World Meningitis Day: The Connection Between Group B Streptococcus (GBS) and Meningitis

By Javairia Khalid

World Meningitis Day, commemorated annually on the 5th of October, is a worldwide health initiative aimed at enlightening the public about the grave, and occasionally deadly, repercussions of meningitis. Emphasized by the powerful message that meningitis can devastatingly claim a life in less than a day or result in permanent disabilities, this day underscores the critical need for awareness, prevention, and management of this condition.

What is Meningitis?

Meningitis is an inflammation of the membranes (meninges) that envelop the brain and spinal cord. Its hallmarks include fever, headache, neck stiffness, confusion, and sensitivity to light. A host of microorganisms, such as bacteria, viruses, fungi, and parasites, can trigger it. Bacterial meningitis is particularly notorious, having the potential to be fatal within hours, and survivors might bear long-term effects like hearing loss or cognitive issues.

Causes of Meningitis

Meningitis can stem from various pathogens:

1. Bacteria: Including Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b (Hib), and Streptococcus agalactiae (group B Streptococcus, GBS).
2. Viruses: Such as enteroviruses, mumps, and herpes simplex virus.
3. Fungi: Like Cryptococcus, especially in individuals with weakened immune systems.
4. Parasites: Such as Amoeba are rare but possible causes.

The Link between Meningitis and GBS

GBS is a bacterial inhabitant of the gastrointestinal and lower genital tracts in adults. While typically harmless for most adults, it can be a severe problem for newborns. When a mother carries GBS, the bacteria might transfer to her baby during childbirth, setting the stage for early-onset neonatal infections. These include sepsis, pneumonia, and notably, meningitis.

Disease Burden

According to the World Health Organization, meningitis affects more than 2.8 million people worldwide each year, resulting in around 288,000 deaths (1) . While everyone remains vulnerable to GBS-induced meningitis, newborns and the elderly face the most risk.

• Newborns: GBS stands as a dominant agent of meningitis in babies, potentially leading to severe repercussions like hearing or vision loss and developmental anomalies. 25% of pregnant women are potential carriers of GBS (2) . GBS disease affects between 1,000 to 4,000 newborns in the U.S. annually (3).

• Children and Adolescents: While GBS is a concern, meningitis due to Hib or N. meningitidis is more prevalent.
• Adults and Elderly: Aging weakens our immune defenses, rendering adults and especially elderly more prone to invasive GBS diseases, encompassing meningitis.

Signs and symptoms

Clinical features of patients with meningitis vary depending on the cause, disease course (acute, subacute or chronic), brain involvement (meningo-encephalitis) and systemic complications (e.g., sepsis). Common symptoms of meningitis include neck stiffness, fever, confusion or altered mental status, headaches, nausea and vomiting, however, these manifestations can differ in babies.

Diagnosis and Prevention

Prevention: Screening pregnant women for GBS colonization, typically between the 35th and 37th weeks, followed by antibiotic administration during labor if positive, can drastically reduce the risk neonatal GBS infections. Ultimately, a GBS vaccine offers the potential of averting disease and reducing overall morbidity and mortality.

Diagnosis: Rapid diagnosis is pivotal. Meningitis resulting from GBS is ascertained via a lumbar puncture, which involves examining cerebrospinal fluid (CSF) for the bacterium. Blood tests can further aid diagnosis.

After-effects of Meningitis

Surviving meningitis isn’t the end of the ordeal for many. The aftermath can be characterized by a range of persistent physical, emotional, and psychological effects:

• Physical effects: These may encompass hearing loss, vision problems, seizures, limb loss (due to septicemia), balance and coordination issues, and chronic fatigue.
• Cognitive and Psychological Effects: Memory issues, difficulty concentrating, mood swings, depression, and other mental health challenges might emerge post-recovery.
• Emotional Toll: The trauma of undergoing such a severe illness can leave survivors and their families grappling with fear, anxiety, and post-traumatic stress.

The World Meningitis Day serves as a reminder of the imperative need to comprehend the dire threat posed by illnesses such as meningitis and their links with agents like GBS. Harnessing awareness, ensuring timely screenings, and advocating for preventive measures are instrumental in mitigating this threat, especially for newborns.

REFERENCES

1. Meningitis [Internet]. [cited 2023 Oct 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/meningitis
2. Group B Strep: Fast Facts and Statistics | CDC [Internet]. [cited 2023 Oct 9]. Available from: https://www.cdc.gov/groupbstrep/about/fast-facts.html
3. Group B Strep and Pregnancy | ACOG [Internet]. [cited 2023 Oct 9]. Available from: https://www.acog.org/womens-health/faqs/group-b-strep-and-pregnancy