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Baby Meningitis Can Damage Long-Term Health

Learning, behavior problems rise 10-fold in infants who get meningitis, says new study

FRIDAY, Sept. 14, 2001 (HealthDayNews) -- A baby who survives meningitis may have severe learning and developmental disabilities that are 10 times greater than kids who never had the potentially deadly brain and spinal cord infection, says a new study.

By the time they're five years old, such children can have several severe problems, which can include seizures and deafness, says Helen Bedford, lead author and senior research fellow at the Centre for Pediatric Epidemiology and Biostatistics, Institute of Child Health in London, England.

In addition, children infected as newborns had more problems than those infected when they were more than one month old, says the study, published in the latest issue of the BMJ.

But other experts say there's no cause for alarm. The overwhelming number of cases stem from viruses and cause no more disabilities than healthy children have.

Also, the strain of what infected the children was a factor in how badly they were affected, says Bedford. "Some organisms gave rise to higher rates of specific disorders. [For example,] pneumococcal meningitis [was] associated with much higher rates of … deafness than other organisms."

According to the study, the most common long-term disabilities linked to meningitis include learning and motor disorders, seizures, hearing impairment, vision problems, language difficulties and various behavioral problems that range from severe temper tantrums to hyperactivity and difficulty concentrating.

Although other studies have shown similar results, this was the first to connect the age of the child at the time of infection with the severity of the disability.

Other experts agree with the finding, but don't feel the study is a cause for alarm.

"In reality, up to 85 percent of all meningitis is caused by a viral infection -- and there is almost no chance that viral meningitis will leave a child with any disability," says Dr. Joseph Stavola, chief of Pediatric Infectious Diseases at New York Weill Cornell Medical Center in New York City.

Though the study did cite both viral and bacterial meningitis as causing disabilities, Stavola points out that the rate of problems linked to viral meningitis was no higher than in the control group.

"I just don't want people worrying that because their baby had meningitis, they are going to wind up with some disability, because that just isn't true unless they had bacterial meningitis, which is actually quite rare," says Stavola.

About 3,000 cases of all types of meningitis are diagnosed in Americans each year, according to the Centers for Disease Control and Prevention.

Symptoms of both types of meningitis in children include fever, feeding problems, vomiting, irritability, seizures and high-pitched crying. Occasionally, the natural flow of fluids around the brain is blocked and causes the skull to enlarge. However, unlike older children or adults, infants may not have the characteristic "stiff neck" symptom.

The most common cause of viral meningitis is the echovirus, a bug spread through human contact; outbreaks are common in day care centers, according to experts.

The most virulent forms of bacterial meningitis are caused by the organisms Streptococcus pneumoniae, and Neisseria meningitides. Other bacteria linked to meningitis include Haemophilus influenzae, Group B streptococcus and Escherichia coli.

This specific study looked at children who contracted all types of meningitis between 1985 and 1987, in England and Wales. All were under one year old when they got sick. Follow-up questionnaires were sent to parents, as well as the physicians who treated 1,700 of these children . Questions focused on the children's health, as well as their developmental and learning skills, and noted the specific type of infection and the child's exact age at the time of the illness.

The final follow-up study involved 1,584 children who had meningitis. They were compared to 1,391 children of similar ages, who hadn't had the disease.

The result: Among those children -- up to age five -- who had survived the illness, more than 15 percent had some type of disability.

"[There is] no reason to suspect that meningitis doesn't cause differing degrees of damage … some children die, some are badly damaged but some less badly damaged," says Bedford.

What To Do

Perhaps the strongest message, says Bedford, is the need for extra vigilance towards children who survive meningitis, with efforts made to ferret out even mild disabilities and treat them early on.

"In the past, [focus] has tended to be on more severe problems. However, a significant proportion also have more subtle problems that, while not disabling, may affect school performance," says Bedford.

Even more important, she says, is preventing the disease in the first place via vaccinations.

In the United States, two vaccines are commonly used to protect children from meningitis: haemophilus influenza type B (Hib) and the newest, pneumococcus bacterium. A vaccine for Neisseria, the second most-virulent cause of meningitis is available, but not advised for children under age two unless they are at extremely high risk, or there is a wide public outbreak of this disease.

For more information on symptoms of meningitis, and tips for prevention, visit the Centers For Disease Control, found here.

To learn more about meningitis in children and infants, click here or learn about echovirus from this fact sheet.

For more information from the American Academy of Pediatrics on the vaccine used to prevent pneumonia ( the leading cause of meningitis in infants ) click here.

SOURCES: Interviews with Helen Bedford, lead study author and Senior Research Fellow, Centre for Pediatric Epidemiology and Biostatistics, Institute of Child Health, London, England; Joseph Stavola, M.D., chairman of pediatric infectious diseases, New York Weill Cornell Medical Center, New York City; Sept. 8, 2001 BMJ
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