Treatment

Meningitis of meningococcal disease is a very serious condition and must be treated as a medical emergency whenever it is detected. However, patient isolation is not necessary but admission to the hospital is mandatory.

Once detected, appropriate administration of antibiotics must begin, ideally after a lumbar puncture has been carried out, if there was a need for it. If treatment had commenced before the lumbar puncture procedure was conducted, it may be difficult to isolate the bacteria from the spinal fluid to confirm the diagnosis. However, confirmation of the diagnosis should be a reason to delay treatment.

Treatment also depends on the kind of meningitis the diagnosis confirms.

Bacterial Meningitis

This form of meningitis must be treated promptly with intravenous antibiotics and recent medications like corticosteroids. This process should trigger recovery and help prevent complicated conditions that may lead to seizures, coma, and brain swelling. A range of antibiotics can treat the condition, including penicillin, chloramphenicol, ampicillin and ceftriaxone. Ceftriaxone is the drug of choice in epidemic regions of Nigeria there are limited health infrastructure and resources.

Viral meningitis

Antibiotics have no effect on viral meningitis, and most cases improve on their own with time. Patients with viral meningitis are often advised to get a lot of rest, take plenty of fluids, and take over the counter drugs to help with pains and feverish conditions.   

Prevention and Control

Vaccination and Immunization

The most effective way to protect yourself and your family from meningitis is to get vaccinated. Licensed vaccine against meningitis have been available for over 40 years, with yearly improvements on strain coverage and vaccine availability. However no universal vaccine against meningococcal disease currently exist.

Three types of meningococcal vaccines are available:

1. Polysaccharide vaccine: This is used in the advent of an outbreak similar to those reported in Nigeria (2009 and 2017).

• They are not effective for children below the age of 2.
• They offer 3 years of immunity
• They are either bivalent (Serogroups A and C), trivalent (A, C, W) , or tetravalent (A, C, Y, W)

2. Conjugate vaccines :They are used in prevention and in response to outbreaks

• They provide a longer lasting immunity of 5 years
• They work for children who are one year old and above.

3. Protein Based Vaccines: This is used against N. meningitides B. It was recently introduced into routine immunization schedule and used in outbreak response.

Chemophophylaxis

This is an antibiotic prophylaxis used as a precautionary method for people who make close contact. When administered promptly, it decreases the risk of transmission.

Ciprofloxacin is usually the go to antibiotic in this case, and ceftriaxone acts as an alternative. 

Sources: World Health Organization (WHO) and other sources.