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Death meningitis: Bacterial Meningitis | CDC

Bacterial Meningitis | CDC

Bacterial meningitis is serious. Some people with the infection die and death can occur in as little as a few hours. However, most people recover from bacterial meningitis. Those who do recover can have permanent disabilities, such as brain damage, hearing loss, and learning disabilities.

Causes

Several types of bacteria can cause meningitis. Leading causes in the United States include

  • Streptococcus pneumoniae
  • Group B Streptococcus
  • Neisseria meningitidis
  • Haemophilus influenzae
  • Listeria monocytogenes
  • Escherichia coli

Mycobacterium tuberculosis, which causes tuberculosis or TB, is a less common cause of bacterial meningitis (called TB meningitis).

Many of these bacteria can also be associated with another serious illness, sepsis. Sepsis is the body’s extreme response to infection. It is a life-threatening medical emergency.  Sepsis happens when an infection triggers a chain reaction throughout your body. Without timely treatment, sepsis can quickly lead to tissue damage, organ failure, and death.

Some causes of bacterial meningitis are more likely to affect certain age groups:

  • Newborns: Group B Streptococcus, S. pneumoniae, L. monocytogenes, E. coli
  • Babies and young children: S. pneumoniae, N. meningitidis, H. influenzae, group B Streptococcus, M. tuberculosis
  • Teens and young adults: N. meningitidis, S. pneumoniae
  • Older adults: S. pneumoniae, N. meningitidis, H. influenzae, group B Streptococcus, L. monocytogenes

Risk Factors

Certain factors increase a person’s risk for getting bacterial meningitis. These risk factors include:

  • Age: Babies are at increased risk for bacterial meningitis compared to people in other age groups. However, people of any age can develop bacterial meningitis. See section above for which bacteria more commonly affect which age groups.
  • Group setting: Infectious diseases tend to spread where large groups of people gather. For example, college campuses have reported outbreaks of meningococcal disease, caused by N. meningitidis.
  • Certain medical conditions: Certain medical conditions, medications, and surgical procedures put people at increased risk for meningitis. For example, having an HIV infection or a cerebrospinal fluid leak, or not having a spleen can increase a person’s risk for several types of bacterial meningitis.
  • Working with meningitis-causing pathogens: Microbiologists routinely exposed to meningitis-causing bacteria are at increased risk for meningitis.
  • Travel: Travelers may be at increased risk for meningococcal disease, caused by N. meningitidis, if they travel to certain places, such as:
    • The meningitis belt in sub-Saharan Africa, particularly during the dry season
    • Mecca during the annual Hajj and Umrah pilgrimage

In many countries, TB is much more common than in the United States. Travelers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environments (for example, clinics, hospitals, prisons, or homeless shelters).

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How It Spreads

Certain germs that cause bacterial meningitis, such as L. monocytogenes, can spread through food. But most of these germs spread from one person to another.

How people spread the germs often depends on the type of bacteria. It is also important to know that people can have these bacteria in or on their bodies without being sick. These people are “carriers.” Most carriers never become sick, but can still spread the bacteria to others.

Here are some of the most common examples of how people spread each type of bacteria to each other:

  • Group B Streptococcus and E. coli: Mothers can pass these bacteria to their babies during birth.
  • H. influenzae, M. tuberculosis, and S. pneumoniae: People spread these bacteria by coughing or sneezing while in close contact with others, who breathe in the bacteria.
  • N. meningitidis: People spread these bacteria by sharing respiratory or throat secretions (saliva or spit). This typically occurs during close (coughing or kissing) or lengthy (living together) contact.
  • E. coli: People can get these bacteria by eating food prepared by people who did not wash their hands well after using the toilet.

People usually get sick from E. coli and L. monocytogenes by eating contaminated food.

Signs and Symptoms

Being pregnant increases a person’s risk of getting a Listeria infection  (L. monocytogenes). Pregnant people with a Listeria infection may not have any symptoms or may only have a fever and other flu-like symptoms, such as fatigue and muscle aches. However, infection during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn, including meningitis. Find out which foods are more likely to contain Listeria and steps you can take to protect your and your baby’s health.

Pregnant women can pass group B Streptococcus (group B strep) to their baby during delivery. Newborns infected with group B strep can develop meningitis or other serious infections soon after birth. Talk with your doctor or midwife about getting a group B test when you are 36 through 37 weeks pregnant. Doctors give antibiotics (during labor) to women who test positive in order to prevent infections in newborns.

