What to do if there is meningitis in the garden. Serous meningitis: symptoms in children, incubation period, quarantine

With the beginning of autumn, unexpected outbreaks of meningitis were discovered in several regions. Unfortunately, the disease takes lives, and most often this happens because its first signs are very similar to common flu or measles.

The first current tragedy occurred in one of the families in the village of Godomichi in Western Ukraine. Parents noticed sharp deterioration the health status of my two-year-old son. An ambulance was called to the child, who immediately took him to little patient to the hospital. On the way, the boy was injected necessary medications. But, unfortunately, it was not possible to save the child. The boy died in intensive care from infectious-toxic shock. Doctors explained that this was an immediate form of the disease, in which there was very little chance of salvation.

Eight-year-old Dianka from Slavyansk also failed to survive. In the evening, the child’s temperature rose to 40 degrees, and her mother gave her an antifever medication. At dawn, a strange purple rash appeared on the child’s body; the mother thought it was measles or rubella. I called an ambulance when my daughter started having seizures. The child was not taken to the hospital alive.

“We realized it too late,” the doctors explain. “In such cases, every minute is important for salvation.” But timely contact with doctors, unfortunately, does not guarantee that doctors will make the correct diagnosis.

What happened to Yulia Zinchuk’s nine-month-old daughter is horrifying. The parents are confident that their child could have been saved, but the incompetence of the doctors led to the tragedy. Now an official investigation is being conducted into this fact. And the sad Yulia recalls how the doctor on duty decided not to take any tests on the child, since the doctor on duty at the laboratory did not pick up the phone, perhaps he was sleeping - he did not want to wake him up. How a girl was prescribed antibiotics without tests. How the little girl screamed and cried, and the neurologist reassured her that it was good sign: The girl is active, she is starting to recover. And when in district hospital The resuscitation team arrived from regional center, they could no longer save the child.

Unfortunately, there are more cases of meningitis every day. Today we know of five deaths since the beginning of the year in Zhitomir: three dead children were not yet a year old. In Kyiv, 47 cases of viral meningitis have been registered, including five children. The infection claimed the life of a forty-year-old man.

In school No. 35, the premises are washed with bleach after classes - a student here fell ill. But the school works, learning continues even in the class where he studied.

Treatment of meningitis should begin immediately, and self-medication is unacceptable.

Doctors are reassuring: there is no talk of a mass epidemic yet, there is no need to panic. But they admit: since the beginning of 2015, the incidence of meningitis has increased by 33% compared to last year.

Well, we don't want to cause panic. But we don’t want to diminish the danger of the disease. Therefore, we turn to the famous Ukrainian pediatrician and infectious disease specialist Evgeniy Komarovsky with a request to tell us about the most important things that we should know about this disease in order to protect ourselves and our families from this terrible scourge.

“The word “meningitis” itself means inflammation of the membranes of the brain,” explains Dr. Komarovsky. – But the causes of this inflammation are different. It can be caused by bacteria, viruses, fungi, and hemophilus influenzae. From this it is clear that meningitis is different: both in the speed of development of the disease, and in the severity of the person’s condition, and in the methods of treatment. However, all types of meningitis have one thing in common - a real threat to life and high probability complications.

— So you don’t have to catch a specific virus to get sick?

- Not necessarily. In order for meningitis to develop, specific, even, at first glance, not very dangerous pathogen should enter the cranial cavity and cause inflammation of the membranes of the brain. Sometimes this occurs when foci of infection appear in the immediate vicinity of the membranes of the brain - with purulent otitis media, for example, or with sinusitis, or with mumps, measles or chickenpox.

— What is meningococcal infection itself, which is sometimes found in the nasopharynx of seemingly healthy people? Why is a person a carrier of it, but may not suffer from meningitis?

