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Fast Fact

Bacterial meningitis can occur at any age, but 95 percent of cases are in children under 5 years old.
Boys are more likely to get it than girls.
Together, three types of bacteria account for over 90 percent of bacterial meningitis: H. influenza type b, meningococcus, and pneumococcus.
These bacteria are transmitted by person-to-person contact through respiratory secretions. Many people carry these bacteria with no serious consequence. (Pneumococcus, for instance, is the most common cause of ear infections.) A few people get very sick. Pneumococcus causes meningitis in about 3 per 100,000 people. (Textbook of Pediatric Infectious Disease, Saunders 1998)
Sudden onset meningitis features shock, internal bleeding, purple spots, and reduced consciousness at the very outset, with a rapidly progressive course often resulting in death within 24 hours.
More commonly, meningitis begins with several days of upper respiratory symptoms or gastrointestinal symptoms. Most children have high fevers, severe headaches, and poor feeding. They may also have muscle aches, nasal congestion, vomiting, neck stiffness, and seizures.
Children with meningitis become increasingly irritable and/or lethargic. The presence of petechiae (purple spots that indicate internal bleeding) is a sign that the infection may be raging out of control.
Pneumococcal meningitis is a devastating disease. Of all causes of meningitis, it is the most likely to have a negative outcome (Pediatric Infectious Disease Journal, May 1993). The overuse of antibiotics is resulting in increasingly resistant strains of pneumococcus every month.
In 1991, a vaccine against the H. influenzae Type b (HIB) bacteria was incorporated into the routine immunization schedule beginning at 2 months of age. The amount of meningitis plummeted. Arkansas Children's Hospital had about 27 cases of HIB meningitis per year in the 1980's before the vaccine was used. By 1993, the number had dropped to only 1.7 per year (Southern Medical Journal, Jan 1994). During the same period the number of cases dropped by 95 percent in the United States as a whole (Textbook of Pediatric Infectious Diseases, Saunders 1998).
The new pneumococcal vaccine for infants is now FDA approved and recommended by the American Academy of Pediatrics for all children less than 2 years of age. Vaccination of children between 2 and 5 years of age may also be considered on an individual basis. In large clinical studies, the vaccine has been shown to decrease the risk of invasive pneumococcal infection (i.e. meningitis and blood infections) by more than 93%. It has also been shown to decrease the risk of pneumonia and otitis media (ear infections). More information about the vaccine can be found at www.cdc.gov/.

see Fast Facts about Meningitis »

The Aftermath of Tragedy

9.12.2001 Add new comment Send to friend Print this article

Submitted by DrGreene on 9.12.2001

One of my children asked me to tell parents everywhere to please turn off their TV's and radios when their kids are around. He has a good point: children do not need to watch images of destruction over and over again. Most children do need (as far as possible) to see that even tragedies of this magnitude do not destroy their day-to-day lives. Keeping up routines is very reassuring, Of course, some kids' lives have been shattered. Those children who are directly impacted, need immediate and long-term support from those around them. Either way, children need strong connections with the significant children and adults in their lives. It's important to spend time together, and to engage any questions or comments that come up as you do. Out of nowhere, my youngest commented that he hopes the war doesn't start soon. When I repeated his wish, he explained further that when the war does start, they will bomb his school. This opened up a key, reassuring conversation. Create an atmosphere of calm attention that encourages questions and comments. Don't be afraid to answer the questions kids ask or to explore together their comments. We each give the other so much when we are together. When spending time together hugs and squeezes can communicate love and security even better than words. If they ask the same question over and over again, physical closeness is especially important. If they ask a question you don't know the answer to, it's okay to say you don't know, but that we do know... (and give a brief, objective list of things we do know). You may want to set aside a moment of silence or a time of prayer in your family to create a space for the solemnity of these events and the peace of going through them together. Some children will sail through this with hardly a thought. For others, the impact will be profound. Please join me in chat to discuss more specifics on moving through this time with our children. Or stop by chat anytime to share experiences and questions with other parents.

Alan Greene MD FAAP

September 12th, 2001