Meningitis: how to protect yourself and your family. Epidemic cerebrospinal meningitis, symptoms, treatment, causes Epidemic of meningitis

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Seven cases of serous meningitis in children have been registered in the capital. Parents are sounding the alarm and fear the outbreak of an epidemic. Why meningitis is dangerous and how to avoid the disease - in the material on the website.

Meningitis is an inflammation of the lining of the brain and spinal cord. In this disease, brain cells are not damaged, and the foci of inflammation are located outside - on the membranes of the brain matter. However, meningitis is perhaps even more dangerous than encephalitis - the mortality rate for this disease is very high, and in addition, children most often suffer from meningitis during epidemic outbreaks.

Types of meningitis and its danger

Despite the common name "meningitis", several completely different types of disease are hidden under it. Meningitis can be purulent, serous and tuberculous.

The first form includes meningitis, as a result of which pus forms on the membranes of the brain, and with serous meningitis, the membranes of the brain are impregnated with serous-fibrinous (protein) exudate. As for tuberculous meningitis, it occurs in patients with tuberculosis against the background of an underlying disease. If the latter type of meningitis is not treated, it always leads to the death of the patient.

In general, purulent meningitis is more dangerous than serous meningitis, develops faster and leads to more severe consequences if the disease is not diagnosed in a timely manner.

Meningitis may not be an independent disease, but may develop as a complication of some other disease. This happens especially often with pneumonia, otitis, frontal sinuses and inflammation of the paranasal sinuses. Therefore, you should take even a common runny nose seriously and not leave it untreated - this will not lead to anything good.

Children can get meningitis during epidemic outbreaks of the disease, which most often occur in the spring and early summer. Moreover, this applies to both purulent and serous meningitis.

The disease (with the exception of the tuberculosis form) develops acutely: the temperature rises to 40-41 degrees within a few hours, the patient suffers from vomiting, and the most important symptom of meningitis is headache. With meningitis it is unbearable. Often a rash appears on the patient’s skin, and sometimes convulsions develop.

At the first suspicion of meningitis, you should immediately call an ambulance: there is a high risk of death for the patient.

How to distinguish meningitis from other diseases

Meningitis is also insidious in that it is often confused with other diseases, usually less severe. A particularly common mistake parents make is to confuse meningitis with the flu. It really does resemble the flu when it is severe, but there are differences.

Firstly, vomiting during meningitis is not associated with food intake, but is the body’s reaction to increased intracranial pressure (as a result of inflammation of the meninges). Secondly, headaches of the same severity as with meningitis do not happen with the flu.

A patient with meningitis, as a rule, lies in a special position on his back: his legs are pulled up to his stomach and his head is thrown back. This is due to numbness of the occipital muscles - the patient simply cannot tilt his head to his chest.

It is useless to give a child with meningitis the antipyretics so beloved by parents - they will not lead to any positive effect. There are also no traditional medicines for this disease; the only way is to immediately call doctors. Meningitis is treated with antibiotics and a spinal tap in a hospital setting.

With meningitis, minutes count—untimely detected meningitis can lead to complications (blindness, deafness, loss of coordination, epilepsy) or death. Therefore, you cannot delay contacting doctors even for a minute.

How to protect yourself from meningitis

In the case of a disease such as meningitis, there is no universal remedy that would help get rid of all fears. But there are a number of recommendations that reduce the risk of disease to a minimum.

Firstly, children should go for walks more often, and the premises should be ventilated more often. The causative agent of the disease is very sensitive to low temperatures and dies quickly. Secondly, you should not take children to places with excessive crowds of people - one of them may be a carrier of meningitis (and there are quite a lot of such people - many do not develop meningitis even after the pathogen enters the body).

Thirdly, you need to vaccinate your child. Here it is necessary to make a reservation; the causative agent of meningitis is not only meningococci, but also streptococci, pneumococci and other types of viruses. Therefore, no vaccine will give a 100% guarantee that the child will not get sick. But it will help reduce the risk of developing the disease.