“If it has already been discovered, then it needs to be treated, and urgently.” After all, she “sleeps” in the body for the time being, waiting for an opportunity. The body's inability to localize the microbe, say, in the nasopharynx, is accompanied by the penetration of meningococcus through the mucous membrane into the blood. With the bloodstream, it enters the meninges, eyes, ears, joints, lungs, and adrenal glands. In each of these organs a very dangerous inflammatory process. It is obvious that defeat meninges accompanied by the development of meningococcal meningitis. Sometimes meningococcus enters the blood quickly and a huge number. Meningococcal sepsis, or meningococcemia, occurs - perhaps the most terrible of all childhood infectious diseases. The microbe releases toxins, under their influence multiple closures occur small vessels. Blood clotting is impaired, and multiple hemorrhages appear on the body.

— Is this the “meningitis rash” as people say?

- Yes, that's her. Sometimes, within a few hours after the onset of the disease, hemorrhage occurs in the adrenal glands, which sharply decreases blood pressure, and the person dies.

- That is, if the doctor said “meningitis” - immediately go to the infectious diseases hospital?

- Yes, because this is not a disease that can be treated at home, “pierced”, “dropped” with the help of a familiar neighbor nurse. But helping the patient is not limited only to the impact on the pathogen. A doctor in a hospital has the opportunity to normalize intracranial pressure, eliminate toxicosis, improve performance nerve cells and cerebral vessels, use powerful anti-inflammatory drugs.

— What symptoms should you be wary of?

— Meningitis is suspected if, against the background of any infectious disease(acute respiratory infections, chickenpox, measles, mumps, rubella, the so-called lip fever) appears intense headache, such that it is more annoying than all other symptoms if this pain is accompanied by nausea and vomiting. In all cases, when in the background elevated temperature body, pain appears in the back and neck, intensifying when moving the head. Drowsiness, confusion, nausea, vomiting, convulsions of any intensity and any duration are also symptoms of meningitis. In children of the first year of life, you should be alert to fever + monotonous crying + “puffy” crown. In addition, some reflexes change, and only a doctor can detect this.

The most important thing: any (!) rash against a background of elevated temperature should alert you. You or your neighbors can be sure that this is rubella, measles or diathesis. But the doctor must see the rash, and the sooner the better. If the elements of the rash look like hemorrhages, if new rashes appear quickly, if this is accompanied by vomiting and high fever, every chance should be taken to ensure that the patient immediately ends up in the hospital.

— Why do they always perform a spinal or lumbar puncture for this disease? Is it possible to do without this painful procedure if it is already clear that a person has meningitis?

- No, you can’t do it, because this is the only reliable way to confirm or exclude a diagnosis. A special fluid circulates in the brain and spinal cord cerebrospinal fluid- cerebrospinal fluid. With any inflammation of the brain and its membranes, cerebrospinal fluid accumulates inflammatory cells and the liquid becomes cloudy. The study of cerebrospinal fluid allows not only to diagnose meningitis, but also to answer the question of what it is: bacterial, purulent or viral. And that's exactly what has crucial in choosing a treatment option.

— Evgeniy Olegovich, is quarantine and isolation of the patient’s relatives always necessary during meningitis? After all, we know cases when one or two people fall ill at a school or kindergarten, but the institution remains open...

— Quarantine is needed until doctors accurately detect the causative agent of the disease. Let's say, if a particular child had staphylococcal infection on the tonsils, a complication arose and meningitis developed - then it is clear that quarantine is unnecessary. If it is discovered that it is viral meningitis, then strict quarantine is needed.

— Is vaccination against meningitis effective? How reliable and safe is it?

— It is important to understand what kind of vaccinations you are getting. Indeed, several years ago in our country the vaccine against hemophilus influenzae was included in the vaccination scheme. Let me explain: there is a bacterium called “hemophilus influenzae”, it causes many different diseases: pneumonia, otitis, sinusitis and, in particular, meningitis. Therefore, in clinics, the introduction of this vaccine began to be called vaccination against meningitis. It is carried out in all civilized countries and is included in standard vaccination calendars; it is done simultaneously with DPT. Modern complex 5- and 6-component vaccines always contain a Hib component. As a rule, hemophilus influenzae infection is dangerous for children in the first five years of life, but then, as the child gets older, the body gradually develops immunity to it. If you have not received such a vaccination before the age of five, then there is no point in doing it later.

