• The World Health Organisation (WHO) published its first-ever global guidelines for meningitis diagnosis, treatment and care, aiming to speed up detection, ensure timely treatment, and improve long-term care for those affected. 

• By bringing together the latest evidence-based recommendations, the guidelines provide a critical tool for reducing deaths and disability caused by the disease.

• Despite effective treatments and vaccines against some forms of meningitis, the disease remains a significant global health threat. 

Meningitis disease

• Meningitis is a life-threatening disease caused by inflammation of the membranes (meninges) that surround the brain and spinal cord.

• There are multiple causes of meningitis, including viral, bacterial, fungal and parasitic pathogens. 

• Acute bacterial meningitis is one of the deadliest and most disabling forms of this illness. It can cause epidemics, lead to death within 24 hours and leave one in five people with lifelong disability after infection. 

There are four main causes of acute bacterial meningitis:

i) Neisseria meningitidis (meningococcus)

ii) Streptococcus pneumoniae (pneumococcus)

iii) Haemophilus influenzae

iv) Streptococcus agalactiae (group B streptococcus)

• These bacteria are responsible for more than half of the deaths from meningitis globally and they cause other severe diseases like sepsis and pneumonia.

• Although meningitis affects all ages, young children are most at risk. 

• Newborn babies are at most risk from Group B streptococcus, young children are at higher risk from meningococcus, pneumococcus and Haemophilus influenzae. 

• Adolescents and young adults are at particular risk of meningococcal disease while the elderly are at particular risk of pneumococcal disease.

• People all over the world are at risk of meningitis. The highest burden of disease is seen in a region of sub-Saharan Africa, known as the African Meningitis Belt, especially recognised to be at high risk of epidemics of meningococcal but also pneumococcal meningitis.

• Around 20 per cent of people who contract bacterial meningitis develop long-term complications, including disabilities that impact quality of life. The disease also carries heavy financial and social costs for individuals, families, and communities.

Transmission

• Most bacteria that cause meningitis such as meningococcus, pneumococcus and Haemophilus influenzae are carried in the human nose and throat. They spread from person to person by respiratory droplets or throat secretions. 

• Group B streptococcus is often carried in the human gut or vagina and can spread from mother to child around the time of birth.

Symptoms

• Common symptoms of meningitis are neck stiffness, fever, confusion or altered mental status, headaches, nausea and vomiting.

• Less frequent symptoms are seizures, coma and neurological deficits (for example hearing or vision loss, cognitive impairment, or weakness of the limbs).

• There are effective treatments and vaccines against some of the main bacterial causes of meningitis. However, meningitis remains a significant threat around the world.

Defeating meningitis by 2030

The guidelines contribute to the broader Defeating Meningitis by 2030 Global Roadmap, adopted by WHO Member States in 2020, which aims to: i) Eliminate bacterial meningitis epidemics.

ii) Reduce cases of vaccine-preventable bacterial meningitis by 50 per cent and deaths by 70 per cent.

iii) Reduce disability and improve quality of life after meningitis.

Achieving these goals requires coordinated action across five key areas:

i) Diagnosis and treatment: Faster detection and optimal clinical management.

ii) Prevention and epidemic control: Developing new affordable vaccines, achieving high immunization and coverage, and improving outbreak preparedness and response.

iii) Disease surveillance: Strengthening monitoring systems to guide prevention and control.

iv) Care and support for those affected by meningitis: Ensuring early recognition and improved access to care and support for after-effects from meningitis. 

v) Advocacy and engagement: Increasing political commitment and inclusion in country plans, better public understanding of meningitis, and increased awareness of right to prevention, care and after-care services.

• With these guidelines, WHO provides countries with a critical tool to close gaps in meningitis diagnosis, treatment and care, ensuring that more people receive timely treatment and long-term support.

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