The history of meningitis

October 2020

In September, we officially launched phase two of the Meningitis Progress Tracker. This unique tool is the first of its kind; bringing together meningitis estimates and data from all over the world. With even more data available through use of powerful visualisations, global health experts, policymakers, and anyone interested in meningitis can better understand the broader picture of the disease, more than ever before. The Meningitis Progress Tracker acts as the official dashboard for the World Health Organization (WHO) Global Roadmap to Defeat Meningitis by 2030. At this significant moment in the history of meningitis, we’ve taken a look back at the story of meningitis so far.
 
It is difficult to definitively say how long meningitis has been part of our lives, as medical tools to diagnose the disease are relatively recent in the timeline of human history. The first recorded observation of what might have been meningitis came from the famous Greek scholar Hippocrates (c.460-370BC), who observed the inflammation of the lining of the brain.
 
One of the earliest descriptions of meningitis that we can point to came from Thomas Willis (1621 – 1675), who described patients with “inflammation of the meninges with a continual fever” in 1661.
 
In the early 1800s, French and English physicians coined the term ‘meningitis’ - combining ‘meninges’ (the name of the brain lining) with the suffix ‘itis’, implying inflammation.
Diagnosis & Treatment
An epidemic of meningococcal disease in Geneva was first clinically characterised in 1805 by Gaspard Vieusseux, a general practitioner. The first outbreak in Africa was recorded in the 1840s, but it wasn’t until 1887 that Austrian bacteriologist Anton Vaykselbaum identified meningococcal bacteria as a cause of meningitis.
 
In 1890, Heinrich Quincke (1842–1922) used a procedure called lumbar puncture (LP) on a patient with suspected meningitis. Even today, LP remains the only way to accurately confirm a case of meningitis and reveal its cause.
What is a lumbar puncture?

What is a lumbar puncture?

In 1906, scientists began to recommend anti-meningococcal serum therapy to protect humans against meningococcal disease; a therapy based on antibodies initially derived from the blood of horses, and later from patients, or individuals recovering from meningococcal disease. Its effectiveness meant that it was used prophylactically in those who had been in close contact with patients of meningococcal disease – though it was a risky procedure. However, once it was realised that people could carry meningococcal bacteria without showing any clinical signs of disease, efforts were focused on eliminating this carrier status. Attempts at spraying dried anti-meningococcal serum into the nostrils however produced disappointing results.
 
Anti-serums remained the therapy of choice until the 1930’s when American scientist Sara Branham (1888-1962) found that meningococcal bacteria could be more effectively treated with sulphonamides.
 
Modern treatments changed with the discovery of penicillin in 1941. The advent of antibiotics revolutionised treatment of meningitis and other bacterial diseases. Antibiotics are extremely good at killing meningitis causing bacteria, so are an effective cure, but do not always act fast enough to prevent the damage the bacteria can cause. This is why acting fast, if you suspect meningitis in yourself or someone you know, is so important.
 
The challenge now and in the future is anti-microbial resistance, and the lack of new drugs in the pipeline, particularly for gram-negative bacteria.

Prevention history
Meningitis has many causes, mostly bacterial and viral, and more rarely other pathogens.  Preventing the illness requires a sophisticated understanding of how the different pathogens work in order to protect against them.

Vaccines have been the breakthrough needed to prevent infectious diseases. Together with clean water, they have had more impact on the world’s health than anything else. Conjugate vaccines, which are effective in young children, were a significant breakthrough in preventing the leading causes of the meningitis. The first was the Hib vaccine in 1987, which was introduced to many countries throughout the 1990s.
The UK was the first country to introduce a conjugate vaccine against meningococcal disease with MenC vaccine in 1999. In 2010 the MenA vaccine was implemented in the sub-Saharan African meningitis belt, with over 300 million people immunised by the end of 2019, virtually eliminating meningococcal A meningitis. Conjugate technology was also used to develop pneumococcal vaccines, introduced first of all in the US in 2000.


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Aftercare
Fortunately, most people in the UK survive.  The after effects are diverse, however, so good quality care and support is not always easily available – even in wealthy countries. In some poorer countries, there may be no support available at all.
 
Attitudes to physical injuries and health impairments following meningitis have been consistent with the issues facing all people with disabilities. Additionally, the taboos surrounding mental health in society, and the mental health after effects of meningitis, are only just starting to be acknowledged.   
 
MRF campaigns to raise awareness of the issues people face, as well as reducing isolation, facilitating peer-to-peer support, offering comprehensive information, and free Support Services in the UK and Ireland.
What’s the situation now?
Two hundred years after it was named, we know much more about the disease we call meningitis.  The deadly illness is still thankfully rare in most countries, but it can strike anyone at any age.
In the UK, surveillance and prevention has largely been effective at tackling outbreaks and it more usually occurs as isolated cases.  Outbreaks and epidemics are still an ongoing global concern, especially in areas such as the ‘meningitis belt’ in Africa where access to healthcare can also be an issue.
 
We cannot afford to become complacent, as the disease can changes over time and re-emerge as a new threat.  There’s still much more to be done in improving prevention, surveillance, diagnosis and treatment, and support for people who have been affected by the disease.  The current vaccines do not cover all causes of meningitis, so as vital research into vaccine development continues, it is important that people are aware of the signs and symptoms.
The future
2020 is a critical year in the history of meningitis. Centuries of experience and research have enabled us to identify causes, improve diagnostics tests, develop treatments, prevent some of the causes of the disease, and develop support strategies for those who are left with the after effects of meningitis. There is now, for the first time in history, a Global Plan in place to defeat meningitis – which, we hope, will be presented at the World Health Assembly in 2020.
 
Your support has allowed us to get this far, and your support will allow us to continue moving forward to create a world free from this disease. Together, we will defeat meningitis.
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About the author

Holly Edwards
Senior Communications Officer

Hi, I'm Holly, and I joined MRF in 2017.

I'm always looking for stories that will help more people understand meningitis and the devastating impact it can have. Working with people who have been affected by meningitis is a great privilege, and I feel very lucky to do what I do.

Tel: 0333 405 6255