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In 1987, tens of thousands of people gathered in Saudi Arabia for the annual Hajj pilgrimage.
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But what started out as a celebration led to a health crisis:
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just a few days after the pilgrimage, more than 2,000 cases of meningitis
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broke out spreading across Saudi Arabia and the rest of the world.
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The outbreak was so fierce that it was believed to have sparked a wave of deadly meningitis
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epidemics that ultimately infected tens of thousands of people worldwide.
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Meningitis is the inflammation of the meninges, three tissue layers responsible
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for protecting the brain and spinal cord. What makes meningitis so dangerous compared
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to other diseases is the sheer speed with which it invades a person's body.
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In the worst cases, it causes death within a day. Fortunately, that's rare
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for patients who receive early medical treatment.
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The disease primarily comes in three forms:
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fungal, viral, and bacterial-- the last being the most deadly by far,
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and what we'll focus on.
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People usually contract bacterial meningitis by breathing in tiny particles
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of mucus and saliva that spray into the air when an infected person sneezes or coughs.
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It can also be transmitted through kissing, or sharing
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cigarettes, toothbrushes or utensils. Some people can be infected and carry the
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disease without showing symptoms or getting sick, which helps the disease
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spread quickly to others.
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Once the bacteria enter the nose, mouth, and
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throat, they cross the surrounding membranes and enter the bloodstream.
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From there, bacteria have rapid access to the body's tissues--including a membrane
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called the blood-brain barrier. This is made of a tight mesh of cells which
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separate blood vessels from the brain, and block everything except for a specific
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set of particles, including water molecules and some gasses. But in ways
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that scientists are still trying to understand, meningitis bacteria can trick
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the barrier into letting them through.
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Inside the brain, the bacteria swiftly infect the meninges.
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This triggers inflammation as the body's immune response
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kicks into overdrive, bringing on fever and intense headaches. As swelling in the
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meninges worsens, the neck begins to stiffen. Swelling in the brain disrupts its
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normal function--causing symptoms like hearing loss and extreme
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light sensitivity. As pressure increases in the cranium, it may also make the
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person confused--one of the hallmarks of the disease.
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A few hours in, the rapidly multiplying bacteria start to release toxins,
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leading to septicemia,
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also known as blood poisoning. This breaks down blood vessels,
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letting blood seep out and form what starts out looking like a rash, and
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evolves into big discoloured blots beneath the skin. At the same time, those toxins
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burn through oxygen in the blood, reducing the amount that gets to major organs like
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the lungs and kidneys. That increases the chance of organ shut down--and alongside
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spreading septicemia, threatens death.
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That all sounds scary, but doctors are so
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good at treating meningitis that a visit to the hospital can drastically reduce an
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adult's risk of dying from it. The longer it's left untreated, though, the more
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likely it will lead to lasting damage. If declining oxygen levels cause cell
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death in extreme parts of the body--like fingers, toes, arms and legs--the risk
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of amputation goes up. And if bacterial toxins accumulate in the brain and trigger
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cell death, meningitis could also cause long-term brain damage and memory loss.
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So fast treatment, or better yet, prevention, is critical.
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That's why most countries have vaccines that defend
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against the disease in its deadliest forms.
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Those are usually given to the people who are most at risk--like young children,
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people with weak immune systems, or people who gather in large groups where an
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outbreak of meningitis could potentially happen.
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In addition to those gatherings,
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meningitis is most common in a region called the meningitis belt that stretches
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across Africa, though cases do happen all over the world. If you're concerned that
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you or someone you know may have meningitis, get to the doctor as soon as
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possible; quick action could save your life.