Meningitis symptoms include sudden onset of

  • Fever
  • Headache
  • Stiff neck

There are often other symptoms, such as

  • Nausea
  • Vomiting
  • Photophobia (eyes being more sensitive to light)
  • Altered mental status (confusion)

Newborns and babies may not have, or it may be difficult to notice the classic symptoms listed above. Instead, babies may

  • Be slow or inactive
  • Be irritable
  • Vomit
  • Feed poorly
  • Have a bulging fontanelle (the “soft spot” on a baby’s head)
  • Have abnormal reflexes

If you think your baby or child has any of these symptoms, call the doctor right away.

Typically, symptoms of bacterial meningitis develop within 3 to 7 days after exposure; note, this is not true for TB meningitis, which can develop much later after exposure to the bacteria.

People with bacterial meningitis can have seizures, go into a coma, and even die. For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

Diagnosis

If a doctor suspects meningitis, they will collect samples of blood or cerebrospinal fluid (fluid near the spinal cord). A laboratory will test the samples to see what is causing the infection. Knowing the specific cause of meningitis helps doctors treat it.

Treatment

Doctors treat bacterial meningitis with a number of antibiotics. It is important to start treatment as soon as possible.

Prevention

Vaccination

Vaccines are the most effective way to protect against certain types of bacterial meningitis. There are vaccines for 4 types of bacteria that can cause meningitis:

  • Meningococcal vaccines help protect against N. meningitidis
  • Pneumococcal vaccines help protect against S. pneumoniae
  • Haemophilus influenzae serotype b (Hib) vaccines help protect against Hib
  • Bacille Calmette-Guérin vaccine helps protect against tuberculosis disease, but is not widely used in the United States

Make sure you and your child are vaccinated on schedule.

Like with any vaccine, these vaccines do not work 100% of the time. The vaccines also do not protect against infections from all the types (strains) of each of these bacteria. For these reasons, there is still a chance vaccinated people can develop bacterial meningitis.

Prophylaxis

When someone has bacterial meningitis, a doctor may recommend antibiotics to help prevent people around the patient from getting sick. Doctors call this prophylaxis. CDC recommends prophylaxis for:

  • Close contacts of someone with meningitis caused by N. meningitidis
  • Household members of someone with a serious Hib infection when the household includes one or more people at increased risk of Hib based on age, vaccination status, and/or immunocompromising conditions

Doctors or local health departments recommend who should get prophylaxis.

Healthy Pregnancy Practices

Pregnant women should talk to their doctor or midwife about getting tested for group B Streptococcus. Women receive the test when they are 36 through 37 weeks pregnant. Doctors give antibiotics (during labor) to women who test positive in order to prevent passing group B strep to their newborns.

Pregnant women can also reduce their risk of meningitis caused by L. monocytogenes. Women should avoid certain foods during pregnancy and safely prepare others.

Healthy Habits

You can also help protect yourself and others from bacterial meningitis and other health problems by maintaining healthy habits:

  • Don’t smoke and avoid cigarette smoke as much as possible
  • Get plenty of rest
  • Avoid close contact with people who are sick
  • Wash your hands often with soap and water (use hand sanitizer if soap and water aren’t available)
  • Cover your mouth and nose with a tissue when you cough or sneeze (use your upper sleeve or elbow if a tissue isn’t available)

These healthy habits are especially important for people at increased risk for disease, including:

  • Young babies
  • Older adults
  • People with weak immune systems
  • People without a spleen or a spleen that doesn’t work the way it should

 

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The cause of death in bacterial meningitis

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. 2020 Feb 27;20(1):182.

doi: 10.1186/s12879-020-4899-x.

A Sharew 
1
, J Bodilsen 
2
, B R Hansen 
3
, H Nielsen 
2
 
4
, C T Brandt 
5
 
6

Affiliations

Affiliations

  • 1 Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark.
  • 2 Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • 3 Department of Infectious Diseases, University Hospital Copenhagen Hvidovre, Hvidovre, Denmark.
  • 4 Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • 5 Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark. [email protected].
  • 6 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. [email protected].
  • PMID:

    32106821

  • PMCID:

    PMC7045616

  • DOI:

    10.1186/s12879-020-4899-x

Free PMC article

A Sharew et al.

BMC Infect Dis.

.

Free PMC article

. 2020 Feb 27;20(1):182.

doi: 10.1186/s12879-020-4899-x.

