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Seasonal paradox in acute meningitis at Nawabshah
Shams uddin Shaikh1, Rasool Bux Shaikh, Muhammad Saleem Faiz
1Department of Medicine, Peoples Medical College, Nawabshah. mamoon@isb.comsats.net.pk
Objective:
To assess the reasons for paradoxical increase in cases of meningitis in the summer of the year 2001.
Design:
An observational study.
Place And Duration Of Study:
Medical Unit III, Peoples Medical College Hospital, Nawabshah, Pakistan, from 1st January, 2001 to 31st December, 2001.
Subjects And Methods:
A total number of 229 cases of meningitis were admitted throughout the year with typical clinical features or CSF findings. Maximum number (179) was noted from April to July, which was alarming. The reason for this change was assessed in these cases.
Results:
One hundred and seventy-nine cases of meningitis presented from 1st April to 31st July 2001. They were predominantly males n= 107 (59.7%) with age range of 15 to 64 years. Presenting symptoms were fever and headache in all and altered sensorium in 160 (89%) cases with positive signs of meningeal irritation in 175 (97.8%). Cerebrospinal fluid examination revealed altered biochemistry and neutrophil leucocytosis in all cases. Organism was identified in 139 (77.65%) cases on gram staining. Culture was done only in 61 (34.07%). Predisposing factors were smoking in 93 (52%) and diabetes in 17 (9.5%) cases. Five female patients were pregnant.
Conclusion:
Common organisms detected were gram positive diplococci (Streptococcus pneumoniae) in 83 (59.7%), gram negative diplococci (Nisseria meningitides) in 51 (36.7%) and Haemophilus influenzae in 5 (3.6%). As the frequency of isolates were approximately same as in other seasons, the increased in meningitis cases during summer was probably due to hot and dry weather causing low absolute humidity.
Insights
Meningitis cases surged in summer 2001, predominantly affecting males. Low absolute humidity due to hot, dry weather is the likely cause of this seasonal increase in meningitis.
Area of Science:
- Epidemiology
- Infectious Diseases
- Environmental Health
Background:
- Meningitis cases typically exhibit seasonal variations.
- A paradoxical increase in meningitis cases was observed during the summer of 2001.
Purpose of the Study:
- To investigate the reasons behind the unusual rise in meningitis cases during the summer of 2001.
Main Methods:
- An observational study was conducted.
- Data was collected from 229 meningitis cases admitted between January 1, 2001, and December 31, 2001.
- Focus was placed on the 179 cases presenting between April and July.
Main Results:
- The majority of the 179 summer meningitis cases were males (59.7%) aged 15-64.
- Common symptoms included fever, headache, and altered sensorium.
- Cerebrospinal fluid analysis showed altered biochemistry and neutrophil leucocytosis in all cases.
- Predisposing factors identified were smoking (52%) and diabetes (9.5%).
Conclusions:
- Streptococcus pneumoniae (59.7%) and Neisseria meningitides (36.7%) were the most common identified organisms.
- The frequency of these organisms did not differ significantly from other seasons.
- The increase in summer meningitis cases is likely attributed to hot, dry weather conditions leading to low absolute humidity.