed by a medical practitioner if they demonstrate
any disease symptoms even after they have been vaccinated.
Well that’s it for this edition, but before I sign
off I would like to send a big thank you to Pak Ben, and Ibu
Asri, both of whom gave up a cozy evening at home to donate
their precious Rh negative type blood. The young child who
had needed the transfusion was involved in a motor vehicle
accident, and had lost a critical amount of blood as a result
of the trauma. The boy is now in a stable condition and will
return home to his family in the near future. Had he not received
the blood transfusion the outcome would surely not have been
so bright. Thank you once again, and anyone wishing to put
their name on the emergency Rh-negative donor list may contact
me by e-mail or fax.
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
