STORY BYIt starts off like the flu. But in a matter of hours, meningococcal meningitis can turn deadly. The party/study-all-night, no-sleep, communal lifestyle of college students puts them at particular risk for the fast-moving disease.
This year, college students can protect themselves with a meningitis shot before they go back to school. The Centers for Disease Control and Prevention (CDC) now recommends routine vaccination of college freshmen living in dormitories with the newly licensed meningococcal conjugate vaccine (MCV4). The vaccine is also recommended for children 11-12 years old and previously unvaccinated adolescents who are entering high school.
The new vaccine protects against meningococcal meningitis, one strain of several types of bacterial meningitis.
Meningitis is an infection of the linings of the brain and spinal cord, caused by a virus or bacteria. Viral meningitis (the kind that Brad Pitt had) is usually less serious, and goes away on its own.
But bacterial meningitis progresses quickly and can kill within hours. Many young adults think they have a cold or the flu. They treat themselves with over-the-counter medicines and wait to get better, wasting critical time.
These symptoms can develop over several
hours, or they may take 1 to 2 days. As the
disease progresses, patients may also have
seizures. For more information about
meningitis, visit the Center for Disease
Control’s website at http://www.cdc.gov
If caught soon enough, the infection can be treated with targeted antibiotics. Still, up to 15 percent of people who contract meningococcal meningitis may suffer long-term permanent disabilities including hearing loss, limb amputation or brain damage. And 10 to 12 percent of people with meningococcal meningitis die, according to the CDC.
“This is the type of meningitis that you do not want to have because the death rate is so high,” says Dr. Lynnette Mazur, professor of pediatrics at The University of Texas Medical School at Houston. “It moves very quickly. In my career, I have only seen one person who survived intact, and that’s because she got treated immediately. We had Life Flight (an air ambulance) pick her up.”
Several different strains of bacteria can cause meningitis. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis. H. influenzae type b used to be a leading cause of meningitis, but now infants are routinely vaccinated against the bacteria.
“Since the HIB vaccination came out in the mid-80s, I haven’t seen any cases (of meningitis) caused by it,” Mazur says. “It is amazing.”
Doctors hope the new meningococcal meningitis vaccine might cause similar "herd immunity" in adolescents, as the HIB vaccine has in infants. Using the theory of herd immunity, if 90 percent of people are vaccinated, the remaining unvaccinated 10 percent would also be protected from infection.
The MCV4 vaccine is administered in the arm in a single shot. Side effects from the shot are usually mild, but may include some swelling at the injection site. Unlike previous meningitis vaccines, the new vaccine is boostable. About three years after getting the shot, patients can receive another one to “boost” its effectiveness.
Because they were not boostable, previous versions of meningitis vaccines were given sparingly – usually only during meningitis outbreaks and to people in close contact with a person infected with meningitis. The vaccine provided immediate protection against meningitis. But should an outbreak occur in the future, the recipient of the vaccination could not be vaccinated again. Theoretically, they would have little protection against meningitis.
At this writing, Mazur says she is still waiting on her supply of the new vaccine, but expects it soon. Some private clinics are beginning to offer the vaccine. Mazur recommends teens and college-age adults put the meningitis shot on their back-to-school list.
“I definitely agree with the recommendation for vaccination,” Mazur says. “This is a bad strain of meningitis, and there’s not much that kids can do to prevent it.”
The MCV4 vaccine does not protect people against meningococcal disease caused by serogroup B bacteria. This serogroup of bacteria causes one-third of meningococcal cases in the United States.
In addition to getting a meningitis shot, what can young adults do to reduce their risk for the disease?
“Stop smoking, go to bed on time, eat right and don’t drink as much,” Mazur says, adding that most college kids won’t follow her prescription for clean living.
Fortunately, meningococcal meningitis isn’t as contagious as the cold or flu. People can’t get it by breathing the air. The bacterium that causes meningococcal meningitis is transmitted through the exchange of nasal and throat secretions from kissing, coughing and sharing drinking glasses. To reduce their risk, young adults should wash their hands frequently and try not to eat or drink after others.
Cutting back on partying also helps reduce risk for meningitis. Going to bars and nightclubs, and drinking alcohol have been associated with greater risk for meningitis.
“There is just something special about teenagers (and young adults),” Mazur says. “They don’t sleep right, they depress their immune system. They make conditions ideal for acquiring meningitis.”
UPDATED: 08-22-2005
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Dr. Lynnette Mazur is a professor of pediatrics at the UT Medical School.
See Dr. Mazur also at:
Summer Carbon Monoxide Dangers
Generators used to cool off homes in hot summer months can cause death through carbon monoxide (CO) poisoning.
CO is an odorless, colorless gas that can kill or seriously and permanently injure people who inadvertently breathe in the noxious fumes emitted from generators in an enclosed space.
During hurricane season, emergency rooms see a rise in cases of CO poisoning from people bringing generators into their homes to provide power, often for cooling fans as well as cooking.
“During Hurricane Rita, we had a family of five die here in Houston for CO poisoning,” reminds UT Medical School Hyperbaric Medicine expert, Dr.Caroline Fife. “The Center for Disease Control and Prevention tracked deaths from CO poisoning due to combustion engines after Katrina and Rita and there was a dramatic increase.”
“Teak surfing”—holding on to the back of a power boat’s swim platform and being towed—is another danger. The boat’s exhaust pipe is in the face of the swimmer.
People riding in the back of pick-up trucks are at risk, too. Numerous cases have been cited of children poisoned by riding beneath tarpaulins or enclosed “cabs” in the back of the truck. In these cases, the trucks had a leak in the exhaust system or a rear-exiting tail pipe, not a side exit.
Fife also has seen this in boats with malfunctioning exhaust systems. She urges doctors and bystanders to pay special attention when groups of people begin to feel ill at the same time, particularly severe headache and nausea. Children often become symptomatic before adults.
“People associate CO poisoning with cold weather and northern states, but in the South, we see it a lot in summer with people just trying to stay cool,” Fife says.
