Impact

Impact on the infected individual

The impact of meningitis differs dramatically depending on whether it is viral or bacterial.

Viral meningitis is usually far less severe than bacterial meningitis and recovery after this disease is usually complete and after-effects are rare.  However, headaches, tiredness and depression may persist for weeks or even months following viral meningitis.

Bacterial meningitis has a far greater impact, with a high incidence of sequelae.  After-effects of bacterial meningitis include: learning difficulties/behavioural problems; memory problems; epilepsy; loss of sight; deafness; and brain damage.  There is also a high mortality rate associated with this disease.

• Loss of hearing
  The most common after-effect of meningitis is hearing loss.  Loss of hearing can be mild or severe, resulting in profound deafness.  Balance problems and tinnitus (ringing in the ears) may also be a result of meningitis, caused by damage to the inner ear.
• Memory problems
  Many people experience short-term memory loss, or find it hard to concentrate following meningitis.
• Learning difficulties/behavioural problems
  Learning difficulties and behavioural problems are common after-effects of meningitis, especially in babies and young children.  These may diminish over time but some may be permanent.
• Loss of sight
  Meningitis can damage the optic nerve, resulting in partial loss of vision or blindness.
• Brain damage
  Severe brain damage following meningitis is not common but may be an after-effect of the disease.
• Epilepsy
  Epilepsy can occur after meningitis and requires long-term medication.

In Europe around 7% of people who suffer meningococcal diseases may die, and of those who survive, around 15% may suffer debilitating after-effects.  Case fatality rates vary between serogroups.  In Europe, between 1999 and 2000, the case fatality rate for serogroup A disease was 14.3%, 10.8% for serogroup W-135, 8.0% for serogroup C, 4.5% for serogroup Y and 4.3% for serogroup Bi.  Case morbidity and mortality rates are higher with pneumococcal meningitis, approximately 20% of these cases will result in death and approximately 25% of cases result in severe after-effectsi.  In 15–30% of cases of Hib meningitis patients will be left with permanent neurological sequelae and the fatality rate of Hib meningitis is 5–10%.  Case fatality rates are highest in infants and the elderly with all types of meningitis.¹

Impact of septicaemia

During septicaemia the bacteria in the blood stream release a variety of toxins, which damage the blood vessels and reduce oxygen availability.  Reduction in the flow of oxygen to major organs such as the skin, brain, liver, kidneys, lungs and heart can cause permanent damage.  Serious damage to large areas of tissue or muscle may mean skin grafts and plastic surgery are necessary to improve the appearance and restore the function of the injured areas. In severe cases amputation may be necessary.  Severe damage to organs such as the heart or brain may result in death.

Impact on healthcare services

Meningitis impacts greatly on the provision and cost of healthcare services as patients require hospitalisation and intensive medical care while being treated for meningitis and may also need extensive medical care to cope with the after-effects of meningitis.

Reference:
1. Communicable Disease Surveillance Centre, European Bacterial Meningitis Surveillance Project February 2002. Surveillance of Bacterial Meningitis in Europe 1999/2000.  Available at: www.euibis.org/documents/bac_meningo_europe_1999-2000.pdf(accessed April 2007).