A significant portion of children become permanently disabled after contracting bacterial meningitis, with affected individuals at 26 times more risk of suffering structural damage to their heads, according to a recent Swedish study.
The peer-reviewed study, published by JAMA Network on Jan. 19, investigated the long-term risk of disabilities among individuals diagnosed with bacterial meningitis during childhood.
Bacterial meningitis is an inflammation of the protective membranes that cover the brain and spinal cord. The condition requires immediate medical attention and can be fatal.
The study analyzed health data from 36,230 individuals in Sweden. Out of these, 3,623 individuals were diagnosed with bacterial meningitis, while the remaining 32,607 acted as a control.
Roughly one in three individuals (29 percent) affected by bacterial meningitis had at least one permanent neurological impairment compared to one in ten from the control group.
Individuals who were infected during childhood were found to have a “higher cumulative incidence” of all seven disabilities—cognitive disabilities, seizures, hearing loss, motor function disorders, visual disturbances, behavioral and emotional disorders, and intracranial structural injuries—analyzed in the study compared to the control population.
Affected individuals were 26 times more at risk of structural damage to the head, almost eight times more at risk of hearing impairment, and roughly five times more at risk of motor impairment.
“This shows that even if the bacterial infection is cured, many people suffer from neurological impairments afterwards,” said Federico Iovino, an author of the study.
The research also discovered a link between age and the risk of disabilities. The median age of the study participants at the time of diagnosis was 1.5 years.
“The relative risk of disabilities was numerically higher for children diagnosed at an early age for all types of disabilities and significantly higher for cognitive disabilities, seizures, behavioral and emotional disorders, and intracranial structural injuries,” the authors wrote.
“Our interpretation is that the damage to the brain and nervous system that can follow an episode of bacterial meningitis is more detrimental for young children who are at a sensitive stage in their physical and mental development.”
The researchers recommended that follow-up procedures for children infected with bacterial meningitis must include strategies to detect the seven disabilities analyzed in the study “as they otherwise could remain undetected for several years.”
The study was sponsored and funded by Merck Sharp & Dohme LLC, a subsidiary of pharmaceutical company Merck.
“The funder had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication,” the study said.
There were also multiple conflicts of interest. Two researchers reported owning stock or stock options from Merck while the study was conducted. Two more owned stock or stock options of Merck Sharp & Dohme.
Three researchers reported receiving grant funding to their institutions from Merck Sharp & Dohme while one individual received personal grants from the company.
One of the researchers served on the advisory board for Merck Sharp & Dohme’s pneumococcal vaccines outside the submitted work. These vaccines target pneumococcal disease caused by the Streptococcus pneumoniae bacteria, one of the three main bacteria found to be causing bacterial meningitis in the study.
Another researcher served on the advisory board for pediatric vaccines from Merck Sharp & Dohme as well as the advisory boards of Pfizer Inc., GlaxoSmithKline, Janssen Pharmaceuticals, and Sanofi Pasteur outside the submitted work.
A Dangerous Illness
Out of the 3,623 cases of bacterial meningitis identified in the study, 24.5 percent were caused by Haemophilus influenza bacteria, 15.8 percent by Streptococcus pneumonia, and 13.7 percent by Neisseria meningitidis.
According to the U.S. Centers for Disease Control and Prevention (CDC), people with Streptococcus pneumoniae and Haemophilus influenza can infect others when they cough or sneeze.
People with Neisseria meningitides spread the bacteria by sharing respiratory or throat secretions like saliva or spit. This usually occurs during close contact while kissing or coughing and also during lengthy contact like living together.
Though antibiotics can cure bacterial meningitis, they can cause permanent neurological impairment. As it is children who are often infected, they may end up suffering long-term consequences throughout their lives.
“When children are affected, the whole family is affected. If a three-year-old child has impaired cognition, a motor impairment, impaired or lost sight, or hearing, it has a big impact. This is about lifelong disabilities that become a great burden both for the individual and for society because the affected need support from the healthcare system for the rest of their lives,” Mr. Iovino wrote in a post for the Karolinska Institutet.
“We are trying to develop treatments that can protect the nerve cells in the brain during the time window of a few days that it takes for antibiotics to have full effect. We now have very promising data from human neurons and are about to enter a preclinical phase with animal models.”
Symptoms of bacterial meningitis include the sudden onset of fever, headache, and stiff neck. Other symptoms like nausea, vomiting, altered mental status, and eyes being more sensitive to light may be experienced.
Babies with the infection may be slow or inactive, vomit, feed poorly, have abnormal reflexes, be irritable, or have a bulging fontanelle, which is the soft spot on the baby’s head.
“If you think your baby or child has any of these symptoms, call the doctor right away,” the CDC states. “People with bacterial meningitis can have seizures, go into a coma, and even die. For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.”