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Transcript
1
Svetlana Avsyanik
Public Health
Bacterial Meningitis
Bacterial meningitis is an inflammation of the membranes that cover the brain and spinal cord
(meninges) that is caused by bacteria and is usually spread to the meninges through the
bloodstream from an infection elsewhere in the body (MDGuidlines, 2004).
There are two
bacteria's that is known to cause this type of meningitis; Streptococcus pneumoniae which
accounts for 40-60% of adult cases and neisseria meningitis (meningococcus) which spreads
quickly in restricted places, such as dorm rooms, boarding schools and the military bases.
Meningococcus is a major cause of bacterial meningitis and other serious invasive bacterial
infections globally (Harrison & Marchant, 2010). Adolescents and young adults have an
increased incidence of meningococcal disease which accounts for nearly 15 percent of all U.S.
cases annually (National Meningitis association). Bacterial meningitis is significant among
infants, young children, college students, refugees and military personnel, due to crowded living
conditions, moving to a new residence, attendance at a new school with students from
geographically diverse areas, going to bars, active or passive smoking and irregular sleeping
patterns (National Meningitis Association).
Meningococcal disease rates change annually. From 1998-2007, about 1,500 Americans were
infected each year, with a range of 900-3,000 cases and 11% of those infected will die (National
Meningitis Association). The incidence of all forms of bacterial meningitis in the U.S. is
approximately 2 to 3 per 100,000. Meningococcal meningitis is endemic in parts of Africa,
India, and other developing nations (MDGuidelines, 2004). According to CDC reports, the
incidence of bacterial meningitis dropped by 31% between 1998-2007 (HealthDay News, Serena
Gordon, 2011). The drop was so significant due to the availability of the immunizations. Dr.
Cynthia Whitney, chief of the bacterial respiratory diseases branch at the CDC, Atlanta stated,
that "there are still at least 4,000 cases a year, including about 500 that are fatal." Black
population along with children under age of 2 are most susceptible to this disease, according to
the CDC. Mortality rate among adolescents is one out of seven cases will result in death. For
those who survive meningococcal disease, approximately 20 percent suffer long-term
consequences such as brain damage, kidney disease, hearing loss or limb amputations (National
Meningitis Association). Mortality rates also differ depending on the causative organism but if
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2
Svetlana Avsyanik
Public Health
Bacterial Meningitis
left untreated, the mortality rate is increased to nearly 100%. About 30% of individuals with
pneumococcal meningitis have moderate to severe problems such as dementia, seizures, hearing
loss and difficulty walking (MDGuidelines, 2004).
As primary prevention it is imperative to complete the recommended vaccine schedule to protect
our children and ourselves and to be educated about bacterial meningitis. Secondary prevention
would be to adhere to the antibiotic regimen recommendation per doctor's orders and to not come
in contact with anyone who is immunocompromised. Tertiary prevention would be to improve
the functionality of ADL's in people who has or have had the disease and have residual physical
limitations such as, limb amputations, hearing loss, learning disabilities and brain damage.
Rehab, occupational and physical therapies, along with speech therapy would improve the daily
functions in people suffered/suffering from bacterial meningitis.
Healthy habits play a very important role in prevention and spreading of bacterial meningitis.
Not smoking, rest, hand washing and not coming in contact with people who are sick are
important habits to uphold which could help infants, the elderly or those with a weakened
immune system from getting this disease. Immunizing infants, children, young people and some
travelers abroad, has been shown to be an effective way of preventing meningococcal and other
causes of bacterial meningitis (Wilcox, 2012).
Childhood immunizations are one of the most successful public health interventions of all time
(Smith, 2010). Even though the immunization rates in the United States are at their highest,
there are still parents/families that refuse to vaccinate their children. According to the National
Immunization Survey (NIS), more than 90% of children have received most recommended
vaccines; although NIS uses a random sampling formula to estimate national immunization rates,
and it is not particularly sensitive to vaccination rates at the local level and may not detect small
communities with very high rates of undervaccination (Smith, 2010). It is surprising to see that
despite of preventable vaccinations from bacterial meningitis, the fatality rate has remained at
14.3%, which is not a significant difference from the 15% in 1995 (McMillan, 2011).
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Svetlana Avsyanik
Public Health
Bacterial Meningitis
As public health nurses, we need to recognize that we have a problem before we can discover a
solution. Because bacterial meningitis can infect people of all ages, we need to be aware that
there are vaccinations for three types of bacteria that can cause this disease; neisseria
meningitidis (meningococcus), streptococcus pneumoniae (pneumococcus), and haemophilus
influenzae type B (Hib) and we need to promote these vaccinations to families and our patients.
According to the CDC, people over the age of 65, or younger who have chronic illnesses or a
compromised immune system, should receive the pneumococcal vaccine as should anyone who
smokes or has asthma despite their age. We need to have strong and healthy families to have
healthy communities. Education would be the primary initiative at the local level. At the state
and federal level, we need to make sure that the vaccines are available and are being promoted
by healthcare professionals.
References
Centers for Disease control and Prevention (CDC). Bacterial meningitis.
http://www.cdc.gov/meningitis/bacterial.html
Gordon, S. (Performer) (2011). CDC report shows bacterial meningitis cases on the decline. In
Health Day. US News. Retrieved from http://www.health.usnews.com
Harrison, L. H., & Marchant, C. D. (2010). The epidemiology and vaccine prevention of
meningococcal disease in the united states. Contemporary pediatrics,
McMillan, J. A. (2011). Taking stock of bacterial meningitis. Contemporary pediatrics,
Smith, M. J. (2010). Parental vaccine refusal. Contemporary pediatrics, 27(3),
Wilcox, A. (2012). Meningococcal B disease: Assessment and management. Nursing standard,
26(26),
(n.d.). Retrieved from http://www.mdguidelines.com/meningitis-bacterial
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Svetlana Avsyanik
Public Health
Bacterial Meningitis
(n.d.). Retrieved from http://www.nmaus.org/meningitis
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