It is important to understand that you cannot protect a person from meningitis at all, but the risk of getting meningitis from Haemophilus influenzae infection has now decreased.

But, as I already said, meningitis, in addition to Haemophilus influenzae, can be caused by many other microbes. These include staphylococci, streptococci, pneumococci, and viruses. There is a vaccine that protects against pneumococcal infection, and it also protects against this type of meningitis. But the most dangerous microbe that most often causes meningitis is called meningococcus. There are a number of countries where they vaccinate against it. We don’t.

— What is the prognosis for recovery from meningitis? Why is it widely believed that the consequences of this disease will accompany a person throughout his life? It's either blindness or deafness or mental retardation, or at least a constant severe headache. Is that so?

- No. Timely treatment of meningitis within two to three days leads to significant improvement state, and in the future - almost always to complete cure without any consequences. I emphasize - timely treatment. Think about it: treatment of meningitis has only become possible in the last 55-60 years. By this time, almost all the patients were dying. Therefore, persistent advice to parents: do not hesitate. Be vigilant and call an ambulance at the slightest suspicion. This is the case when it is better to play it safe, because the count is not even in hours, but in minutes.

Irina Lvova, Express

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A pupil of Chelyabinsk kindergarten No. 295 fell ill with meningitis. The boy’s mother reported this to 74.ru. The woman is perplexed why the management of the preschool institution did not inform other parents about this. The kindergarten said that the diagnosis of the five-year-old child has not been confirmed, and all necessary measures have been taken for the safety of other children.

“My son got sick a week ago,” Chelyabinsk resident Katerina told 74.ru. – The first signs were noticed on Sunday evening, August 13th. On Monday we already ended up in children's hospital No. 8 at ChMZ. They took a puncture, and the result was very sad. The grandmother went to the hospital with the child. A couple of days after hospitalization, I came to the kindergarten to pick up my things. All the children were in the group, and in response to my question about quarantine, the teachers displeasedly stated that “the SES will come to them today to pour bleach on everything.” I'm shocked. Only my child got sick, and therefore there will be no quarantine. I think the parents of other children don’t even know that you can get sick in our kindergarten.

The woman claims that, except for the kindergarten, her son did not go anywhere and did not swim.

“So the likelihood of catching the virus somewhere else is extremely low,” says Katerina. “I’m glad that my son is recovering.” But I don’t understand why they keep silent about the fact that he fell ill with meningitis in the kindergarten.

Kindergarten No. 295 “Skazka” confirmed that they are aware of the situation.

“The diagnosis of meningitis in our pupil has not yet been confirmed,” emphasized the head of the preschool institution, Marina Baturova. – One case of disease detected enterovirus infection unspecified etiology. To prevent the spread of infection, we carried out a number of necessary measures. Rospotrebnadzor employees also came to us for inspection. All their instructions have been fulfilled.

The manager clarified that even before the specialists’ visit, the kindergarten workers treated all the premises with a disinfectant.

“The group is isolated, that is, children go out for walks through a separate entrance, do not intersect with other children on the playground and do not attend classes,” continues Marina Baturova. – Every day the children of the group are examined by doctors from the clinic, our doctor and a nurse. Upon admission to kindergarten, each child's temperature is measured. We ask the children if their parents gave them pills in the morning, because sometimes mothers and fathers, who are important to go to work, treat the children and bring them to kindergarten. In this case, the kids will definitely talk about it.

In addition, the group’s employees passed the necessary tests.

“This diagnosis has been ruled out for them,” concluded the head of kindergarten No. 295. – On Thursday, August 24, Rospotrebnadzor employees will come to us with control tests laboratory research. In the meantime, the kindergarten has been under quarantine since August 14. With entero viral infection it lasts 10 days, with viral meningitis - 20 days from the moment last visit child. Since the etiology of the viral infection has not been clarified, the quarantine will last until September 2.

Let us remind you that today, August 22, the children’s health camp of the South Ural Railway “Alyonushka” was closed for quarantine until the end of the shift. 267 children left the institution, one of them was sent to hospital with suspected meningitis.

