Meningitis; what is it? What to watch for!

What is it?

Meningitis is an inflammation of the lining that covers the brain and spinal cord.  It is caused by bacterial or viral infections.  The bacterial form can be fatal and causes serious long term health complications – especially if not treated early.

How do you get it?

Close contact is needed to pass it on to others such as kissing, coughing or sneezing near to others.  Living close together in shared accommodation can pose a risk, as does sitting close together in lecture theatres, though less so. Thats why all Freshers should be immunised!

Signs and Symptoms

Symptoms can appear in any order and some may not appear at all;

  • Fever
  • Headache
  • Vomiting
  • Muscle pain
  • Fever with cold hands and feet
  • Drowsy – difficult to wake
  • Confusion and irritability
  • Stiff neck
  • Dislike of bright lights
  • Pale blotchy skin
  • Spots/rash (that do not fade under pressure, do the ‘glass test’)
  • Convulsions/seizures

What can I do?

Get vaccinated – MenACWY vaccine directly protects vaccinated people from 4 strains of meningococcal meningitis and stops them from carrying the bacteria.

Familiarise yourself with signs and symptoms and be alert.

Look out for yourself and friends.  Share awareness and care for each other – don’t assume an illness is hangover or touch of flu – if you think a friend or housemate is ill trust your instincts and seek medical help.  Keep an eye on your friends if they are getting a lot worse quickly seek help.

How do I get help?

Call the GP or NHS 111 if out of GP opening hours

Describe the symptoms and say that you think it could be meningitis.

In an emergency dial 999 for an ambulance or go to your nearest Accident and Emergency Department.

Download our ESC Student Health App for more info, on your phone. on the App Store now.

 

https://itunes.apple.com/gb/app/esc-student/id934979379?mt=8

 

For further information https://www.meningitisnow.org/fight-for-now/

 

 

 

 

 

 

Health Advice for the Returning Traveller; When to see the GP?

It’s the time of year again when all our backpacking students return from the four corners of the world. Some will be arriving for the first time in Bristol, as international students of course, and many of you will have been traipsing through the jungles/ beaches and villages of the world’s most remote places, possibly even to Coca-cola free zones!

Unfortunately, even if you did everything right, had every last jab, and took all your malaria pills, you may still be at risk of post-travelling illness, so here is a quick summary of what to watch for and what to act on;

  • Tell the nurse/ doctor exactly where you have been, and dates
  • Tell them if you worked in ‘at risk’ environments, eg in a hospital/ clinic
  • Most illnesses will be common conditions like pneumonia/ fungal skin rashes
  • Be honest about malaria tablet history and compliance
  • Report any treatment tried or taken overseas
  • Fever is a common symptom requiring medical attention in returning travellers, especially if it is accompanied by; rash/ jaundice/ breathing difficulties/ bruising/ persistent vomiting/ altered conscious level or paralysis (the latter are extremely rare with only 0.3% of unwell travellers ever requiring hospital admission).
  • Malaria commonly presents with fever, chills, sweats, headaches, muscle pains, nausea and vomiting.
  • Jaundice (yellowing of the skin, and whites of the eyes) can indicate Hepatitis, most commonly type A, from infected food and water.
  • Arbovirus infections (Dengue, West Nile and Chikungunya fevers) are the main cause of viral fevers in returning travellers, and tend to have short incubation periods, typically less than two weeks .ie you will show symptoms within 2 weeks of being infected.
  • Diarrhoea is extremely common in travellers, and those who develop three or more loose stools in an eight-hour period, especially if associated with nausea, vomiting, abdominal cramps, fever, or blood in stools, may benefit from antibiotics.
  • Prolonged, severe diarrhoea with blood should be reviewed by a GP.
  • Skin rashes are very common, and should be reviewed by your GP if not settling, or if associated with fever.
  • The vast majority of travellers’ infections have a short incubation period, meaning that symptoms will start within 10 days or less from infection. The notable exceptions are schistosomiasis (bilharzia)/ malaria/ TB/yellow fever, and Q fever.

 

 

Therefore, if you continue to feel unwell despite being home, and eating and drinking normally for you, then please come and see one of the GPs. You may also find it useful to look at the following;

 

http://www.nathnac.org/travel/index.htm

 

 

 

World Immunisation Week 24 – 30 April 2014; “Are you up-to-date?”

