One in three children with bacterial meningitis live with permanent neurological disabilities due to the infection. This is according to a new epidemiological study led by the Karolinska Institutet and published in a leading medical journal JAMA Network Open.
For the first time, researchers have identified the long-term health burden of bacterial meningitis. The bacterial infection can currently be treated with antibiotics, but often leads to permanent neurological damage. And since children are often affected, the consequences are significant.
“When children are affected, the whole family is affected. If a three-year-old child has a cognitive impairment, a motor disability, reduced or lost vision or hearing, it has a significant impact. These are lifelong disabilities that become a great burden for both the individual and society, as those affected need healthcare support for the rest of their lives,” says Federico Iovino, associate professor of Medical Microbiology at the Department of Neurosciences, Karolinska Institutet, and one of the authors of the current study.
By analyzing data from the Swedish Quality Register for Bacterial Meningitis between 1987 and 2021, the researchers were able to compare just over 3,500 people who contracted bacterial meningitis as children with just over 32,000 matched controls from the general population. The average follow-up time is over 23 years.
The results show that those diagnosed with bacterial meningitis have a consistently higher prevalence of neurological disabilities such as cognitive impairment, seizures, vision or hearing problems, movement disorders, behavioral disorders or structural head damage.
The risk was highest for structural head injuries — 26 times the risk, hearing impairment — nearly eight times the risk, and motor impairment — nearly five times the risk.
About one in three people who contracted bacterial meningitis had at least one neurological damage compared to one in ten among the controls.
“This shows that even if the bacterial infection is cured, many people suffer neurological damage afterwards,” says Federico Iovino.
Having identified the long-term effects of bacterial meningitis, Federico Iovino and his colleagues will now move forward with their research.
“We’re trying to develop treatments that can protect neurons in the brain during the window of a few days it takes for antibiotics to take full effect. We now have promising data from human neurons and are just entering a preclinical phase with animal models. Ultimately, we hope to introduce it to the clinic within the next few years,” says Federico Iovino.
The research was funded by Merck & Co (in Sweden MSD).
Bacterial meningitis is a rare but very serious infection that can affect people of all ages, but is more common in newborns, children and teenagers, and the elderly. It is often caused by pneumococcus (Streptococcus pneumoniae) which is also a major cause of bacterial respiratory infections such as pneumonia, otitis and sinusitis, which also mainly affect the younger and older members of society.
Without treatment, bacterial meningitis is fatal, but the infection can now be treated with antibiotics. However, antibiotics have a hard time penetrating the blood-brain barrier, which means it takes time to fight the infection. During this time, nerve cells can be damaged and lead to various permanent neurological damages. In addition, there is a constant threat of antibiotic resistance in clinics.
Source: Federico Iovino, Public Health Agency and Centers for Disease Control and Prevention.