In 1987, tens of thousands of people gathered in Saudi Arabia for the annual Hajj pilgrimage. But what started out as a celebration led to a health crisis: just a few days after the pilgrimage, more than 2,000 cases of meningitis broke out spreading across Saudi Arabia and the rest of the world. The outbreak was so fierce that it was believed to have sparked a wave of deadly meningitis epidemics that ultimately infected tens of thousands of people worldwide.
Godine 1987, desetine hiljada ljudi okupilo se u Saudijskoj Arabiji za godišnji hadžiluk. Ono što je počelo kao proslava dovelo je do zdravstvene krize: samo nekoliko dana nakon hadžiluka, pojavilo se više od 2000 slučajeva meningitisa koji se širio po Saudijskoj Arabiji i po ostatku sveta. Izbijanje je bilo tako žestoko da se verovalo da je podstaklo talas smrtonosne epidemije meningitisa od kojeg se naposletku inficiralo desetine hiljada ljudi širom sveta.
Meningitis is the inflammation of the meninges, three tissue layers responsible for protecting the brain and spinal cord. What makes meningitis so dangerous compared to other diseases is the sheer speed with which it invades a person’s body. In the worst cases, it causes death within a day. Fortunately, that’s rare for patients who receive early medical treatment.
Meningitis je zapaljenje moždanih opni, tri sloja tkiva koja su odgovorna za zaštitu mozga i kičmene moždine. Ono što čini meningitis toliko opasnim u poređenju sa drugim bolestima je brzina kojom napada nečije telo. U najgorim slučajevima prouzrokuje smrt u roku od jednog dana. Na sreću, to je retko kod pacijenata koji rano prime terapiju.
The disease primarily comes in three forms: fungal, viral, and bacterial-- the last being the most deadly by far, and what we’ll focus on. People usually contract bacterial meningitis by breathing in tiny particles of mucus and saliva that spray into the air when an infected person sneezes or coughs. It can also be transmitted through kissing, or sharing cigarettes, toothbrushes or utensils. Some people can be infected and carry the disease without showing symptoms or getting sick, which helps the disease spread quickly to others.
Bolest uglavnom dolazi u tri oblika: gljivičnom, virusnom i bakterijskom - poslednji je najsmrtonosniji, i na njega ćemo se fokusirati. Ljudi uglavnom pokupe bakterijiski meningitis tako što udahnu male čestice sluzi i pljuvačke koji se rasrprše u vazduhu kad zaražena osoba kije ili kašlje. Može se preneti i ljubljenjem, deljenjem cigareta, četikica za zube ili pribora za jelo. Neki ljudi mogu biti zaraženi i da imaju bolest a da ne ispolje simptome niti se razbole, što pomaže bolesti da se brže širi do drugih.
Once the bacteria enter the nose, mouth, and throat, they cross the surrounding membranes and enter the bloodstream. From there, bacteria have rapid access to the body’s tissues --including a membrane called the blood-brain barrier. This is made of a tight mesh of cells which separate blood vessels from the brain, and block everything except for a specific set of particles, including water molecules and some gases. But in ways that scientists are still trying to understand, meningitis bacteria can trick the barrier into letting them through.
Onda kad bakterije uđu u nos, usta i grlo, one pređu okolne membrane i uđu u krvotok. Odatle bakterije imaju ubrzan pristup telesnim tkivima, uključujući i membranu zvanu krvno-moždana barijera. Ona je napravljena od tesne mreže ćelija koje odvajaju krvne sudove od mozga, i blokiraju sve osim specifičnih čestica koje uključuju molekule vode i neke gasove. Na načine koje naučnici još pokušavaju da shvate, bakterija meningitisa može da obmane barijeru i da prođe kroz nju.
