How to prevent meningitis in a child?

Meningitis is a state of inflamed meninges. Meninges are the covering of the spinal cord and brain. Meningitis can affect not only adults but also children. Meningitis can be caused by a viral infection. Bacterial or fungal infection can also contribute to meningitis. Meninges has three layers. The outermost layer is called the dura layer, the middle layer is known as the arachnoid layer, and the innermost layer is the pia layer. Reports show that there are about 10 to 20 new cases of meningitis per 100,000 children every year. There are about 42,000 hospitalizations due to viral meningitis each year in the United States of America. Children below 1 year of age are the most commonly affected by viral meningitis. In countries with temperate climates (four seasons), viral meningitis usually peaks during autumn and summer. Causes of meningitis in children are similar to causes of meningitis in adults which mainly caused by infections.

The definition of viral meningitis is fever with features of meningeal irritation with no evidence of bacterial infection. Viral meningitis usually starts with a virus infecting the respiratory or digestive tract. The virus later will multiply and occupy the lymph nodes. Later, the virus will infect other organs or structures like the meninges. Viral meningitis is commonly caused by Enteroviruses. 85% of viral meningitis cases are due to infection by Enteroviruses. Other viruses are:

  • Herpesviruses
  • Arboviruses
  • Parechoviruses
  • Influenza
  • Rabies

Enteroviruses mostly spread via the fecal-oral route, while some via inhalation of respiratory droplets containing enteroviruses. Rabies happened following direct contact with animal saliva containing rabies virus. Arboviruses spread via an insect bite. The features of viral meningitis are quite similar to bacterial meningitis but less severe. The clinical features of meningitis in children depends on the immune status, age, and underlying causes.

The signs and symptoms are:

  • Fever
  • Poor feeding
  • Diarrhoea
  • Skin rash
  • Vomiting
  • Bulging fontanelle
  • Respiratory symptoms
  • Stiff neck

History taking is very much important in helping doctors to distinguish one type of meningitis from another. Doctors will ask questions that have clinical values. Physical examination is later carried out to detect any clinical signs and evidence that points towards certain illnesses. Investigations are done after history taking and physical examination to gather more evidence to confirm the diagnosis of viral meningitis. Cerebrospinal fluid (CSF) studies, blood tests, and imaging are commonly done.

Children below 1 year of age will require hospitalization for further management. Hospitalized children are placed in dark and quiet rooms to rest. Children are given acetaminophen to treat fever, pain, or headache. Antibiotics are given while waiting for test results. Once viral meningitis is confirmed, antiviral will be given to replace the initial antibiotics therapy. Acyclovir is the most commonly given antivirus in viral meningitis cases. Children who suffer from viral meningitis often recover fully following treatment.

Prevention should be the main consideration in health-related issues. Meningitis especially viral meningitis can be prevented by:

  • Vaccinations
  • Maintain good hygiene especially hand hygiene upon changing the diaper
  • Use insects repellents
  • Contact precautions following the duration of the illness

Do not hesitate or wait too long before bringing your sick child to a doctor. Doctors are not to cause harm, instead, we are trained to help patients recover. Modern medicine is a field fully supported by scientific evidence. Faith and trust should be with such therapy and not with other treatments with no concrete evidence. Causes of meningitis in children are treatable and preventable. Please bring your sick child to a certified doctor for health evaluation.