We may be well into 2020, but we are still in the throes of the winter season and all of the coughs, sneezes and other viruses it brings with it. But while unpleasant, most of these are treatable with over-the-counter medicine and a couple of days in bed.
However, the colder months also see a rise in something a lot more serious – meningitis. In 2018, there were 96 cases of meningococcal disease and bacterial meningitis and last winter there was a definite seasonal rise over the colder months, with it being more prevalent in Ireland than most other European countries.
According to the Meningitis Research Foundation (MRF) wintertime illnesses, such as flu, are thought to enable meningitis-causing bacteria to invade the body more easily through the nose and throat, and they can spread more rapidly when people spend longer periods together indoors.
Vulnerable
"Thankfully meningitis is not a common illness, and although cases vary from year to year it is more common in Ireland and the UK than in most other countries in Europe, and more common than in the US and Canada, " says Linda Glennie, director of research at MRF. "In 2014, the latest year for which comparative data have been published, Ireland had the third highest rate of meningococcal disease in Europe. We do not know why the rates are higher in certain countries, but these trends have persisted for many years.
“Babies, young children and older teenagers are most vulnerable from meningitis, but everyone is at risk from this deadly disease. Early symptoms are usually fever, vomiting, headache and feeling unwell. Limb pain, pale skin, and cold hands and feet often appear earlier than the rash, neck stiffness, dislike of bright lights and confusion. So if you, or someone you know is ill and getting rapidly worse, people should not be afraid to seek urgent medical help – even if they’ve already been seen by a doctor that same day.”
Adam Bruton knows only too well the importance of early detection as three years ago, he felt ill after returning home from work on a Friday evening and believing he was coming down with flu, took himself to bed.
However his symptoms got rapidly worse, so he asked his mother to take him to the out-of-hours medical clinic. Unfortunately, the doctor on duty didn’t recognise the symptoms and sent him home with instructions to rest for a few days until he recovered.
Given the severity of his condition, the Dublin man didn’t miraculously recover and if it wasn’t for the swift thinking of his GP who, although on holidays, diagnosed a suspected case of meningitis over the phone and urged his parents to take him to hospital immediately.
“The D-Doc diagnosed me as having ‘a stiff neck and a strained back’, gave me a Valium injection to ‘loosen up’ my neck and sent me home to rest for two days,” says the 27-year old. “I returned home and went back to bed, completely drained and in agony but, trusting the doctor’s advice, I passed out for a few hours. In the meantime, my dad had tried to call our family GP a couple of times but couldn’t reach him as he was abroad.
“My family were beginning to really worry about my deteriorating condition and reduced level of consciousness and at about 8pm my dad received a phone call from our GP who after hearing my symptoms, asked to speak to me and immediately advised me to get to hospital. He said he would call forward and let them know I would be coming in with a case of suspected meningitis – this is when it became really scary.”
Adam, who works in the airline industry, was rushed to casualty by his mother and after a short wait, was admitted and began to receive urgent medical attention. “After an initial assessment, I was brought to an A&E bed and began speaking with a doctor who advised me of the situation,” he recalls.
“She tried to put me at ease by telling me it looked to be viral meningitis which is less dangerous of the two but still extremely serious. The next step was to get some caffeine into me as apparently it helps to reduce the swelling of the brain and I was then advised that I would have a lumbar puncture – via a six inch needle into my spinal cord, which for someone who has a massive fear of needles, was terrifying.
Isolation room
“Immediately after the lumbar puncture, the doctors placed me in an isolation room where staff and visitors had to wear gloves and masks. They started to pump all kinds of medication into me and told me that they were treating me for bacterial meningitis ‘just in case’ as with bacterial, it is so important to get ahead of it and begin treatment immediately.”
Thanks to the prompt action of medical staff, Adam recovered from his ordeal – but he was in hospital for three weeks and upon his discharge, was bedbound for a lot longer. It took months for him to return to some sort of normalcy but, as a keen athlete, says some things look set to have changed forever.
“Being quite stubborn I just wanted to get out of hospital and get home to continue on with my life, my travels and just get back to normal,” he says. “Even when I was bedbound I was telling friends and family that I felt fine and would be out running again in no time. But I was very wrong – and it didn’t take long before I realised that just because I had been released from hospital, it didn’t mean that I was ‘fit and healthy’. Walking 500m to the shops would induce painful headaches and extreme feelings of lethargy.
“The headaches and complete lack of energy continued for months and it really did impede my day to day life. I had asked a couple of close friends to observe me over a couple of months and when I asked them how I was doing they told me of a few changes they had noticed. I brought these points with me to my doctor on one of my follow-ups as it was difficult to see that my closest friends had noticed such a change in personality and temperament.
“The doctors made me aware that memory loss, stress, frustration and becoming distant and disconnected from people were all part of the recovery and noted that in many cases these can be lifelong side effects. They also said the energy levels would return to a certain extent but there was no way to determine if they would ever return to what they were. This hit me hard because now I am faced with the fear of never being able to run again and not recovering 100 per cent mentally.”
But despite the ordeal he has been through and its potentially lasting effects, Adam, who has been fundraising for MRF, believes he is lucky to be alive and would encourage people of all ages to get vaccinated against meningitis as it can and does “strike out of nowhere”.
Dangerous
“I would encourage people 110 per cent to get vaccinated against meningitis as it’s the first line of defence,” he says. “If you experience any symptoms – not just a rash, I would urge you to get in touch with your GP or go straight to the hospital. Don’t put it off like I did – as looking back, my fear of the joke of an Irish hospital system could have put me in a very dangerous position.
“So I would urge students to be aware of the symptoms as unfortunately, they can appear to be a bad hangover but turn out to be a little more sinister. If you have suspected meningitis, the best place for you is in hospital.”
Glennie agrees and says vaccination against meningitis is advisable for all age groups.
“We are sorry to hear of what Adam has been through and MRF is really grateful to him for raising funds to support initiatives like MRF’s Genome Library, which identified the deadly strain of MenW, responsible for many cases in Ireland,” she said. “Identifying this strain led to the introduction of MenACWY this academic year for Irish schoolchildren in their first year at secondary school.
“This new MenACWY vaccine is an addition to MenB and MenC jab offered to babies; together these will help protect against meningococcal infection – the other vaccines in the immunisation programme for babies and young children protect against two other deadly forms of meningitis: pneumococcal and Hib meningitis. So we encourage people to take-up all the vaccinations they are eligible for.”
