On January 6, a man in nearly 40 years died of a suspicion of meningococcal meningitis. The case has occurred in Recife. The patient, a resident of the rural area of Gravatá, in the age of Pernambuco, was admitted to the municipal hospital, Dr. Paulo da Veiga Pessoa, with high fever, vomiting and stiffness to neck.
A man who lived in a rural urban area died of meningitis in Pernambuco on January 6
The local medical team immediately sends him to Correia Picanço State Hospital, a reference in the treatment of infectious diseases in the region, but he does not resist.
According to the prefecture of Gravatá, professionals, relatives and friends in close contact with the victim have undergone examinations and have benefited from preventive treatment. The State Health Department (SES) of Pernambuco is currently investigating this fact.
Another suspect case had been registered in the state, this time in the city of Caruaru. It was January 9, when a 42-year-old woman with the same symptoms was looking for a long-term care unit (UPA). However, as SES says, the possibility of meningitis has been ruled out.
Meningitis is an inflammatory process of the meninges, membranes involving the brain and spinal cord. It is caused by various infectious agents (bacteria, viruses and fungi). Then, get to know each type of disease better.
Bacterial meningitis
This is the most serious form of the disease, and several bacteria can cause it, such as Neisseria meningitidis (or meningococcus), Streptococcus pneumoniae (or pneumococcus), Haemophilus. influenzae, Mycobacterium tuberculosis, Streptococcus sp. (including group B), Listeria monocytogenes, Escherichia coli and Treponema pallidum.
It is important to emphasize that the incidence of each depends on the age group. The Department of Health warns that newborns have Group B streptococci, Streptococcus pneumoniae, Listeria monocytogenes and Escherichia coli; infants and children, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae and Streptococcus group B; adolescents and young adults, Neisseria meningitidis and Streptococcus pneumoniae, and the elderly, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Group B streptococci and Listeria monocytogenes.
Your symptoms include high fever, headache and stiff neck or neck. It is also normal for the patient to experience discomfort, nausea, vomiting, photophobia (increased sensitivity to light) and mental confusion. As the photo develops, convulsions, delirium, tremors and coma are added to the list.
Among the most worrying bacterial meningitis, according to the infectious epidemiologist Jean Gorinchteyn of the Emilio Ribas Institute of São Paulo, there is meningococcus, just the suspected one in Pernambuco, and pneumococcus.
The first occurs when the bacterium falls into the bloodstream and promotes the release of inflammatory factors. This causes the vessels to dilate, leading to a drop in blood pressure and tachycardia that can lead to death.
"This is feared enough because of its rapid evolution, its high lethality, its possible sequelae (blindness, deafness and limb amputation) and its potential for epidemics and epidemics", explains the doctor. In addition to the signs already described, it is normal to cause purplish spots, body aches, chills, diarrhea, fatigue and cold feet and hands.
In the case of pneumococcus, the causative agent is transported by the blood to the brain, where it generates a strong inflammatory reaction. The symptoms are basically the same as those of meningitis, but there is a risk of significant neurological consequences, such as difficulty walking and talking.
The transmission of bacterial meningitis occurs from person to person through the respiratory tract or, in other words, from droplets and secretions that come out of the nose and throat when infected persons cough or sneeze. Other bacteria, such as Listeria monocytogenes and Escherichia coli, have spread in contaminated foods.
Viral meningitis
The causative agents are nonpolio enterovirus (Coxsackie and Echovirus), herpes virus (herpes simplex, varicella-zoster, Epstein-Barr and cytomegalovirus), arbovirus (dengue, zika , chykungunya, yellow fever fever and West Nile fever), measles and mumps virus and adenovirus.
The symptoms resemble those of bacterial meningitis, but they are less severe. They include fever, headache, stiffness in the neck or neck, nausea, vomiting, loss of appetite, irritability, drowsiness or sleep disturbance, lethargy (lack of energy) and photophobia.
This type has several forms of transmission, depending on the virus. With regard to enteroviruses, the contamination is fecal-oral: it occurs by close contact with a sick person, by contact with objects and surfaces containing the micro-organism, by water or raw food infected. Arboviruses are transported by the bite of infected mosquitoes.
Fungal meningitis
Cryptococcus neoforman, Cryptococcus Gatti, Candida albicans, Candida tropicalis, Histoplasma capsulatum, Paracoccidioides brasiliensis and Aspergillus fumigatu are caused by the disease.
Meningitis can also be caused by fungi seven different fungi
The signs are basically the same as the others: high fever, severe headache, stiff neck, nausea, vomiting, mental confusion and sensitivity to light.
In this form of pathology, transmission is by the inhalation of spores (small pieces of fungi) that enter the lungs and reach the meninges. Some fungi are also present in soils or environments contaminated with bird droppings, such as pigeons and bats.
Diagnosis and Treatment
The diagnosis of meningitis is made by means of blood tests and cerebrospinal fluid (CSF). It is they who will determine the type of illness and hence the conduct that will be adopted by the doctors.
In the case of bacteria, the treatment is carried out with antibiotics, badociated or not with steroids, from 7 to 14 days. Hospitalization is usually necessary.
According to the agent, antivirals and steroids should be administered for about a week in the virus. In general, people are hospitalized and monitored for signs of increased severity.
Finally, in fungal meningitis, the prescription is an antifungal of 4 to 12 weeks, also chosen according to the microorganism identified in the body of the patient.
Prevention
Demetrius Montenegro, Oswaldo Cruz University Hospital (HUOC) of the University of Pernambuco (UPE), says that some of the infectious agents causing meningitis exist already.
Photo: Getty Images / BBC News Brazil
"They are offered year-round to children and adolescents in the public health network." Adults with a chronic illness, such as diabetes or heart disease, or treated for cancer should receive them, "he says.
The vaccination program of the National Immunization Program (NIP) is as follows: meningococcal serogroup C conjugate, 10-valent pneumococcus (conjugate), pentavalent and BCG.
In addition to this protection, the doctor recommends to avoid spending too much time indoors and filled with people; make sure that the house and workplace are well ventilated, including in winter, and take care of personal hygiene.
Incidence of Meningitis in Brazil
Data from the Ministry of Health show that in 2018, up to Epidemiological Week 52 (23-29 December), 1,072 cases of meningococcal disease were registered in Brazil and 218 deaths. In 2017, during the same period, they were respectively 1,138 and 266.
For pneumococcal meningitis, there were 1,030 occurrences and 321 deaths in 2017, and 934 and 282 in 2018. For other bacteria, 2,687 cases and 339 deaths in 2017, and 2,568 and 316 in 2018.
In the case of the viral virus, the government recorded 7,924 cases and 107 deaths in 2017. Last year, there were 7,873 and 93. Meningitis due to other etiologies recorded 796 events and 169 deaths in 2017, and 624 and 122 in 2018.
In addition, Member States indicate that in Brazil "meningitis is considered an endemic disease, so cases are expected throughout the year, with occasional outbreaks and epidemics".
And the body supplements pointing out that the incidence of bacteria is more common in autumn-winter and viruses in the spring-summer.
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