Fourthly, you should pay attention to such a symptom as a runny nose. Very often, meningitis begins with a runny nose and pharyngitis (inflammation of the back of the throat).

But wearing a hat, contrary to the popular stereotype (and who wasn’t told in childhood “Put on a hat, it’s cold, you’ll get meningitis”?), has no significance for the development of infection.

Vasily Makagonov

Epidemiology. The source of infection is a patient with meningitis, or a healthy carrier of the bacteria. Most often, children under 5 years of age and young people become ill. The incidence increases in February - April.

Etiology, pathogenesis. The causative agent is Wekselbaum's meningococcus. It is located both extra- and intracellularly. Very sensitive to cold, so cultures should be done at the patient's bedside. Based on their antigenic structure, there are 5 serological types (A, B, C, D, E). Sensitive to sulfonamide drugs, penicillin, chloramphenicol, tetracyclines.
Sometimes a mild inflammatory process in the form of rhinopharyngitis develops at the site of penetration. Then the pathogen enters the blood and is hematogenously introduced into all organs. It primarily affects the meninges, causing purulent inflammation. Purulent exudate accumulates at the base of the brain and on the surface of the frontal and parietal lobes. In some patients, from the very beginning, a septic process develops with damage to a number of organs and systems, and the development of hemorrhagic syndrome. After an illness, strong immunity is formed.

Symptoms, course of epidemic cerebrospinal meningitis

Incubation 3-4 days (from 2 to 7 days). In the midst of complete health, chills occur, the temperature quickly reaches 39-40° and higher numbers. Patients complain of severe headaches. Vomiting is often observed, usually multiple times, sometimes - convulsions, coma (in children). Some patients develop hyperesthesia of the sensory organs (increased sensitivity to light, noise, hyperesthesia of the skin). On examination, facial hyperemia, catarrh of the upper respiratory tract (rhinitis, pharyngitis), herpetic rash on the skin are noted; in the septic form of meningitis (meningococcemia), there may be various elements of the rash on the skin (roseola, macules, papules, hemorrhages). The most common are fairly large hemorrhages into the skin (5-10 mm in diameter). In infants, bulging of the fontanelle is noted. Tendon reflexes are brisk, and there are usually no signs of focal brain damage. In severe cases, there is a decrease in tendon reflexes, Babinski's symptom, central paralysis, damage to the cranial nerves (visual, auditory, abducens, less often facial, oculomotor). If untreated, the fever lasts 1-2 weeks, then gradually decreases. Recovery is slow. With antibiotic therapy, temperature normalization usually occurs after 4-5 days, and sanitation of the cerebrospinal fluid occurs only after 2-3 weeks.
Cerebrospinal fluid flows out under increased pressure (up to 600 mm year), cytosis up to 6000-10,000 or more. Neutrophils predominate. Microscopy of the methylene blue-stained sediment reveals (intra- and extracellular) meningococci. The amount of protein in the cerebrospinal fluid is increased, sugar and chlorides are decreased. Neutrophilic leukocytosis is observed in the peripheral blood.

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Atypical forms of meningitis. The fulminant form is usually observed in children under 2 years of age. Develops suddenly. It is characterized by severe toxicosis, high fever, hemorrhagic rashes on the skin, rapid development of coma, and a collapsed state. Death occurs within the first 24 hours from the onset of the disease. There are no meningeal symptoms or significant changes in the cerebrospinal fluid. Menigococcemia manifests itself as a septic disease, occurring with skin hemorrhages, damage to joints, eyes (uveitis), but without meningeal signs. The abortive form is characterized by a mild course, 2-3 days of fever, mild meningeal signs, slight changes in the cerebrospinal fluid (cytosis up to 500-600 in 1 mm2).

Recognition is based on a characteristic clinical picture (acute onset, severe meningeal symptoms, changes in the cerebrospinal fluid). Confirmed by the isolation of meningococcus from the cerebrospinal fluid, blood and fluid of herpetic vesicles.