Back in 2012 I watched a BBC documentary ‘Ewan Macgregor: Cold Chain Mission’ http://www.unicef.org.uk/asp/cold-chain-ewan-mcgregor/index.asp. This filmed the actor’s mission as an ambassador of UNICEF to deliver vaccines, and immunise children in some of the world’s remotest places. This particular programme followed his journey to India and Nepal and highlighted the incredible journey he made trekking 2 days over the Himalaya whilst maintaining the ‘cold chain’ of the vaccines he was delivering to remote mountain villages. The cold chain is the essential system of transporting and storing vaccines within a safe temperature range (2°c to 8°c) from the place of manufacture to the point of administration. This ensures people receive an effective vaccine that has retained its viability by not being exposed to temperatures outside of this range. So you can only imagine how difficult this was given the circumstances of this trip!

A couple of things have stayed with me since watching this programme, namely;

• The complicated planning and effort it took the team to maintain the cold chain whilst trekking in the mountains, to preserve the efficacy of the vaccines they were delivering (without a vaccine fridge!). It really was a mission!

• The determination of these few health care workers to ensure even the remotest of children was protected against disease.

• The remoteness of where people live and their lack of basic medical care – to include limited access to vaccinations.

• The relief I saw in the parents as their children were immunised. They understood all too well the importance of immunisation, quoting that the measles vaccine being offered ‘will keep their children safe.’ I got the impression they had perhaps seen at first hand the devastating, sometimes fatal effect of measles infection in a child.

Immunisation is recognised as one of the most successful and cost effective health interventions ever introduced. It prevents 2 – 3 million deaths every year. New vaccines now protect against diseases such as pneumonia and rotavirus diarrhoea- two of the world’s biggest killers in children under 5. We also now have vaccines to protect against cervical cancer for adolescents and adults.

As highlighted in the BBC documentary, large numbers of people are not immunised, and for those who start but don’t finish immunisation schedules this is due to:

-inadequate supply of vaccines

-lack of heath care workers

-insufficient political and financial support

Here in the UK, we are extremely fortunate to have a system in place that is easy to access, evidence based, safe and funded by the NHS to ensure we are all protected against the most devastating ‘vaccine- preventable’ diseases. We now have a schedule that is started in pregnancy to protect pregnant women against influenza, and their babies, when born, from whooping cough – this continues through to the birth of their babies – the first few months of life, toddler age, pre-school age, on to teens and then later on in life above the age of 65 years.

We are very lucky indeed.

However, many people here in the UK are still not being vaccinated or are not up-to-date with the schedule. Unlike some other countries, we have robust systems in place to immunise our population, so why is this?

Lack of education about vaccination is one of the key reasons why adults consciously choose not to be vaccinated themselves, or not to vaccinate their children. Here in the UK, there have been many ‘scare’ stories and ‘controversies’ concerning immunisation that have influenced uptake of vaccinations and unfortunately we are now seeing the after effects of these, one being the recent measles outbreak.

A common misconception is that vaccines are unsafe. Remember they have been widely available for many years- some since the 19th century! They are thoroughly tested for safety before they are made routinely available, and each vaccine’s safety is then continually monitored even after it’s been made available. So in fact they are very safe and millions of children and adults are vaccinated every year without long term adverse effects.

I have at times consulted with students who at the age of 18yrs have never received a vaccine in their lifetime – as their parents did not consent to this. Fortunately, this happens infrequently and the person attending the appointment makes an informed choice, based on what they have read and what we discuss in the consultation, to complete a primary course of vaccinations, to ensure they have adequate immunity in their adult lives.

However, as more research and evidence becomes available, immunisation schedules change – so ‘lack of knowledge’ can be as a result of changes, rather than decision not to immunise. The schedule you received as a child may have changed by the time you reach adulthood. Some people also ‘miss’ receiving vaccinations due to illness on the day of vaccination.

