Developments

World Meningitis Day


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World Meningitis Day was established as a day to raise awareness about this devastating and potentially life-threatening disease.

On Tuesday 24 April 2012, the Confederation of Meningitis Organisations (CoMO) and its global members are encouraging individuals, families and communities to learn the signs and symptoms of meningitis, the importance of urgent treatment of the disease, and that prevention is available through vaccination against some forms of meningitis as part of its annual World Meningitis Day.

The global awareness day has grown over the past three years and now reaches across the globe from North and South America, through Europe to the Middle East, into the Indian subcontinent and throughout South East Asia and the Far East to Australia to join hands across state lines, country borders and continents.

Every year more than 1.2 million people are affected by meningitis. Bacterial meningitis is the most severe and common form and it causes approximately 120,000 deaths globally each year.

Even with prompt diagnosis and treatment, approximately 10% of patients die and up to 20% or more sustain permanent damage and disability.

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World Meningitis Day is organized by The Confederation of Meningitis Organisations (CoMO), which is an international member organization that is constantly working to reduce the incidence and impact of meningitis worldwide.

This year’s campaign will focus on the 4 different causes or types of meningitis; bacterial, viral, fungal and parasitic. It also highlights that due to the variety of bacteria and viruses that can cause it, multiple vaccines are needed to protect against the disease.

No single universal ‘meningitis vaccine’ – Even if an individual receives all available meningitis vaccines he is still susceptible to acquire meningitis from the other strains or types of microorganisms. Hence it is best to receive all vaccines available.

For example, bacterial meningitis can be caused by many bacterial species. And for the very same reason, there are a variety of vaccines that are needed to protect against it. Be aware of the safe and effective vaccines that protect against the most common meningitis types.

The theme for World Meningitis Day 2019 is Life After Meningitis. The campaign will focus on the after effects of meningitis, whether that is bereavement after losing someone to meningitis or managing a wide range of consequences AfterMeningitis.

Bacterial meningitis is a medical emergency and has a high mortality rate if untreated. All suspected cases, however mild, need emergency medical attention. Empiric antibiotics must be started immediately, even before the results of the lumbar puncture and CSF analysis are known. Antibiotics started within 4 hours of lumbar puncture will not significantly affect lab results.

The choice of antibiotic depends on local advice. In most of the developed world, the most common organisms involved are Streptococcus pneumoniae and Neisseria meningitidis: first line treatment in the UK is a third-generation cephalosporin (such as ceftriaxone or cefotaxime). In those under 3 years of age, over 50 years of age, or immunocompromised, ampicillin should be added to cover Listeria monocytogenes. In the U.S. and other countries with high levels of penicillin resistance, the first line choice of antibiotics is vancomycin and a carbapenem (such as meropenem). In sub-Saharan Africa, oily chloramphenicol or ceftriaxone are often used because only a single dose is needed in most cases.

Staphylococci and gram-negative bacilli are common infective agents in patients who have just had a neurosurgical procedure. Again, the choice of antibiotic depends on local patterns of infection: cefotaxime and ceftriaxone remain good choices in many situations, but ceftazidime is used when Pseudomonas aeruginosa is a problem, and intraventricular vancomycin is used for those patients with intraventricular shunts because of high rates of staphylococcal infection. In patients with intracerebral prosthetic material (metal plates, electrodes or implants, etc.) then sometimes chloramphenicol is the only antibiotic that will adequately cover infection by Staphylococcus aureus (cephalosporins and carbapenems are inadequate under these circumstances).

Once the results of the CSF analysis are known along with the Gram-stain and culture, empiric therapy may be switched to therapy targeted to the specific causative organisms. Because antibiotic-resistance is a prevalent problem, information from drug susceptibility testing should also be gathered.

Meningitis affects 1 million people globally each year. The disease, which can kill a person in 24 hours, is caused by inflammation of the brain and spinal cord. Many types of bacteria, and some viruses and fungi, cause meningitis. Some types can be prevented with safe and effective vaccines; others cannot. The organizers of World Meningitis Day (April 24) plan to highlight the many causes of meningitis. The ASBMB is observing the day by sharing articles on various meningitis-causing pathogens.

Pumtiwitt McCarthy, an assistant professor at Morgan State University in Maryland, studies the enzymes that produce polysaccharides on the surface of Neisseria meningitidis. She hopes this type of basic science will lead to lower-cost tools for vaccine production. McCarthy discusses her scientific journey here.

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Vaccination against Neisseria meningitidis, a leading cause of bacterial meningitis, can be costly because researchers must grow the bacterium in culture to isolate oligosaccharide antigens. An article in the Journal of Biological Chemistry reports the development of enzyme-based tools to make oligosaccharides in vitro, which could someday lower the cost of vaccine production.

Trafficking of N. meningitidis lipoproteins to the outer bacterial membrane determines which antigens are available for immune recognition. A paper in Molecular & Cellular Proteomics investigated how N. meningitidis and other Gram-negative bacteria transport these proteins. Read the paper here.

Enterococcus faecalis is a commensal organism in the gastrointestinal tract, but can form dangerous biofilms on implanted medical devices that can lead to complications like bacterial meningitis. A paper in Molecular & Cellular Proteomics identified markers of biofilm formation ability that might help develop drugs to target biofilm formation and prevent infection.

Bacteria from the birth canal can be associated with life-threatening meningitis in newborns. Fortunately for infants, oligosaccharides from human milk can protect them from the same neonatal pathogens. A paper in the Journal of Biological Chemistry, accessible here, isolated the human milk oligosaccharide responsible for the protective effect.