Inside the brain, the bacteria swiftly infect the meninges. This triggers inflammation as the body’s immune response kicks into overdrive, bringing on fever and intense headaches. As swelling in the meninges worsens, the neck begins to stiffen. Swelling in the brain disrupts its normal function-- causing symptoms like hearing loss and extreme light sensitivity. As pressure increases in the cranium, it may also make the person confused-- one of the hallmarks of the disease. A few hours in, the rapidly multiplying bacteria start to release toxins, leading to septicemia, also known as blood poisoning. This breaks down blood vessels, letting blood seep out and form what starts out looking like a rash, and evolves into big discoloured blots beneath the skin. At the same time, these toxins burn through oxygen in the blood, reducing the amount that gets to major organs like the lungs and kidneys. That increases the chance of organ shut down --and alongside spreading septicemia, threatens death. That all sounds scary, but doctors are so good at treating meningitis that a visit to the hospital can drastically reduce an adult’s risk of dying from it. The longer it’s left untreated, though, the more likely it will lead to lasting damage. If declining oxygen levels cause cell death in extreme parts of the body --like fingers, toes, arms and legs-- the risk of amputation goes up. And if bacterial toxins accumulate in the brain and trigger cell death, meningitis could also cause long-term brain damage and memory loss. So fast treatment, or better yet, prevention, is critical. That's why most countries have vaccines that defend against the disease in its deadliest forms. Those are usually given to the people who are most at risk--like young children, people with weak immune systems, or people who gather in large groups where an outbreak of meningitis could potentially happen.
Unutar mozga, bakterije brzo inficiraju moždane opne. Ovo pokreće zapaljenje dok imuni sistem ubrzava svoj rad, što dovodi do temperature i jakih glavobolja. Kako se otok u moždanim opnama pogoršava, vrat počinje da se koči. Otok u mozgu remeti njegovo normalno funkcionisanje, prouzrokujući gubitak sluha i ekstremnu osetljivost na svetlost. Kako se pritisak u lobanji povećava, može i da dovede do zbunjenosti osobe, što je jedno od obeležja ove bolesti. Nakon nekoliko sati, ove bakterije koje se brzo razmnožavaju počinju da ispuštaju otrove, čime dovode do sepse, takođe poznate i kao trovanje krvi. Ovo razbija krvne sudove, dopuštajući krvi da curi napolje i da formira nešto što izgleda kao osip, a potom se razvija u velike mrlje ispod kože. U isto vreme, ovi otrovi sagorevaju kiseonik u krvi, smanjujući količinu koja dospeva do glavnih organa poput pluća i bubrega. To povećava šansu da organi prestanu sa radom, a pored širenja sepse, preti smrt. Sve to zvuči strašno, ali doktori su toliko dobri u lečenju meningitisa da poseta bolnici može drastično smanjiti rizik da odrasla osoba umre od njega. Što je duže nelečen, to je veća šansa da će doći do trajnih posledica. Ako opadajući nivoi kiseonika prouzrokuju smrt ćelija u ekstremitetima - u prstima, rukama i nogama - rizik od amputacije se povećava. A ako se otrovi bakterija nagomilaju u mozgu i pokrenu smrt ćelija, meningitis može prouzrokovati dugoročno oštećenje mozga i gubitak pamćenja. Brza terapija, ili još bolje, prevencija, je presudna. Zato većina država ima vakcine koje štite od bolesti u njenom najsmrtonosnijem obliku. One se uglavnom daju ljudima koji su najviše pod rizikom - deci na ranom uzrastu, ljudima sa slabim imunim sistemima ili onima koji se okupljaju u velike grupe
In addition to those gatherings, meningitis is most common in a region called the meningitis belt that stretches across Africa, though cases do happen all over the world. If you’re concerned that you or someone you know may have meningitis, get to the doctor as soon as possible; quick action could save your life.
gde bi meningitis potencijalno mogao da izbije. Pored takvih okupljanja, meningitis je najčešći u regiji zvanoj „pojas meningitisa” koji se prostire duž Afrike, mada slučajevi se dešavaju u celom svetu. Ako ste zabrinuti da vi ili neko koga poznajete možda ima meningitis, idite kod lekara što je pre moguće;