Specific goals for this world immunisation week are:

 

  1. 1.      For you to know what vaccines are available to protect you against disease
  2. 2.      Check your vaccination status. Perhaps print off the UK schedule and check on behalf of members of your family. Make sure they are all ‘up-to-date’ – remember schedules do change…
  3. 3.      Book an appointment at SHS for any vaccines you think are missing

Young people attending Universities and Higher Education are known to be at ‘higher risk’ for certain infections, including meningitis C and mumps/measles. These infections are spread through respiratory contact- coughing and sneezing, so easily transmitted. By ensuring that you are up-to-date with your immunisations you will protect both yourself and others, via ‘herd immunity’. Herd immunity is ‘the indirect protection from infection of susceptible members of the population, and the protection of the population as a whole, which is brought about by the presence of immune individuals.’ No vaccine is 100% effective- measles vaccine is 90-95% effective, and some people are unable receive a live vaccine like MMR, e.g. the immunocompromised, so by you making sure that you’re up-to-date with your vaccinations you will be giving yourself the best protection available and also contributing to increased herd immunity in the population around you for those who most need protection.

So, are YOU ‘Up-To-Date’?

You need to ensure you have received the following vaccines:

Number of Injections

Vaccine

5

Tetanus, Diphtheria and Polio

2

combined Measles, Mumps and Rubella

1

(2 as from August 2104)

Meningitis C

3

HPV- Gardasil (females under 18 yrs only)

Annual

Influenza vaccine – ‘at risk’ groups only

 

Remember, you are able to find out if you have missed any of your immunisations by checking:

-Your GP immunisation records

-Your parent’s records

-Your school, as some immunisations are given in schools and not documented in your GP records

If you find you are not ‘up-to-date’ with your immunisations schedule, we encourage you to come in to SHS so we may help you complete your schedule.

If you are planning a trip abroad, especially to ‘high risk’ destinations, please always check you are ‘up-to-date’ with your travel immunisations at least 6-8 weeks before you travel.

We have a safe and adequate supply of vaccines in the practice and we take care of the cold chain, so all you need to do is book an appointment with one of the nurses either by phone or online, and they will then administer any free NHS vaccines you are missing.

You haven’t got to cross the Himalaya to receive a life protecting immunisation; you can have them here at SHS, but if you do intend to cross the Himalaya, please ensure you are also up-to-date with your travel immunisations as well!

 Useful Links:

UK Immunisation Schedule:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/227651/8515_DoH_Complete_Imm_schedule_A4_2013_09.pdf.

 

Measles Outbreak:

http://www.nhs.uk/Conditions/vaccinations/Pages/measles-outbreak-advice.aspx.

http://www.bbc.co.uk/news/health-22277186.

 

History of vaccination, ‘From antiquity to the present day…’

http://www.hpa.org.uk/webc/hpawebfile/hpaweb_c/1279889314367.

 

Travel Immunisations:

http://www.fitfortravel.nhs.uk/home.aspx.

 

World Health Day 7th April 2014: safer travel for all Bristol students

World Health Day is celebrated on 7 April every year to mark the anniversary of the founding of the World Health Organization in 1948. Each year a theme is selected that highlights a priority area of public health. In past years themes as diverse as road safety, climate change and high blood pressure have been chosen. The topic for 2014 is vector-borne diseases, which could be of great personal relevance to a large number of students who make international journeys whilst they are studying at the University of Bristol.

Vectors are organisms that transmit pathogens and parasites from one infected person (or animal) to another. Vector-borne diseases are illnesses caused by these pathogens and parasites. Vector-borne diseases account for a massive 17% of the estimated global burden of all infectious diseases.

The most well known and deadly vector-borne disease is of course Malaria but the world’s fastest growing vector-borne disease is Dengue with a 30-fold increase in disease incidence over the last 50 years. Others you may have heard of are Yellow Fever and Schistosomiasis. Vector borne diseases are most commonly found in tropical areas and places where access to safe drinking-water and sanitation systems is problematic. However, globalization of trade and travel and environmental challenges such as climate change and urbanization are having an impact on transmission of vector-borne diseases, and causing their appearance in countries where they were previously unknown.

 

So World Health Day 2014 has a particular relevance for people on the move, which includes many UoB students. Large numbers of you will travel to countries where vector borne diseases pose a threat. This includes some of our International Students who return home during the course of their degree. Many of the risks of global travel can be minimized by precautions taken before, during and after travel. Whether you are a student planning an exciting trip during one of the university holidays, or whether you are an International Student intending on going home during your degree, it is important that travellers to developing countries consult a travel medicine clinic well in advance of the intended journey. We run travel clinics at Students’ Health service, which are open to our International Students too.

