Parents are warned to be vigilant for signs of meningitis in for children

Outbreaks of meningitis in Britain since Christmas have claimed the lives of 12 children, causing widespread fear among parents. The victims include the eight-month-old daughter of former Gladiator star and Olympic athlete Judy Simpson. She and her husband, Robin, have spoken about the agony at losing their only child, Joan Mary, to the disease.

"We would urge parents and particularly doctors of young people to be extra vigilant so that this awful disease does not strike again," said the couple in a statement.

This is the time of year when parents begin to worry about meningitis. The Eastern Health Board has just issued a warning to parents to be vigilant for signs of meningitis.

Dr Lelia Thornton, an EHB public health specialist, said parents should familiarise themselves with the signs and symptoms of the disease and seek early medical treatment when necessary.

According to the Meningitis Research Foundation children under five continue to be the age group most at risk from meningitis. Young people in their teens and early 20s are also in an elevated risk group.

Meningitis is the inflammation of the membrane lining the brain and spinal cord and is caused by either viruses or bacteria. Meningitis caused by viruses is not usually life-threatening. The bacterial form is usually the most serious form of the disease.

On average one in 10 cases of bacterial meningitis may be fatal and one in seven may have long-term after-effects, such as deafness and brain damage.

Last year, according to provisional figures from the Department of Health, there were 488 cases of meningococcal disease (bacterial meningitis) in the State and 21 deaths to November. The figures have been steadily rising in recent years, with 506 cases in 1997 and 30 deaths, up from 410 cases in 1996 with 15 deaths. So last year showed a downward trend.

Meningococcal disease, said Dr Thornton, may initially be present as a flu-like illness, with symptoms such as headache, vomiting, fever, widespread aches and pains and sore throat, making initial diagnosis difficult. However, it may then progress to symptoms such as sensitivity to bright lights, neck stiffness, confusion or delirium, drowsiness, unresponsiveness and even coma.

She said that another important sign to watch out for was rash. "This may start as just one or two tiny pinpoint spots or blotches anywhere on the body. The spots may turn into tiny bruises which don't turn white when touched."

In babies the signs are non-specific but include fever, being off feeds, irritability, high-pitched cry, vomiting and drowsiness. Meningitis is not confined solely to young children, she said, and cases can occur in all age groups.

"Meningococcal disease is caused by the bacteria meningococcus. This is a common bacteria which can normally be found in up to 10 per cent of the population. The bacteria is carried in the nose and throat and usually causes no illnesses," she explained.

The bacteria can be transmitted by coughing, sneezing or intimate kissing. "It is not, however, highly infectious and is not easily transmitted, unlike viruses such as measles. Usually prolonged close contact is required to transmit the meningococcal bacteria." She explained that in a small percentage of people who acquire this bacteria, usually from a healthy carrier, the bacteria gets into the bloodstream and can cause meningitis or septicaemia (blood poisoning).

Dr Thornton said there was no suitable vaccine for routine use against this form of meningitis and septicaemia. The introduction in 1992 of the Hib vaccine dramatically reduced the incidence of Hib meningitis here. A vaccine is available for the less common strains of meningococcal meningitis, A and C. If someone is ill with either strain those living with them may be offered this vaccine.

The Meningitis Research Foundation is involved in funding a team of researchers from Imperial College London to look at a vaccine against B strain meningococcal disease, which has been developed in Cuba and appears to have eliminated the disease there.

Ms Janna Moore, the foundation's press officer in Ireland, said that in the 1980s Cuba had a big problem with meningitis "which it appears to have solved".

The situation is more complicated in Ireland because of the many different strains of B type, but they are hopeful of developing a vaccine against B strain which accounts for over 50 per cent of the meningococcal here.

Bacterial meningitis is treated with antibiotics, which is why early diagnosis is essential. Leaflets on the disease are available from local community care offices or the health promotion unit of the Department of Health. For further information contact the Meningitis Research Foundation at (01) 836-6347