Treatment of epidemic cerebrospinal meningitis

Sulfonamide drugs are used. The drugs are given orally in 4 doses. At the same time, penicillin is prescribed intramuscularly up to 1,000,000-1,500,000 units per day (for children 500,000-800,000 units). In severe forms, the sodium salt of penicillin is additionally administered intralumbarally in a dose of up to 50,000 units for adults (for children under 1 year, 3,000 units; for older ones, the dose is increased by 3,000-5,000 units per year of life). Levomycetin is also prescribed at 50 mg per 1 kg of body weight per day and cortisone up to 150-200 mg for adults and up to 30-50 mg per day for children. With improvement of the condition (after 2-4 days), intralumbar administration of penicillin is canceled, treatment with cortisone is continued for 3-4 days. Patients receive sulfonamide drugs and intramuscular penicillin for 4-5 days after clinical recovery. Patients are discharged after clinical recovery, normalization of cerebrospinal fluid and a double negative test result for meningococcus in the throat mucus.
Prevention. Isolation of patients, identification of healthy bacteria carriers in children's groups. Bacteria carriers are isolated (at home) for 7 days and treated with sulfonamides.

Sergey Petukhov, RIA Novosti columnist.

By the morning of Thursday, June 27, 37 children were hospitalized in Moscow with enterovirus infection, seven of them had it.

The Rostov record of 182 children with enterovirus infection, including 52 with serous meningitis, and even Lipetsk, where there are 170 people in hospitals in the regional center and Yelets, 50 of whom have symptoms of serous meningitis, Moscow has not yet broken.

The capital's doctors claim that there is no epidemic of enterovirus infection, much less meningitis, either in the country or in Moscow, and meningitis is not something to be afraid of. And the incidence of even the usual summer norm is 400-600 patients.

The Investigative Committee of Russia officially stated that its “investigators will clarify the circumstances of the mass disease of people, the causes and conditions that contribute to the occurrence and spread of meningitis among residents of different regions of Russia, in order to prevent more serious consequences.”

What is going on in general: what are our children becoming infected with and what are they suffering from, are health authorities hiding the meningitis epidemic that has broken out in the country, and is it possible to interrupt the epidemic process with the help of the Criminal Code of the Russian Federation?

Has the epidemic begun?

By definition, an epidemic is an excess of a certain, statistically usual for a given infection, threshold of incidence in a particular territory during 1-2 incubation periods of this disease.

Since June 2, when the first cases of serous meningitis were recorded in Rostov-on-Don, more than two incubation periods of this disease have already passed (the period when the virus is already in the body, but symptoms of the disease are not yet noticeable, is 6-13 days). But whether the epidemic threshold has been exceeded remains unclear, because none of the Ministry of Health officials announced this threshold for Rostov.

For each disease, each region has its own epidemic threshold, which is calculated using a special method with rather complex formulas and changes from year to year.

The question of the epidemic is not a terminological one. If the epidemiological threshold is exceeded, the relevant regulations automatically come into force and are mandatory for execution by local health authorities. If there is no official epidemic, then doctors act according to circumstances and according to their own judgment.

This is exactly what seems to be happening now. For example, in the Lipetsk region there is no epidemic yet, but quarantine measures are already in place. Police patrols blocked local beaches and caught all swimmers from rivers and ponds.

In this case, the Ministry of Health found itself hostage to its own departmental standards. There is no reason to declare an epidemic, so we have to cope with the expanding geography of outbreaks of serous meningitis in manual control mode.

What do children get infected with and what do they get sick with?

Of the five regions where, according to media reports, there have been outbreaks of meningitis (Rostov-on-Don, Astrakhan region, Adygea, Lipetsk region, Moscow), the situation can be more or less clearly understood so far only in Rostov and the Lipetsk region.

One can also hope that the Rostov EV-71 remained in Rostov, and in other regions, including Moscow, “intestinal” meningitis has a different etiology (pedigree), and everything will end well.

Has a new infectious disease appeared in Russia?

Regarding the etiology of Moscow meningitis and their happy ending, hopes are quite high. What about the successful outcome of this whole meningitis story? And what is considered such an outcome?