Over two weeks in August, the number of Chelyabinsk residents sick with enterovirus infection tripled: from 29 to 95 people. These are the latest data from the regional Rospotrebnadzor. Serous meningitis was confirmed in 44 patients. Among the sick, 18 are adults, the remaining 77 are children.
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Serous meningitis in children is a very serious illness, which is caused by fairly stable external environment enteroviruses called Coxsackie and ECHO. This disease is accompanied by inflammation of the soft meninges. You may ask, how can you get serous meningitis and is it contagious?

Causes of the disease and how is serous meningitis transmitted among children?

Enteroviruses that cause such insidious disease, can be picked up in the following ways:

How contagious is serous meningitis and do adults get sick?

The greatest threat is to children preschool age from three to six years, and especially for babies born ahead of schedule. Babies born on time and feeding mother's milk, up to six months of age are completely protected from serous meningitis and they don't get sick.

As for schoolchildren, their susceptibility to pathogens is significantly reduced. And among the adult population it is reduced to almost zero.

Incubation period of serous meningitis and its manifestations

The incubation period, that is, the period from the penetration of the virus into the body until the first appearance clinical manifestations viral serous meningitis, varies within from two to four days and depends on the type of pathogen.

As a rule, this disease It begins acutely, which is why it is often called acute serous meningitis.

The following symptoms are noted:

In the results of the analysis on general analysis blood in the first days of the disease is noted increased performance lymphocytes. And a few days later - only lymphocyte counts.

In general, body temperature returns to normal three to five days later. And all other symptoms of serous meningitis disappear after five to seven days from the first manifestations. However, you should not completely relax, since in a matter of days the disease can remind itself again.

So, what to do if such manifestations occur in your child? You should seek medical help.

In most cases, the patient must be immediately hospitalized in the infectious diseases department. Although in some cases treatment is carried out in outpatient setting. Infectious disease doctors prescribe antibiotic therapy, combined with plenty of fluids.

Also shown is strict bed rest. Therapy is adjusted according to indications. The duration of inpatient treatment ranges from two to three weeks.

We looked at it in great detail in a separate large article. Often parents do not know how to accurately determine the disease, what methods are available. We are filling this gap. Now you can accurately recognize the disease and call in time. ambulance.

And we talk about how to prevent meningitis, i.e. about prevention. Arm yourself with this information and don’t be afraid of epidemics!

Epidemic outbreaks and quarantine for serous meningitis

According to epidemiologists, outbreaks of this disease occur approximately once every five years. After all, meningitis is considered an uncontrollable disease, since there is no vaccine against it yet. Although it can be cured, complications are still possible.

How many days does quarantine last? Those preschool and educational institutions, where patients with meningitis are found, are closed for a two-week quarantine and work is carried out to disinfect the premises. All children in contact with sick children are given preventive measures.

How dangerous is serous viral meningitis?

Consequences of serous meningitis in children

As a rule, this disease can be successfully dealt with. But some children experience headaches and asthenic phenomena upon completion of treatment. In this case, you cannot do without consulting a neurologist.

If treatment is not started in a timely manner, the consequences are much worse:

1. Complete or partial hearing loss.
2. Problems with the functions of the speech apparatus.
3. Partial or complete loss of visual acuity.
4. Malfunction of the brain.
5. Delay in psychomotor development.
6. Rarely - coma up to and including death.

• Children should not swim in open water.
• Eat only thoroughly washed vegetables and fruits.
• Eat with clean hands.
• Use only high-quality water for drinking.

Memo to parents

1. Routes of transmission and infection of serous meningitis: contact, airborne, waterborne.
2. Subject to availability high temperature body, cramps, vomiting, diarrhea, call a doctor immediately.
3. Do not try to treat enteroviral serous meningitis in your child on your own.
4. Strictly follow all doctor's instructions to avoid any complications.
5. Quarantine for serous meningitis lasts two weeks
6. Monitor your child's lifestyle: do not allow him to eat with dirty hands unwashed food, swimming in the river.
7. Carry out hardening procedures to strengthen the immune system.

Video

Elena Malysheva clearly shows and talks about how to protect a child from enteroviral meningitis.

