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New, Faster Diagnosis of Meningitis Can Save Lives

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Meningitis can be infectious, particularly when the disease is spread among large groups of people living in crowded conditions. It is most prevalent in sub-Saharan Africa, where outbreaks of bacterial meningitis are blamed for thousands of deaths. Young children and the elderly are most susceptible to the disease. A quick diagnosis of whether the illness is viral or bacterial is critical to effective treatment. VOA's Melinda Smith has more on a new technique which speeds up the process.

Wherever little children gather, germs are sure to follow. In most cases, the viruses that are spread through close contact are easily treatable. But when children experience symptoms such as a stiff neck, high fever, headaches and sensitivity to light, or vomiting, bacterial meningitis may be suspected.

When one child was admitted recently to Children's Hospital in Boston, Massachusetts she was tested for meningitis, an inflammation of the membranes surrounding the brain and spinal cord.

Dr. Lise Nigrovic, with the emergency medical department at the hospital, says time can be significant in telling the difference between viral and bacterial meningitis. "Bacterial meningitis is a potentially life-threatening and serious condition which requires intravenous antibiotics at hospital admission."

As a precaution, doctors have frequently given patients antibiotics to counter the more deadly bacterial form while they wait for results of the bacterial culture. That can often take two to three days.

Dr. Nigrovic says a child with viral meningitis may receive a stronger dose of antibiotic than he or she needs. "Intravenous antibiotics are not helpful to viral meningitis. And the overuse of antibiotics for vital infections has the potential to increase resistance over time."

So researchers at Children's Hospital and 19 other pediatric medical centers in the U.S. have adopted a list of risk factors to help them make the correct diagnosis. First among them, a physician's observation of symptoms, then a blood test and three specimens of spinal fluid. Laboratory results were produced in minutes, not days. The rate among low-risk children proved to be 99 percent accurate, thereby eliminating the need for antibiotics and for keeping children hospitalized longer than necessary.

That was good news to parents, such as Jay Smith. "Bacterial meningitis is something that scares me as a parent and most parents, so if they had something that can help differentiate the two I'd be comfortable with that."

There are several vaccines available for routine prevention of meningitis. Some countries, such as Saudi Arabia and Sudan, offer these vaccines to the general population. But according to the World Health Organization, routine immunization in many parts of sub-Saharan Africa is less effective beyond three to five years, and cannot be used on children under the age of two. Researchers are hoping this new method of risk assessment will help save many more lives.

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