The tragic story of a three-year-old boy who died of undiagnosed meningitis last week has brought the illness into the spotlight.
The boy from Archidona was suffering a fever and blocked sinuses on Wednesday last week but was treated with flu medication when his parents took him to the emergency room.
He missed school the following day as his symptoms worsened and the GP referred him to the Antequera Hospital where he tragically died that night.
The Junta de Andalucía's delegate for Malaga province, José Luis Ruiz Espejo, has called this “an isolated case” and has asked people to remain calm.
He said that tests are being done to determine what kind of meningitis the boy died from.
The parents, teachers and children from the class of the boy were given antibiotics as a precautionary measure.
The regional health department has been in collaboration with the mayor of Archidona, Mercedes Montero, to spread information to families and schools about meningitis, how to identify it, and the course of action if anyone suspects that they, or someone else, could have the illness.
The most serious strains of meningitis are caused by bacteria, primarily meningococcus.
The 'meningitis B' strain is the most common type in Spain.
According to the World Health Organisation (WHO) every year around half a million people in the world contract meningitis, resulting in 50,000 deaths.
What is meningitis?
Meningitis is an infection which causes the inflammation of the membrane covering the brain and the spinal cord.
The disease can be classified into three types: bacterial, viral, and fungal.
In developing countries, bacterial meningitis is responsible for many deaths in newborns, elderly people, and those with immune system deficiencies.
Meningitis is contagious and can be contracted at any time of the year, with people most susceptible during winter and spring.
How is it spread?
Someone with meningitis can spread it by coughing or sneezing near someone else who can then breathe in the germs.
Close contact and small spaces are the easiest ways of transmitting the infection, which is why people often catch it in schools and family environments.
However, meningitis is not as contagious as a cold or flu.
The virus can enter the body through someone's eyes, nose, or mouth, which is why it is so easy for children to pass it to one another when they spend so much time together at school.
Bacteria is the cause of the majority of meningitis cases.
Among adults, the pneumococcus bacteria is the most prevalent, while for children and young people it is meningococcus.
The infection is spread quickest through close, long-lasting contact with an infected person, for example through kissing, sneezing, coughing, sharing rooms, or sharing cutlery and crockery.
The incubation period is four days on average, but this can range from two to ten days.
According to the WHO there are people who can carry the bacteria without having any health issues.
However, in other individuals, the germ can break through the barrier and penetrate the body which results in the illness.
The symptoms of meningitis come on suddenly.
These are usually a fever, headache and stiff neck, accompanied by nausea, vomiting, confusion and an abnormal intolerance to light.
In some cases, symptoms similar to those of flu are displayed and some people get marks on their body: lots of little red spots, known as petechiae, may appear anywhere on the body, and often join up creating haematomas.
Experts recommend going to the nearest accident and emergency department as soon as these symptoms appear.
In 2006, experts from the medical publication The Lancet said that other symptoms such as leg pain, cold hands and feet and pallor are warning signs that appear even before the other symptoms already listed.
In the case of babies and small children, they should be taken to a doctor if they lose their appetite, have a stiff neck or a limp body, or difficulty staying awake. Other warning signs are lethargy, irritability or cold hands and feet.
Who does it affect?
Meningitis mainly affects children under one year old. The second most affected age group is children aged between one and nine years old and the third is adolescents aged between 15 and 19 years old.
Children under three years old usually have the worst prognosis when it comes to consequences and mortality.
Ninety-nine per cent of recorded cases are of previously healthy people who suffered no previous illnesses.
The number of new cases of the illness in Spain remains stable every year. The figures, currently showing 0.7 cases per 100,000 people, are decreasing, although these are among the highest in Europe.
How to prevent it
There are currently several vaccinations against meningitis, protecting against the different strains of bacteria.
Being vaccinated is the best way to avoid catching the infection.
How is it diagnosed?
The initial diagnosis can be done with a physical examination, followed by a lumbar puncture which shows the cerebrospinal fluid (CSF) is infected.
Sometimes the CSF is observed under a microscope. The diagnosis is supported or confirmed by the presence of the bacteria in a blood or CSF sample, agglutination test, or with a polymerase chain reaction (PCR).
Identifying the type of bacteria causing the meningitis is important for choosing the right antibiotic and means of control.
Meningitis can be fatal and should always be seen as a medical emergency.
The patient has to be checked into a hospital or health centre, although isolation is not necessary.
A course of antibiotics should be started as soon as possible, preferably immediately after the lumbar puncture.
Starting treatment before this can complicate the bacterial growth in the CSF and make it difficult to give a concrete diagnosis.
Different antibiotics can treat meningitis, such as penicillin, ampicillin, chloramphenicol, and ceftriaxone .