Authors

A Sharew 
1
, J Bodilsen 
2
, B R Hansen 
3
, H Nielsen 
2
 
4
, C T Brandt 
5
 
6

Affiliations

  • 1 Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark.
  • 2 Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • 3 Department of Infectious Diseases, University Hospital Copenhagen Hvidovre, Hvidovre, Denmark.
  • 4 Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • 5 Department of pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hilleroed, Denmark. [email protected].
  • 6 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. [email protected].
  • PMID:

    32106821

  • PMCID:

    PMC7045616

  • DOI:

    10. 1186/s12879-020-4899-x

Abstract


Background:

Death from bacterial meningitis is rarely attributed to the actual event causing death. The present study therefore categorized and characterized the cause and time of death due to bacterial meningitis.


Methods:

In a cohort of patients > 15 years of age with community acquired bacterial meningitis the medical records were reviewed, and a clinical cause of death categorized into six main categories: 1) CNS complications, 2) Systemic complications, 3) Combination of systemic and CNS complications, 4) Sudden death, 5) Withdrawal of care, or 6) Unknown.


Results:

We identified 358 patients of which 84 (23%) died in-hospital. Causes of death were ascribed to CNS complications in 43%, Systemic complications in 39%, Combined CNS and systemic complications in 4%, Sudden death in 7% and withdrawal of care in 5%. Brain herniation, circulatory failure, intractable seizures and other brain injury were the most common specific causes of death within 14 days from admission (55%).


Conclusion:

Fatal complications due to the primary infection – meningitis – is most common within 14 days of admission. The diversity of complications causing death in meningitis suggest that determining the clinical cause of death is essential to the evaluation of novel treatment strategies.


Keywords:

Bacterial meningitis; Brain herniation; Cause of death; Central nervous system complications; Sepsis; Systemic complications.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

Time from admission to death.…

Fig. 1

Time from admission to death. At 7 days from admission 41 of 84…


Fig. 1

Time from admission to death. At 7 days from admission 41 of 84 patients were dead (49%). Within 14 days of admission 56 patients (66%) had died. Median time to death was 8 days (3 to 16.8)

See this image and copyright information in PMC

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Everything we know about the deadly meningococcal outbreak at Ozon’s warehouse – July 7, 2023 in Yekaterinburg there was an outbreak of meningococcal an infection that develops in a matter of hours, affecting young and healthy people.

According to the latest official data, the disease was confirmed in eight employees of the warehouse, at least two of them died. The Ministry of Health of the Sverdlovsk region said that the cause of their death is being investigated.

E1.RU correspondents visited the centers of infection – the warehouse itself and the hostel where one of the deceased lived, and told everything that is known about the dangerous outbreak. Details are in this article.

Cases among Ozon employees were reported on July 5 by the Sverdlovsk Rospotrebnadzor. Sanitary doctors determined the boundaries of the foci, identified people who had contact with the sick, and took tests from them. Warehouse employees immediately began to be vaccinated – more than a hundred people have already been vaccinated.

At the same time, they did not close the distribution center, it continues to work and ship orders as before. The press service of Ozon said that all the sick are employees of contracting organizations, they are under the supervision of doctors. The company assured that it complies with all the instructions of the supervisory authority: a mask regime was introduced at the warehouse, they began to measure the temperature at the entrance and treat surfaces with an antiseptic, employees with signs of a cold are not allowed to work.

Mask mode introduced in the warehouse

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However, some employees believe that this is not enough and that the warehouse needs to be temporarily closed.

– The manual for a tick required all employees to wear masks, measure the temperature at the entrance, like put ionizers and treat everything with an antiseptic. In reality, everyone is crowding at the entrances, not everyone wears masks,” a warehouse employee told E1. RU. – Where is the leadership going? Or does everyone not care about a dangerous bacterium?

The journalists of E1.RU decided to see with their own eyes how the requirements of Rospotrebnadzor are observed at the warehouse. In the smoking room at the main entrance to the distribution center, we notice several employees. They refuse to give detailed comments, but they all give out as one:

– Everything is calm with us, the mask regime is in effect, everyone’s temperature is measured. We continue to work.

— The company takes great care of us, we are all vaccinated.

— There is no scandal, we are working.

There is an inscription, but there is no disinfectant

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Those with whom we managed to talk claim that they had not heard anything about the dead and were not familiar with the sick. Everyone here looks so calm that at some point it begins to seem as if there is no outbreak of a dangerous infection. Life goes on as usual: a pizza delivery man arrives at the warehouse, but dozens of employees calmly smoke and chat.

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When one of the guards notices journalists with cameras, he tells all employees to enter the building. We continue to monitor.

