At the slightest hint of a meningitis outbreak, we parents are prone to panic. While the Dubai Health Authority has stated that there have been no confirmed cases of meningococcal meningitis in the emirate recently, we asked Dr Iviano Ossuetta, head of paediatrics and neonatology at Danat Al Emarat Hospital, what we should know about meningitis in the UAE and when we should and shouldn’t worry...
1) What causes meningitis?
Meningitis is an inflammation of the meninges (which is a lining of the brain) causing illness of the brain in particular and the individual in general. There are infectious and non-infectious causes of meningitis. Children are more likely to have infectious forms of meningitis, which reaches the brain usually via the bloodstream. Of the various infectious causes (Viruses, Bacteria and Fungal Microbes), viruses make up the greater proportion. Some viral conditions such as chicken pox and measles may occasionally present with meningitis, although this is very rare. A major risk factor for meningitis is overcrowded living quarters and this is more evident with certain strains of bacterial meningitis e.g Meningococcal meningitis.
2) How common is it in the UAE?
While this is a worldwide problem, it is not a very common condition in the UAE. One study in Al Ain reviewed cases over a five year period and identified 92 cases, of whom 19 were under 20 years old. The yearly rate declined steadily from a peak of 35 cases, to a low of 5 cases per year over the five year study period. Those aged Under 5 years were at greatest risk of infection.
3) How dangerous is it usually?
Meningitis is classified as a medical emergency but is treatable with antimicrobials and intensive medical support where needed. However it may cause significant harm in some cases, especially if treatment is late or delayed because of its effect on the brain in the long term. Severe infections may be fatal.
4) Can children be vaccinated against it?
Children are already vaccinated against an important cause of meningitis, which is Haemophilus Influenzae B, as part of their HAAD schedule. They are also vaccinated against Pneumococcus bacteria. In some countries, vaccination is provided for another bacterium known to cause meningitis (Meningococcus). This is not routinely administered in the UAE as part of the immunization schedule but is a requirement for those undergoing the Hajj or Umra.
5) What should parents do if they suspect a child may have it?
Parents should take their child into hospital if they suspect that this may be the case. Clinics will be able initiate treatment but cannot keep children for ongoing treatment. If parents are particularly concerned about a very unwell and lethargic child, then they should call for an ambulance.
6) To what extent should we worry about our children getting meningitis?
Parents should not be unnecessarily worried about this but should be aware of signs and symptoms.
7) What are the key signs to look out for?
If you are concerned about your child, a baby or young child with meningitis may:
• have a stiff neck and dislike bright lights
• have a high fever, with cold hands and feet
• vomit and refuse to feed
• feel agitated and not want to be picked up
• become drowsy, floppy and unresponsive
• grunt or breathe rapidly
• have an unusual high-pitched or moaning cry
• have pale, blotchy skin, and a red rash that doesn’t fade when a glass is rolled over it
• have a tense, bulging soft spot on their head (fontanelle)
• have convulsions or seizures
There is considerable overlap between the initial signs of a simple common viral infection (eg fever, tiredness) and something more serious like Sepsis, which is relatively uncommon. While it is important to be vigilant, you should also remain as calm as possible, and always seek medical help if you are worried.