What is meningitis?
Meningitis is an inflammation of the linings of the brain and spinal cord caused by either viruses or bacteria.
Viral meningitis is more common than bacterial meningitis and usually occurs in late spring and summer. Signs and symptoms of viral meningitis may include stiff neck, headache, nausea, vomiting, and rash. Most cases of viral meningitis run a short, uneventful course. Since the causative agent is a virus, antibiotics are not effective. Persons who have had contact with an individual with viral meningitis do not require any treatment.
Bacterial meningitis occurs rarely and sporadically through out the year, although outbreaks tend to occur in late winter and early spring. Bacterial meningitis in college-aged students is most likely caused by Neisseria meningitidis or Streptococcus pneumoniae. Because meningococcal meningitis can cause grave illness and rapidly progress to death, it requires early diagnosis and treatment. In contrast to viral meningitis, persons who have had intimate contact with a case require prophylactic therapy. Untreated meningococcal disease can be fatal.
How does meningococcal disease occur?
Approximately 10% of the general population carry meningococcal bacteria in the nose and throat in a harmless state. This carrier state may last for days or months before spontaneously disappearing, and it seems to give persons who harbor the bacteria in their upper respiratory tracts some protection from developing meningococcal disease.
During meningococcal disease outbreaks, the percentage of people carrying the bacterium may approach 95%, yet the percentage of people who develop meningococcal disease is less that 12%. This low occurrence of disease following exposure suggests that a person's own immune system, in addition to bacterial factors, plays a key role in disease development.
Meningococcal bacteria cannot usually live for more than a few minutes outside the body. As a result, they are not easily transmitted in water supplies, swimming pools, or by routine contact with an infected person in a classroom, dining room, bar, restroom, etc.
Roommates, friends, spouses, and children who have had intimate contact with the oral secretions of a person diagnosed with meningococcal disease are at risk for contracting the disease and should receive prophylactic medication immediately. Examples of such contact include kissing, sharing eating utensils, and being exposed to droplet contamination from the nose or throat.
How many cases of meningococcal disease occur each year?
The annual incidence of meningococcal disease in the United States is about 1 case per 100,000 population. In Maryland, there is an average of 10 - 12 cases per year, which comprises all age-groups. These cases generally occur from January to April. The case fatality rate is approximately 12%. To date there have only been 15 cases of meningitis reported in the state.
Can meningococcal disease be mistaken for other health problems?
Meningococcal disease is potentially dangerous because it is relatively rare and can be mistaken for other conditions. The possibility of having meningitis may not be considered by someone who feels ill, and early signs and symptoms may be ignored. A person may have symptoms suggestive of a minor cold or flu for a few days before experiencing a rapid progression to severe meningococcal disease.
What are the signs and symptoms of meningococcal disease?
Understanding the characteristic signs and symptoms of meningococcal disease is critical and possibly lifesaving.
Common early symptoms of meningococcal meningitis include fever, severe sudden headache accompanied by mental changes (e.g., malaise, lethargy), and neck stiffness.
A rash may begin as a flat, red eruption, mainly on the arms and legs. It may then evolve into a rash of small dots that do not change with pressure (petechiae). New petachiae can form rapidly, even while the patient is being examined.
What is the treatment for meningococcal disease exposure?
Treatment of infected persons
Meningococcal disease can be rapidly progressive. With early diagnosis and treatment, however, the likelihood of full recovery is increased.
Early recognition, performance of a lumbar puncture (spinal tap), and prompt initiation of antimicrobial therapy are crucial.
The use of such prophylactic antibiotics a ciprofloxacin or rifampin is recommended for those who may have been exposed to a person diagnosed with meningococcal disease. Anyone who suspects possible exposure should consult a health care provider immediately.
As an adjunct to appropriate antibiotic chemoprophylaxis, immunization against the meningococcus bacterium may be recommended when an outbreak of meningococcal disease has occurred in a community. It is important to note that meningococcal vaccine should not be used in place of chemoprophylaxis for those exposed to an infected person; the protection from immunization is too slowly generated in this situation.
Meningococcal Meningitis Vaccine
Immunization against the bacterium N. meningitidis may be recommended for persons over 2 years of age if they are members of a population that is experiencing an outbreak of meningococcal disease, e.g., students at a university when an outbreak has occurred.
Vaccination of college students is required by the state of Maryland for all new freshman/transfer students living on campus, or a waiver form completed and signed. All students choosing to receive the vaccine are required to have either the original vaccine or a booster after the age of sixteen (16) in order to satisfy the requirement. The staff of Health Services strongly recommend all students living on or off campus having the vaccine as opposed to signing a waiver. The vaccine is available in Health Services. Please call to reserve a dose, and to schedule an appointment. The Health Services staff is available during summer orientation, and again at check in to administer Meningitis vaccines to students who have reserved a dose. The price of the vaccine is currenlty $80.00. Your student account will be billed when having the vaccine here. Please remember that the vaccine does not protect you from all types of Meningitis.
How can one reduce the risk of contracting meningococcal disease?
Maximize your body's own immune system response. A lifestyle that includes a balanced diet, adequate sleep, appropriate exercise, and the avoidance of excessive stress is very important. Avoiding upper respiratory tract infections and inhalation of cigarette smoke may help to protect from invasive disease. Everyone should be sensitive to public health measures that decrease exposure to oral secretions, such as covering one's mouth when coughing or sneezing and washing hands after contact with oral secretions.
For more information call: Washington College Health Services (410) 778-7261.