There is a sign on the entrance doors saying “Make sure to wear masks”, but many people leave the premises without masks.

— Are you afraid of getting infected? We ask one of the girls.

— Why be afraid? she wondered.

At the entrance to the warehouse there are warnings about safety rules…

to be

In response to this question, her other colleagues either silently shrug their shoulders, or immediately take out masks from their pockets, pull them over their faces and run away from the cameras.

When the working day in the warehouse ends, the service bus comes for the workers, but not everyone wears masks in the cabin.

Some employees get to the city by service bus

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The driver does not have a mask either

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At the hostel where they live employees of the company and where another focus of infection was discovered, the situation is more tense. Temporary housing for workers is located on the second floor of the tiny Pobeda shopping center. The entrance to the hostel is on the left, and the next door leads to grocery stores and ateliers. People go there who are unaware of the dangerous neighborhood.

The hostel is located on the second floor of a small Pobeda shopping center

Sunday, July 2 According to him, 21-year-old Kirill died that day. After that, all the guests were quarantined, they took tests. Those who were diagnosed with the disease were taken to the hospital, the rest began to be vaccinated.

– Tonight (from 5 to 6 July. – Note ed. ) the doctors also came because someone got sick. They took the girl, she is also 21 years old. She did not contact the deceased, she arrived after his death. Now nothing is known about her condition, she does not get in touch, – says Evgeny.

He adds that the hostel has several rooms, three washrooms. Guests who do not have their own dishes use the common one. The premises are regularly cleaned, but sometimes residents are given dirty bedding, the man shares.

Pobeda Hostel is owned by entrepreneur Anastasia Barabina. The IP is registered in the Republic of Bashkortostan, in the city of Sterlitamak.

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An ambulance drives up to the hostel, the paramedic and the driver put on protective suits, masks, gloves and goggles. Passers-by watch this process with bewilderment. The medic goes inside and five minutes later comes down with two guests. These are men of Asian appearance: one looks over 50, the other is no more than 30. They and other residents of the hostel are given masks.

Medics and the driver had to change into special suits

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When the ambulance leaves , two frightened passers-by ask us what It happened. It turns out they didn’t know anything about the meningococcal outbreak.

Passers-by do not understand what is happening and are a little scared

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The regional Ministry of Health confirmed the death of a 21-year-old Ozon worker, but said the cause is still being determined.

Kirill’s neighbor Evgeny told E1.RU that the guy had blood cancer. This information has not been officially confirmed.

– His legs gave out, he began to speak incoherently. An ambulance arrived, he was taken to the hospital, where he died. No one was allowed into the hostel or let out. At first, the quarantine lasted less than a day. Then we were all quarantined for another day and a half. They took tests, left, arrived with the results and took away five people with confirmed meningococcus. They gave vaccinations, but this was optional, they didn’t force anyone, ”said Yevgeny.

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What is happening at the Yekaterinburg Ozon warehouse, where there was an outbreak of a dangerous infection

Video: Irina Porozova / E1.RU, Ozon press service

three more women died of infection.

“I haven’t been to work yet, but the guys who went there say that three women died: one in the canteen, the other in one of the blocks, the third on the way to the hospital,” Evgeny shared.

Another Ozon employee spoke about the death of several E1.RU employees on condition of anonymity.

— At the moment I am the contact person, as I worked directly on a shift with one of the women who died. They say she is not alone. Because of this, I was twice called to the SES. The first time they took a swab from the mouth, a day later – PCR from the nose. When the results are in, they don’t say, they only said that they would inform the management. So scared of the unknown. I don’t go to work, because I’m afraid,” shared the Yekaterinburg woman.

Official sources say so far only two deaths: in addition to a 21-year-old man, a 46-year-old man also died. The exact cause of his death is also yet to be determined. According to the telegram channel Baza, both of the deceased developed the infection in just a day.

As for the sick, as they said in the regional Ministry of Health, as of 19:00 on July 6, six Ozon employees were hospitalized in the Sysert Central District Hospital.

– Without a clinic (clinical manifestations. – Note ed. ), contact, positive lab results. The condition is satisfactory, the ministry said.

What is the difference between meningococcus and meningitis? Meningococcus (neisseria meningitidis) is a bacterium that causes acute bacterial meningitis. Meningococcal disease is an acute infectious disease. Meningitis is an inflammation of the lining of the brain and spinal cord. Meningococcus can get into the lining of the brain (the patient will have meningitis), into the brain tissue (encephalitis). When the pathogen enters the bloodstream, a diagnosis of meningococcemia is made.

