Meningitis and hearing loss
Meningitis is an inflammation of the lining of the brain which has several different causes.
By far the most common form is viral meningitis which, although rarely life threatening, can leave sufferers weakened with constant headaches, tiredness and depression. Antibiotics are ineffective for viral meningitis and recovery can be slow.
Bacterial meningitis, although rare, can be far more serious. According to the statutory bodies responsible for surveillance of meningitis, in 2000 there were 3318 cases of bacterial meningitis and septicaemia in England and Wales. 362 cases of meningococcal disease were reported in Scotland and in Northern Ireland 206 cases of bacterial meningitis and septicaemia were reported. These cases were broken down into two main types; each named after the different bacterial organisms:
- Meningococcal (strains A, B and C)
- Pneumococcal
Since 2000, cases of C strain meningococcal disease have dropped, due to the introduction of Men C vaccine, which has been offered to everyone under 25 over the past two years. However, there is no vaccine that can prevent all forms. Cases continue to occur because routine immunisation is not available to protect against some forms.
Bacterial meningitis can be treated by antibiotics, but it is essential that the infection is diagnosed as early as possible.
What are the chances of hearing loss following meningitits?
Deafness is the most common of all forms of permanent damage following meningitis, affecting as many as seven per cent of all children who recover. Damage can result from both the direct effect of the infection on the brain and also the body's response to it. Strong reactions likely to cause permanent damage are more commonly associated with pneumococcal meningitis. The site of permanent hearing loss is almost always the cochlea. Damage usually happens within the first couple of days of the illness.
The chances of a child experiencing a degree of hearing loss following meningitis depend on a number of factors. The age of the child is crucial, with newborn babies facing a particular risk.
Before 1992 when Hib (Haemophilus influenzae type b) vaccine was introduced into the childhood vaccination schedule, Hib was the biggest cause of meningitis in children under 5 years of age and was a major cause of deafness. However, even since then, hearing problems remain one of the most common after effects of bacterial meningitis.
Other forms of meningitis which are not vaccine preventable and which pose a significant risk of hearing loss, are group B streptococcal and E coli meningitis, which together account for most cases of meningitis in newborn babies (neonatal meningitis).
Bacterial meningitis accounts for around six per cent of all hearing impairment in children. According to recent research 72 per cent of these children will become deaf before their third birthday. Deafness at this age can have a severe impact upon a child's development of social and language skills. For this reason it is vital that hearing impairment following meningitis is identified as soon as possible so that parents can adopt appropriate strategies for combating its effects.
However, a 1993 study showed that around 22 per cent of all children who survived meningitis were not tested for impaired hearing. Given that many cases of meningitis occur in children before they have developed speech, even children who have suffered profoundly impaired hearing could go undetected. In such cases, children are disadvantaged educationally and are unable to benefit from hearing devices and other strategies which could be of use.
Hearing impairment in older children may also go undetected, especially if the hearing loss is mild or affects only one ear.
As long as hearing tests are not conducted automatically following meningitis, all parents are strongly urged to ensure that their child does undergo a test. Experts advise that assessment should take place four to six weeks after discharge from hospital so that the child can fully recover without compromising the detection of a hearing loss.
Other common long-term effects of meningitis include tinnitus: permanent or temporary sounds (usually described as ringing sounds) experienced in the head or ears.
What are the symptoms of meningitis?
Meningitis and septicaemia, the blood poisoning form of the disease, can be difficult to identify, as the symptoms can be flu-like. However, given the rapid development of these conditions, it is vital that it identified and treated early. Symptoms include:
| Meningitis | Septicaemia | |
| Rash | Yes, not present in all cases | Yes, develops anywhere on body |
| Fever/vomiting | Yes | Yes |
| Cold hands and feet | No | Yes |
| Rapid breathing | No | Yes |
| Stomach/joint/muscle pain | No | Yes, sometimes with diarrhoea |
| Drowsiness/losing consciousness | Yes | Yes, not in all cases |
| Severe headache | Yes | No |
| Dislike of bright lights | Yes, not often present in young children | No |
| Stiff neck | Yes, not often present in young children | No |
Babies may also suffer from:
- Tense or bulging soft spot on the baby.s head
- Blotchy skin, getting paler or turning blue
- Refusing to feed
- Irritable when picked up, with a high pitched or moaning cry
- A stiff body with jerky movements, or else floppy and lifeless
However, it is important to note that symptoms will vary and not everyone will display all the symptoms listed.
