Meningitis
什麼是Meningitis
Meningitis (inflammation of the linings of the brain) can be caused by many types of organisms, such as bacteria and viruses.
Meningococcal meningitis is caused by a specific bacterium known as N. meningitides. In addition to several types of N. meningitidis, another common bacterium that can cause meningitis is called Streptococcus pneumoniae. There are 83 known types of Streptococcus pneumoniae. Usually this streptococcus bacteria causes pneumonia in the lungs. However, this organism may spread through the blood to infect the linings of the brain.
In countries where the disease is common, up to 5 to 10 percent of the general population will carry the N. meningitidis bacterium in their nose or throats.
Another form of meningitis is called aseptic meningitis. The most common cause of aseptic meningitis is a viral infection, and enteroviruses are common causes of viral meningitis, especially in children during the summer months. However, aseptic meningitis may be caused by other viruses, such as arboviruses, HIV, herpes simplex virus (HSV) types 1 and 2, some bacteria, fungi, and parasites. Most people who get infected with enteroviruses are asymptomatic or have only a general febrile illness.
您如何獲得Meningitis？
Person-to-person transmission occurs by inhaling respiratory droplets containing the bacteria or virus or by close contact with an infected person’s respiratory secretions or saliva.
Enteroviruses are most often spread via the fecal-oral route from person to person through fecal contamination of water or food or contact with contaminated inanimate objects. Enteroviruses can also be spread through respiratory secretions (saliva, sputum, or nasal mucus) of an infected person
易感性和抵抗力
General susceptibility is low. The disease is most common in very young children or young adults. Excessive crowding contributes to the spread of bacterial meningitis. Susceptibility generally decreases with age.
有哪些症狀？
The illness usually involves the sudden onset of fever, severe headache, a stiff neck, nausea with some vomiting, and may be accompanied by a small rash. The patient may become confused and delirious and enter into a coma, sometimes very quickly after the onset of the illness. Unless the illness is diagnosed early and treated rapidly and aggressively with antibiotics and other supportive measures, the fatality rate can be quite high. With early and aggressive treatment with antibiotics for bacterial meningitis, the death rate has been reduced to between 5 and 15 percent.
Antibiotics are not effective for aseptic meningitis caused by viruses. However, most people who get infected with enteroviruses are asymptomatic or have only a general febrile illness.
預防措施
對於那些在流行病國家（即撒哈拉以南非洲）旅行或居住的人們，建議接種由細菌引起的腦膜炎奈瑟菌疫苗。當在其他地區有很多病例或這種細菌爆發時，也可能建議接種疫苗。美國疾病控制與預防中心建議對所有11至12歲的青少年和青少年接種腦膜炎球菌結合疫苗，並在16歲時加強劑量。青少年和年輕人（16至23歲）也可以接種B血清群腦膜炎球菌疫苗。如果他們存在以下疾病：諸如脾臟受損或缺失，免疫系統受損或屬於因B群腦膜炎球菌疾病暴發而增加風險的人群。對於直接接觸細菌性腦膜炎的人，建議使用抗生素預防接觸者的疾病。在美洲，歐洲，澳大利亞，中國和印度，已經出現了耐環丙沙星的腦膜炎球菌病的零星分離株。因此，美國疾病控制與預防中心建議，在已確定具有環丙沙星抗藥性菌株的社區中，不應再將環丙沙星用於腦膜炎球菌的化學預防。現在推薦使用頭孢曲松，利福平和阿奇黴素。遵循一般的食物和水預防措施並保持謹慎的個人衛生習慣將有助於預防由腸病毒引起的無菌性腦膜炎。
治療
Early and aggressive treatment with a variety of commonly available antibiotics is generally effective. For aseptic meningitis, only general supportive measures are available.
驗證
疫苗接種
通常在哪裡發生？
腦膜炎球菌感染在世界任何地方都被發現，病例通常是零星的。非洲撒哈拉以南國家在旱季（通常是從12月至4月）經常出現細菌性腦膜炎的流行。這些國家被稱為撒哈拉以南的腦膜炎帶，包括岡比亞、塞內加爾、馬里、布吉納法索、加納、尼日爾、奈及利亞、喀麥隆、乍得、中非共和國、蘇丹、烏干達、肯雅、埃塞俄比亞和厄立特里亞。
腸病毒是無菌性腦膜炎的主要原因，全世界都有這種病毒。