 

Childhood Immunisations; everything you need to know

In the UK, all children are offered immunisations to protect them from potentially serious or life threatening diseases. The vaccination schedule begins at 8 weeks and at Students’ Health Service (SHS) we offer the full range of vaccines (except BCG). View the current routine immunisation schedule here.

Once registered at SHS, you will be invited to make an appointment for your children if they require vaccination. If you have come to Bristol from another country, please inform us of the vaccination history of your children, so we can continue to protect them while you are here. if you have moved from elsewhere in the UK your child’s records will follow, but please bring your Red Book.

If you require a relative or nanny to bring your child for their vaccinations, you will need to notify us in writing. Please see our consent policy.

It is natural as a parent to feel anxious about bringing your baby/child for their vaccinations. If you have a new baby they will be seen by a doctor at 6 weeks old, for consent to immunisation,  and by a nurse at 8 weeks for their first vaccinations. Older children will not need to see a doctor first.

It is important to bring the child’s ‘Red Book’ or vaccination history with you so the correct vaccinations are given and recorded.

It is a good idea for your child to be dressed in easy to remove clothing and to inform older children about what is going to happen to them. This makes it less stressful for them.

When vaccines are given, you will be asked to sit your child on your knee and hug them firmly. The whole process is very quick!

Sometimes after a vaccination, children will develop a mild fever. It is ok to give them infant paracetamol or ibuprofen to bring their temperature down.

 

For further details see below:

 

http://www.nhs.uk/Conditions/vaccinations/Pages/vaccination-schedule-age-checklist.aspx

Watch out for your mates…. Tales of Meningitis

 

“I was revising in the library for my last exam, getting excited to go home for the summer when I felt a rush of shiver run through me. I got a headache, felt sick and cold.  My headachegot worse as the day went on and I was so tired.  My friend lent me his jacket and I fell asleep with my head on the desk for a while”

And about another university student-

“The next day she said she still felt under the weather, was going to bed early. We owe her life to her housemate, Andy, who noticed she hadn’t got up the next morning.”

Both of these students had meningitis and survived due to their friends seeking medical help and calling 999 when they were found seriously unwell.

Meningitis is thankfully rare, and rates of one type- Meningitis C – are reducing, due to vaccination with the Meningitis C vaccine. But we cannot vaccinate against all types yet.

Meningitis can affect all age groups, but young adults are at higher risk. This is especially the case for students living in halls and socialising in larger groups.

So what is Meningitis?

It’s inflammation of the membranes surrounding the brain and spinal cord- the meninges. Septicaemia is the blood poisoning form of infection.

Viral meningitis is the most common form, and is usually less serious than bacterial meningitis. There are around 2,500 cases of bacterial meningitis yearly in the UK, and double that number of viral cases.

 In the UK the most common form of bacterial meningitis is meningococcal and pneumococcal meningitis. Meningococcal meningitis and septicaemia often occur together. 10% of bacterial meningitis cases result in death and 15% will result in long term complications.

So what do you need to watch for?

General symptoms

These symptoms can develop as part of the body’s normal response to an infection.

  • Vomiting and/or diarrhoea
  • Severe lethargy (tiredness, exhaustion, fatigue)
  • Irritability/Unsettled behaviour
  • Ill appearance
  • Severe joint/muscle pain
  • Headache
  • Breathing difficulties
  • Fever

Specific symptoms of MENINGITIS

These are more specific to meningitis and are less common in other illnesses.

  • Stiff neck 
  • Dislike of bright light 
  • Seizure, stiff/jerky movements
  • Altered mental state/confusion 

Specific symptoms of SEPTICAEMIA

These symptoms are more specific to septicaemia. However, other illnesses may also cause some of these symptoms, such as the non-fading rash.

  • Cold hands & feet 
  • Leg pain 
  • Abnormal skin colour 
  • Altered mental state/confusion
  • Non-fading rash 

So what to do?

Make sure you have had your Meningitis C immunisation (and check for 2 MMR injections too whilst you’re at it!)

Be aware of the symptoms and signs of meningitis and septicaemia, and act on any concerns- seek help!….and watch out for your mates!

 

http://www.meningitisuk.org/

http://www.nhs.uk/conditions/Meningitis/Pages/Introduction.aspx

Download the free app- Meningitis signs and symptoms by the Meningitis Trust