Now the main question for all of us is: is this the usual seasonal story with the “stomach flu”, inflated by the media, or are we really faced with a new disease with which we will now have to live, as we live with the usual, winter flu?

The paradox is that you don’t have to choose here; both are equally true. The media really inflated this story, but they didn’t invent it, and they didn’t have to inflate it especially, because this epidemic disease really exists, its scale in the world is enormous, and it just reached Russia.

The Investigative Committee can be forgiven for its determination to study the epidemiology of enterovirus infections. Rospotrebnadzor has known it for a long time. In any case, on May 15, 2008, at the height of the Chinese epidemic, he sent out a circular letter to the heads of his departments in the constituent entities of the Russian Federation and the heads of health authorities of the constituent entities of the Russian Federation “On recommendations on the epidemiology, clinical picture, diagnosis and prevention of diseases caused by enterovirus type 71.”

The letter and its eight-page appendix detail EV-71 “as one of the most significant pathogenic agents among human enteroviruses,” which is “highly neuropathogenic and can cause large outbreaks with fatal outcomes.” And then follow “recommendations on the epidemiology, clinical picture, diagnosis, treatment and prevention of diseases caused by enterovirus type 71.”

So, to put it in the aphoristic manner of Gennady Onishchenko, the current outbreak of serous meningitis did not catch his department “with its pants down.” Everything was known and planned in advance.

The ambulance paramedic and the clinic doctor do not read circular letters; their contents are communicated to him in a timely manner by local medical superiors. Or not in a timely manner. Or they don’t deliver at all.

As for everyone else, that is, you and me, it seems that in addition to the usual winter flu, we will now have to live with the summer “stomach flu”.

The difference between them is that the “summer” flu in an adult is mild, you may not even notice it - the temperature will rise for a day or two, it will spread, a rash will form from blisters on the hands, and will pass. But it is dangerous for children; there is a high risk of meningitis.

True, not that terrible meningitis, which is caused by meningococci and can make a person an idiot, but another - serous, from which in our country people die, fortunately, quite rarely.

But otherwise, it’s just another flu - and if with epidemics, then with vaccinations, quarantine and other inconveniences of an infectious disease. There is no vaccination against it yet, but it will definitely be done by next summer.

According to Rospotrebnadzor, it came from China and is easily transmitted through the air. Enteroviral meningitis is a relative of polio and the notorious Coxsackie. At first, he was even confused with Coxsackie, when symptoms of enterovirus infection were found in children in the Chelyabinsk region this summer.

Brother Coxsackie: Russia is facing an epidemic of meningitis ECHO30h

An aggressive subtype of enterovirus ECHO30 is coming to Russia, which has already been detected in five regions beyond the Urals and in the central part of the country.
Brother Coxsackie: Russia is facing an epidemic of meningitis ECHO30h. 375764.jpeg

According to Rospotrebnadzor, a surge in the disease with the dangerous ECHO30 virus can be predicted in the fall of 2017. According to experts, the virus came from China and its neighboring regions.

The virus is dangerous because it is easily transmitted by air and causes serous meningitis in a short time. Most Russians do not yet have immunity to it.

Cases of infection of 30 people have already been recorded in six regions of Russia, so the chief sanitary doctor of the Russian Federation, Anna Popova, sent out a warning about the danger to the chief doctors in the regions.

Note that ECHO30 is an enterovirus, that is, it multiplies in the stomach or intestines. It mainly affects children and people with weak immune systems. It appeared about 20 years ago and has caused outbreaks of serous meningitis around the world, from the United States to China.

It is worth adding that polio and the Coxsackie virus are viruses of similar types. ECHO30 has almost ten varieties, which may primarily affect children.

As Pravda.Ru reported, a new type of tick-borne borreliosis has been identified in Russia. It accounts for more than half of the cases of this disease in the country. Based on its symptoms, it can easily be confused with tick-borne encephalitis.

Although the disease is similar to encephalitis, it requires different treatment. The same medications help as for ordinary tick-borne borreliosis, otherwise it is called “Lyme disease.”