Doctor of Medical Sciences Vladimir Nikiforov, Head of the Department of Infectious Diseases and Epidemiology of the Russian National Research Medical University. N. I. Pirogova, said that under the name “meningococcal infection” a large pool of various forms of the disease is hidden, which is caused by one pathogen. According to publications in the media, the expert suggested that in this case we are talking about meningococcal meningitis.

– This is not a very good form, but, frankly, if you start treating it right right away, then the outcome is favorable. This is a bacterial infection, it can be treated with modern antibacterial agents, strong antibiotics,” Vladimir Nikiforov noted.

He believes that the deceased went to the doctor late. According to the scientist, meningococcal meningitis manifests itself abruptly: a high temperature begins, signs of intoxication appear and, most importantly, a severe headache.

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Vladimir Nikiforov suggested that the disease could be caused by a particularly aggressive strain, or the deceased had problems with immunity and developed an infectious-toxic shock.

– Meningococcus is not capable of causing either an epidemic or a pandemic. It is transmitted by airborne droplets, like flu, like covid, but it is not very contagious. In other words, infection is possible only with close contact of a person with a person in a confined space.

Doctors distribute masks to hostel guests

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Recall the previous outbreak of meningococcal infection at the Ozon warehouse was in November 2022, when doctors detected the disease in 11 warehouse employees in the Moscow region. According to unofficial information, all infected people lived in a hostel in Nakhabino.

You can read more about how you can catch meningococcus, how to protect yourself from it and how to understand that it’s time to see a doctor, you can read in this material. We also wrote about how the disease develops. Here you will find the answer to the question of whether you now urgently need to be vaccinated, and here we tell you if an infectious package can arrive.

We collect all related news in a special section.

Meningitis: threat or reality? | Articles by EMC doctors about diseases, diagnosis and treatment

Children’s Clinic

Moscow, st. Pravdy, 15 building 1

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November 10, 2015

It is unlikely that there will be a person in a civilized society who has never heard of such a disease as meningitis. And everyone understands that we are talking about a serious infection that can become fatal or have severe complications.

Meningitis can be caused by both viruses and bacteria. Among the latter, the most significant are Haemophilus influenzae B, pneumococcus (Streptococcus pneumoniae) and meningococcus (Neisseria miningitidis). Since the widespread vaccination against Haemophilus influenzae and pneumococcal infection was introduced, meningococcus has become the most common causative agent of meningitis. Also, meningitis is not the only disease caused by N. miningitidis. No less terrible is systemic meningococcal infection – menigococcemia .

Children of the first two years of life and people of the older generation are most susceptible to the disease.

Symptoms of meningitis

The first manifestations of meningococcal infection are non-specific: high fever, nausea, vomiting, headache, muscle pain, disorientation. Similar symptoms can occur with viral infections, especially influenza. But the severity of the patient’s condition and the rapid progression of the disease make it possible to suspect meningitis. Patients are hospitalized, as a rule, on the first day of the disease. Treatment of infection is difficult and lengthy.

Despite modern methods of diagnosis and treatment, the risk of death still remains. Among children, the risk of such an outcome of infection is 10 times higher than in adults.

The insidiousness of the infection lies in the fact that it leaves serious consequences even with proper and timely treatment. Among the complications of meningitis, such disorders of the nervous system as convulsions, hydrocephalus, neuropsychiatric retardation, mental retardation, ataxia, significant hearing loss, and others are known.

Prophylaxis

Vaccines have now been developed to protect the body against meningococcal disease . They differ in composition, the possible age of the start of vaccination, the frequency of vaccine administration. For example, until recently, vaccines were available that were allowed only in children over 2 years of age. But sometimes it may be too late. Since 2013, the European Commission has adopted a decision on the routine vaccination of children in the European area from the age of 2 months. A monovalent vaccine is used, that is, it protects only against meningitis caused by one type of bacterium (serotype B). Drugs that provide protection against several serotypes (C, B, Y, W135) have been used since 9- one month old. In Europe and North America, meningitis vaccination is mandatory.

It is very important to get vaccinated if you are traveling to areas where the infection is most common. These are the countries of northern Africa (the so-called Meningitisbelt), such as Guinea, Burkina Faso, Nigeria, Chad, Sudan, Ethiopia. Vaccination is also mandatory for those who go on a pilgrimage to Mecca. At the same time, it should be borne in mind that for those planning a trip to these regions, a single (routine) vaccination will not be enough.

One of the meningococcal vaccines is also available at our clinic.