PUBLISHED: 12-14-09

Author Information:
TaylorGleason

tnorris@chroniclemail.com

Meningitis treatment may be improved

New research finds how to better combat inflammation-causing bacteria

Temperatures in Chicago have dropped precipitously low and along with the seasonal worries of keeping warm comes the additional fear of developing meningitis, an illness that thrives in winter.

“When the vaccine came out for meningitis, the first group we could really think to give it to was college students because they live so close together,” said Dr. Blair Odland, who works at Columbia’s Student Health Center.

Meningitis, both bacterial and viral, is difficult to treat because it affects a part of the body which medicine cannot usually reach—the nervous system.

Thanks to a study that was published in May, scientists now know how bacterial meningitis reaches nerve tissue—the meninges—to cause inflammation, which will help create better prevention and treatment for the illness.

Bacterial meningitis is more severe than its viral sibling and can cause death just hours after someone experiences the symptoms.

Researchers at The University of Nottingham and St. Jude Children’s Research Hospital in Chicago worked together on the study to discover how the bacteria pass through the blood brain barrier, which is meant to keep foreign compounds away from the brain and nerve tissue, in order to form a better treatment plan for bacterial meningitis.

“The blood brain barrier is a specific tissue with cells that form tight junctures,” said Justin Thornton, a project researcher at St. Jude. “It doesn’t allow foreign organisms to go into the sterile section [of the brain and spine].”

Thornton said there are three kinds of bacteria that can cause meningitis.

The scientists involved with the study sought to understand the original interaction between meningitis bacteria and the blood brain barrier.

The researchers found that meningitis-causing bacteria used a form of molecular mimicry in order to get through the blood brain barrier by covering their outer layer with a protein which can pass the barrier.

Think of it like an under-aged youth using a fake identification card to get into a club. The bacteria masquerade as a certain protein in order to gain access to the brain’s sanctuary. This discovery means big things for the way meningitis is treated, Thornton said.

Antibiotics are “somewhat effective,” he said, but some have trouble crossing the blood brain barrier to get to the infection, so it would be best to prevent the bacteria from crossing the barrier in the first place.

“Now we hope to develop a better protein-base vaccine to block initial interactions with the blood brain barrier,” Thornton said.

It appears all three bacteria could be blocked by the same protein, so one vaccine could protect against three meningitis-causing bacteria types.

Another problem with meningitis is that its symptoms look like many other illnesses and doctors can misdiagnose a patient as having a cold or flu without
considering meningitis.

“It’s very frightening because you hear of a doctor sending a patient home and saying, ‘We’ll check on it in the morning,’ and then they die that night,” Odland said. “You always wonder, ‘Would I be able to tell it was meningitis?’”

Doctors had that kind of trouble when diagnosing Jordan Mogensen, 5, when her mother, Holly Mogensen of Sioux City, Iowa, brought her to the doctor because she had been acting strange.

“She was taking a long time to look your way when she was called,” Holly said. “I knew that wasn’t my daughter, but the doctors sent us home and thought she would be better the next day.”

After a week of trouble, Jordan was eventually taken to the hospital and diagnosed with a severe case of viral meningitis. Although Holly said the family thought they were going to lose Jordan, the 5-year-old left the hospital two days later and recovered at home.

Jordan has only suffered minor side-effects such as slurred speech, for which her school provides therapy.

Odland said the type of meningitis that colleges fear is bacterial because viral meningitis “will just be the worst headache of your life and then be gone,” but bacterial meningitis has up to a 35 percent morality rate.

Among those who survive bacterial meningitis, Thornton said half suffer long-term neurological problems such as hearing loss, seizures or difficulty moving.

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