AFTER MENINGITIS

Even when well enough to leave hospital, meningitis patients are not always ready to return to normal life. The disease is often followed by a variety of after-effects, some permanent and physically disabling, and some (less obvious) emotional. Although many people make a swift and complete recovery, others need a lot of support and care over the weeks and months following their illness. Unfortunately, it is impossible to predict which after-effects, if any, an individual may suffer.

Most people who have been in hospital, for whatever reason, feel upset by the experience. With a serious illness like meningitis, even when treatment is complete, people of any age may take some time to recover.

Viral and bacterial meningitis

The after-effects of viral and bacterial meningitis are very similar, but bacterial meningitis is considered to be much more serious than viral, since it is fatal in about 1 in 10 cases. However, it is a mistake to assume that patients who have had viral meningitis are any less vulnerable to the after-effects. The symptoms and possible long-term complications of both strains of the disease can be very similar (although individuals will be affected in different ways).

After-effects

Meningitis has a wide range of effects on patients. Many make a fast and problem-free recovery, while for others the after-effects vary considerably. The following is only intended as a guide. In young children, in order of likelihood (although many of these after-effects could occur after a hospital admission for any illness):

• babyish behaviour, or extra clingy
• temper tantrums
• forgetting recently learned skills
• demanding attention
• reverting to bed-wetting
• wakeful at night

The younger the child, the harder it is for them to express how they feel. Some children may seem to get one minor illness after another when they have had a major infection such as meningitis. This is quite common, improves in time given plenty of patience and understanding.

In all children and adults, the extensive after-effects include:

• general tiredness
• recurring headaches
• difficulty in concentration
• short-term memory lapses
• clumsiness
• giddiness
• balance problems
• depression
• violent temper tantrums
• bouts of aggression
• mood swings
• learning difficulties, or reduced ability in some areas of school work
• deafness
• tinnitus (i.e. ringing in the ears)
• soreness or stiffness in the hip or knee
• eyesight difficulties
• epilepsy
• brain damage

It is important to talk to teachers about any problem a child may be experiencing

Serious complications

One of the most common problems is deafness, which affects around one in ten people and can either be temporary or permanent. Anyone who has had bacterial or viral meningitis should have a hearing test. This is especially important for young children, where hearing loss is often more difficult to detect. Children's hearing tests are arranged through GPs or the local hospital ENT (Ear, Nose, and Throat) Department.

Other serious complications can include brain damage, epilepsy, and changes in eyesight. Behavioural difficulties (such as violent temper tantrums, aggression, mood swings, and learning difficulties) can also be long-term problems. Occasionally, during the illness septicaemia (blood poisoning) can occur, which in extreme cases can result in the amputation of limbs, fingers, or toes.

Recovery

Some of the most common after-effects are not immediately visible, but can nevertheless affect the patient's quality of life dramatically. For example, if a sufferer is left feeling tired, depressed, and unable to concentrate, it may be weeks or even months before they are able to return to a normal routine.

So the more stress-free the recovery period can be, the sooner the sufferer can get better. Patients should not rush themselves, but rather listen to what their body is telling them and not attempt too much too soon. Many patients have found success using "alternative" medicines to deal with after-effects.

Recurrence

It is unusual for anyone to get the disease more than once, even when it is caused by different germs. Having the vaccination against Hib (Haemophilus infuenzae type b) meningitis protects children against this form of the disease. Hib meningitis almost exclusively affects children under four years old. The introduction of the vaccine has dramatically reduced the number of cases of this form of the disease.

It is possible for someone to suffer pneumococcal meningitis more than once, due to a tiny fracture or defect in the skull, but this happens very rarely.

Socialising

Although there is only a slightly increased risk of contracting the disease from patients who have had meningococcal meningitis, sufferers of this strain are given antibiotics upon discharge from hospital to make sure they are no longer infectious. A vaccine should also be recommended for those in close contact with patients who have suffered A or C meningococcal meningitis.

All strains of meningitis are a low risk in terms of patients passing on the germ. Patients can safely return to work or school and socialise with friends and relatives as soon as they feel well enough.

Example cases

"My daughter had viral meningitis and encephalitis at 16 weeks some years ago. Thankfully she is now a thriving four-year-old. I wondered if other sufferers of problems occurring after meningitis had considered using homeopathy. Whilst I would never recommend homeopathy or other alternative medicine as a substitute for mainstream health services, it does seem to be a sensible path to take, particularly when nothing else is available".
J. R. of Skipton.

"Having meningococcal meningitis eleven years ago at the age of 15 left me totally deafened. This completely changed my life and the lives of my family and friends. The problems associated with being deaf are many, including learning to lip-read, relying on others for telephone communication, and limited employment prospects. However, after many trials and tribulations I am now living as full a life as possible, and have recently had a cochlear implant which has greatly improved my quality of life. There is hope after meningitis - even if left with a severe disability."
J. W. of Gloucestershire

(not every person who has lost their hearing is suitable for a cochlear implant).

Help

In some instances hospitals will refer patients to a specialist rehabilitation centre that can help. Patients may be referred to a physiotherapist in their community. Consultants will normally see both children and adults who have had bacterial meningitis a few weeks after leaving hospital to check that there are no complications. GPs and health visitors can advise the patient on where to go for further help.

There are many organisations that specialise in more serious complications. If unsure of where to go or how to find out about these organisations, please contact the support services department at the National Meningitis Trust. Staff will give details or suggest other forms of help.

If the after-effects do not improve, or if worried about anything, ask your family doctor or health visitor for help. Meningitis sufferers who have been discharged from hospital should not feel there is no further care available to them.