History of Meningitis
Even though the history of meningitis goes back to Hippocrates and his descriptions of "water in the brain", the credit for accurately identifying and describing the disease goes to the Swiss Vieusseux (an association of scientific & literary personalities). They described the disease we know as meningitis from an outbreak in Switzerland in the year 1805.
The disease was very prevalent in the royal family of Japan during the 19th century and the history of meningitis determined the history of Japan since it was the biggest cause of pre-maturity deaths among the royals. Emperor Komei was the one of three children who survived out of 15, the rest succumbing to the dread meningitis.
History of Meningitis
Simon Flexner was the first to report some success in the treatment of meningitis in 1913. His is one of the first cases in the history of meningitis to have used intrathecal equine (derived from horses) meningococcal antiserum. The success using this agent was so great that the mortality rate from bacterial meningitis dropped from almost 90% to about 31%. Between 1928 and 1936, about 169 children diagnosed with meningitis were treated with this antiserum at the Bellevue Hospital, New York. For the first time in the history of meningitis treatment, the mortality dropped to below 20 %. In 1937, Fothergill that treating H. influenzae caused meningitis with a combination of intravenous and intrathecal antiserums saved about 15% of the patients, who before this regimes had an almost 100% fatality rate.
The introduction of sulfonamides created another revolution in the history of meningitis treatment by reducing the fatalities in meningococcal meningitis to between 5 and 15 %. Alexander, in 1944, announced that treatment of H. influenzae Type B caused meningitis has a almost unbelievable( at the time) mortality rate of 22% when treated with a combination of intravenous rabbit antiserum and sulfonamides. The discovery of treatment of this strain with a combined therapy of sulfadiazine and chloramphenicol, in the 1950s further reduced the mortality to between 5 to 10 %. It also had the additional benefit of doing away with the antiserum administration.
in comparatively modern times, the history of meningitis treatment has taken a revolutionary turn with the intravenous use of penicillin and ampicillin (a 3rd generation cephalosporin) and with the use of either or both of these drugs, the mortality rate for meningococcal meningitis has been reduced to about 10%, that for H. influenzae meningitis is about 5% while that for pneumococcal meningitis, unfortunately, remains at about 20%.