Meningitis is a deadly disease in which the membranes of the brain and spinal cord. The disease is caused by one or more microbes; it can be a virus, a bacterium, or a fungus.

Primary meningitis is distinguished when the disease is an independent form and can be caused by a virus or bacteria (this is mainly meningococcus or Children, adolescents, and elderly people suffer from it more often. There is also secondary meningitis, which does not have age differences. It occurs as a complication viral diseases(measles, chickenpox, mumps, rubella) or purulent (otitis, sinusitis, sepsis). Meningitis in kindergarten is primary process, and most often it is caused by none other than meningococcus. Meningococcal meningitis is a form of infection.

What is meningococcal infection?

The disease is caused by a microbe that spreads from one person to another by airborne droplets. This bacterium is very contagious, but quickly dies in cool air, so outbreaks are possible in close contact or in people in a warm, enclosed area.

80% of cases of primary meningitis are associated with meningococcus, and severe forms almost always occur in children from six months of age (children up to 6-10 months are protected from the bacterium by maternal antibodies) or adolescents due to the fact that they have not yet developed immunity to it. That's why meningococcal meningitis also called " childhood meningitis"(previously it was called epidemic cerebrospinal because of its contagiousness).

Every year there are isolated cases of meningococcal infection, then group B meningococcus is registered. But once every three to four years there is an outbreak of meningitis caused by group A meningococcus. Most often, epidemics are observed in the winter-spring period, which is associated with a general decrease in immunity during this period period, and with the fact that at this time of year children hardly go out and stay indoors.

There are several forms of meningococcal infection. The most dangerous of them in terms of infectiousness:

Carriage, when a person does not feel sick, but actively releases the bacterium by airborne droplets for 2-4 weeks;

Which is easily tolerated, very often goes undiagnosed, as it looks like a regular ARVI.

Other forms of infection are life-threatening. These are meningitis (or meningoencephalitis) and meningococcal sepsis (meningococcemia). Meningitis in kindergarten caused by this bacterium does not necessarily occur with a rash, so there is no need to wait for its appearance. Likewise, the appearance of an unusual rash, even without any other signs, is a reason to call an ambulance (not a local pediatrician, but an ambulance, since sometimes minutes count).

How does meningococcal meningitis manifest?

The disease almost always begins acutely, but it can also develop as a complication of meningococcal nasopharyngitis, then it will be preceded by slight increase fever, runny nose, pain and discomfort in the throat. The first symptoms are a severe headache, which occurs simultaneously with a rise in temperature to high numbers. Vomiting also appears (it is often repeated, it does not get better after it), photophobia. The skin's sensitivity to normal touches increases (they begin to cause discomfort). Meningitis can develop quickly, when only 2-3 hours pass from the appearance of a severe headache to loss of consciousness, but it can also occur slowly.

It usually looks like lethargy, which turns into doubtfulness; it becomes difficult to wake the child. Sometimes this condition is preceded by convulsions (short-term and longer with impaired consciousness), sometimes by agitation and inadequacy of the child.

A rash is not a mandatory sign. With meningococcal infection, the elements of the rash almost always have the following characteristics:

Dark color;

Dense to the touch, it seems that they protrude above the surface of the skin;

Most often they begin to appear on the hands, feet, legs, forearms, buttocks, on the torso and head - then;

Shape - close to the shape of a star;

There may be areas of necrosis;

The rash does not turn pale when a glass is pressed on it or the skin underneath is stretched.

Even if there are no such symptoms, just an incomprehensible rash has arisen against the background of an elevated temperature, and it does not look like an allergic one, this is a reason to call an ambulance.

How to avoid catching meningitis in kindergarten?

100% off of this disease it is impossible to protect yourself. But if you harden your child, don’t forget about taking preventive vitamins during the cold season, and immediately contact an ENT specialist, pediatrician or infectious disease specialist if a cough, snot and other signs of ARVI occur, then you can prevent meningococcus from getting from the nasopharynx somewhere further. If a meningococcal infection is discovered in the kindergarten, you need to consult with an infectious disease specialist about prophylactic antibiotics (maybe it makes sense to take a nasopharyngeal culture). All adults should wear a mask when around a child.

