With the report of a possible case of meningitis this past Wednesday following closely on the heels of three cases of encephalitis, one resulting in the death of a second grader, Rhode Island has attempted to stave off the spread of what ever may be causing the outbreak by closing schools in the affected areas. The second grader died when what had been previously diagnosed as walking pneumonia escalated into encephalitis. The words, viral, bacterial, and mycoplasma have been thrown into the mix making typical wintertime illnesses sound like a modern plague and people are reacting.
Mycoplasma pneumoniae, otherwise known as walking pneumonia, is an inflammation of the lung. This is the smallest self-replicating biological system known to man. It is also the cause of 70% of pneumonias in school age children each year. Though pneumonia has a bad reputation it is really only dangerous in those with weak or compromised immune systems. Though it will make you feel lousy it will not necessarily confine you to a hospital or even a bed in most cases.
Close and extended contact can cause the spread of the mycoplasma. Breakouts have been registered in summer camps and boarding schools where children inevitably breathe in the air coughed out by someone who is infected. Symptoms can take one to three weeks to present and will come on slowly. A decrease in energy and the onset of what seems like a cold are beginning signals. The symptoms increase over a period of two weeks until the illness finally takes hold in the lungs. Untreated it can last for up to a month. With the proper types of antibiotics, the more common types of antibiotics have no effect; the patient will be back to normal in a mere five to seven days. The only lasting vestige will be a dry cough, often described as a tickle in the chest, caused by replacement of the damaged ciliated cells.
In very rare instances this type of infection can be a doorway to the more serious encephalitis, or meningitis, as was the case in Rhode Island. Encephalitis is an inflammation of the brain typically caused by viral infection. It can be mild or severe. The duration is subject to severity. Anything from bed rest, to life long ramifications, to death may be the end result. A severe headache is the predominant symptom and may be accompanied by sensitivity to light, vomiting, irritability, cold-like symptoms, fever, and fatigue. Encephalitis though scary is rare and not easily transmitted. The most common transmissions are fecal-oral and can be avoided with proper hand washing.
Meningitis is a swelling of the lining of the brain and spinal cord. Ninety-five percent of bacterial meningitis cases occur in children under the age of five. Three types of bacteria are the usual culprits, H. influenza type b, meningococcus, and pneumococcus. (You may recognize flu and pneumonia.) These are generally transmitted when the infected person coughs and excretes the bacteria from their lungs into the air. Meningitis presents in two ways. The first may seem like a common cold or flu. Respiratory problems, nausea, fever, headache and lack of appetite are typical. The patient will often become lethargic and have muscle aches as well. Increased severity may be indicated by the appearance of purple spots. The second, less common type, is rapidly incapacitating marked by internal bleeding, purple spots, reduced consciousness, and shock. This type often results in death within 24 hours. Meningitis is among the most serious of childhood ailments. In the past most children who have contracted it have died within days. Today, with the proper antibiotics the majority of those stricken live without any lasting effects.
In an effort to limit contact between possibly infected children, schools in three districts of the state were closed Thursday and Friday but are scheduled to re-open Monday with some new tactics in place. Each class will have alcohol based sanitizing gels available to the students and there will be a lesson in proper coughing procedure. This will encourage children to cough into their elbow rather than their hand in an attempt to limit contact areas and airborne bacteria.
While these efforts are commendable they may be less than effective. If the infections take 1 to 3 weeks to present with symptoms two days off without any newly reported cases does not mean there will not be any in a week, or two, or three. Alcohol gels may be the wave of the decade but they are no more effective than properly washing your hands with soap and water for fifteen seconds. The trick with either method is getting children to do them often and properly. Not an easy task with 20 children to supervise at any one time.
Walking pneumonia: http://www.drgreene.org/body.cfm?xyzpdqabc=0&id;=21&action;=detail&ref;=206
RI school closings: http://www.msnbc.msn.com/id/16468062/
http://www.abc6.com/engine.pl?station=wlne&id;=23694&template;=breakout_story_local_news.shtml&dateformat;=%M+%e,%Y
Encephalitis: http://www.drgreene.org/body.cfm?id=21&action;=detail&ref;=1080
Meningitis: http://www.drgreene.com/21_1139.html