A greater guarantee is provided by vaccination against meningococcus, which can only be given to children over two years of age every three to four years (this depends on the vaccine). After vaccination, only local reaction and an increase in temperature within 36 hours (this indicates the formation of immunity).

It is especially indicated for those with congenital problems with the central nervous system, since they develop meningitis most often in kindergarten.

If meningitis appears in a kindergarten, it is urgent to declare quarantine and take preventive measures. Serous meningitis is one of the the most dangerous diseases, which can lead to fatal outcome. The cause of the disease can be either a virus or a bacteria. The primary form of meningitis most often affects children. This pathology is caused by meningococcus or Haemophilus influenzae.

In kindergarten, the cause of meningitis can only be meningococcal infection. The patient's protective tissues of the brain become inflamed. With meningitis, the pathogen in children's institutions can be transmitted from one child to another by airborne droplets. In the confined space of kindergartens at room temperature, meningococcus spreads quickly. It is worth keeping in mind that up to the age of 10 months, the child is protected by the mother’s antibodies; the baby does not have its own immunity to meningitis.

According to statistics, outbreaks of meningitis are registered once every 4 years; the cause of the epidemic is meningococcus, belonging to group A. Such incidence is seasonal, the peak of which occurs in the winter-spring period.

There are also situations when the baby is a carrier of the infection, but is not sick himself. Within 4 weeks, it actively releases the pathogen into the surrounding space. This form is called meningococcal nasopharyngitis. This pathology It is very difficult to identify, since in all respects it resembles ARVI. This the only form, which does not pose a serious threat. Other forms of meningitis are very dangerous.

A characteristic sign of the disease is the appearance of a rash. Meningitis is always acute.

• The first sign of the disease is a severe headache.
• At the same time, the child’s temperature rises, it can reach +40ºС.
• Another symptom of the disease is frequent vomiting which does not bring relief to the child.
• Photophobia occurs.
• Any touch causes discomfort.
• Very often, only a few hours pass from the moment the temperature rises to loss of consciousness. But sometimes the disease can progress slowly.
• Serous meningitis is characterized by general meningeal symptoms and, for example, nausea.

The meningococcal rash is dark in color and hard to the touch. The rashes themselves seem to protrude above the skin. The rash appears on the body, starting from the hands, feet and legs. Then it appears on the forearms, buttocks, torso and head. This rash cannot be confused with one caused by an allergy. If a rash appears on the child’s body and the temperature rises at the same time, it is necessary to urgently call an ambulance. The earlier the disease is diagnosed, the lower the risk of developing severe complications. Generally incubation period is about 3 days.

In order to accurately determine the diagnosis, it is necessary to ask the child to tilt his head forward and touch his chin to the sternum. If the baby is sick, he will not be able to do this.

Quarantine and prevention of meningitis in kindergarten

Even if there is only a suspicion of meningitis, a quarantine must be declared in the kindergarten. The quarantine period is 10 days. In this regard, a special order is issued indicating the start date of quarantine and the day it ends. If 1 more child falls ill, the quarantine is extended.

During this period, parents may refuse to allow their child to attend kindergarten. Also, all mothers and fathers should consult a doctor. He can appoint preventive treatment, in which the child is prescribed antibiotics. Children over 2 years old do preventive vaccination. After 3-4 years it is repeated. Prevention of the disease may also involve hardening the baby.

During quarantine, some restrictions are imposed on the group. Children cannot walk in the areas of other groups. They do not participate in public events, do not attend music or physical education classes outside their group.

Changes sanitary regime. Wet cleaning is carried out 3 times a day. The premises are quartzed several times a day. All dishes and toys are washed using disinfectants. The premises are ventilated more often than usual. During quarantine, children cannot be vaccinated.

Control over the implementation quarantine measures carried out by a health worker and the head of the children's preschool.

In a children's clinic, parents may be given a sick leave certificate during quarantine if their child cannot be given a place in another group, but this is only if the child himself for a long time didn't visit kindergarten and was not in contact with the sick person. Children who have been in contact with a sick person may be carriers of the infection.