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Killer Disease on Campus

FAQs, Links & Books

 

Frequently Asked Questions

What is meningitis?
What are the signs and symptoms of meningitis?
How is meningitis diagnosed?
Can meningitis be treated?
Is meningitis contagious?
Are there vaccines against meningitis?
Who should receive the meningitis vaccine?

What is meningitis?
Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ. Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, learning disability, or death. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis, because antibiotics can prevent some types from spreading and infecting other people. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis, but new vaccines being given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.

NOVA's program "Killer Disease on Campus" depicts young adults and children with N. meningitidis, also known as meningococcal meningitis, a bacterial form of the disease.

What are the signs and symptoms of meningitis?
High fever, headache, and a stiff neck are common symptoms of meningitis in anyone over the age of two years. These symptoms can develop over several hours, or they may take one to two days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, experience vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.

How is meningitis diagnosed?
Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. The diagnosis is usually made by growing bacteria from a sample of spinal fluid. The spinal fluid is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where fluid in the spinal canal is readily accessible. Identification of the type of bacteria responsible is important for selection of correct antibiotics.

Can meningitis be treated?
Bacterial meningitis can be treated with a number of effective antibiotics. It is important, however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15 percent, although the risk is higher among the elderly.

Is meningitis contagious?
Yes, some forms are bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Hib or N. meningitidis. People in the same household or day-care center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiring the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib meningitis disease are no longer recommended if all contacts four years of age or younger are fully vaccinated against Hib disease (see below).

Are there vaccines against meningitis?
Yes, there are vaccines against Hib and against some strains of N. meningitidis and many types of S. pneumoniae. The vaccines against Hib are very safe and highly effective.

There is also a vaccine that protects against four strains of N. meningitidis, but it is not routinely used in the United States and is not effective in children under 18 months of age. The vaccine against N. meningitidis is sometimes used to control outbreaks of some types of meningococcal meningitis in the U.S. Meningitis cases should be reported to state or local health departments to assure follow-up of close contacts and recognize outbreaks. Although large epidemics of meningococcal meningitis do not occur in the U.S., some countries experience large, periodic epidemics. Overseas travelers should check to see if meningococcal vaccine is recommended for their destination. Travelers should receive the vaccine at least one week before departure, if possible. Information on areas for which meningococcal vaccine is recommended can be obtained by calling the Centers for Disease Control and Prevention at (404)-332-4565.

A vaccine to prevent meningitis due to S. pneumoniae (also called pneumococcal meningitis) can also prevent other forms of infection due to S. pneumoniae. The pneumococcal vaccine is not effective in children under two years of age but is recommended for all persons over 65 years of age and younger persons with certain chronic medical problems.

Who should receive the meningitis vaccine?
In 1999, the CDC, in cooperation with the American College Health Association and others, conducted a number of studies and literature reviews to better define the risk of meningococcal disease associated with college students. As a result, it was determined that freshman college students, particularly those who live in dormitories, constitute a group at a modestly increased risk for meningococcal disease.

The currently available meningococcal meningitis vaccine protects against four types of the bacterium Neisseria meningitidis, a very important cause of bacterial meningitis and sepsis in adolescents and young adults in the United States. The vaccine will not totally eliminate the risk of meningococcal disease, though it is highly effective against the four types of bacterial meningitis that account for about 70 to 80 percent of the cases of meningitis in college students. It is recommended that parents and students learn more about meningococcal disease (meningitis and sepsis) and the vaccine that can prevent it. More information is available by visiting the American College Health Association's Web site at http://www.acha.org.

People travelling abroad should also check to see if meningococcal vaccine is recommended for their destination. Information on areas for which meningococcal vaccine is recommended can be obtained by calling the Centers for Disease Control and Prevention at (404)-332-4565. Travelers should receive the vaccine at least one week before departure, if possible.

Others who have certain disorders of the immune system or workers in clinical laboratories responsible for processing specimens may be candidates for meningococcal vaccination. Specific information and recommendations are available at the CDC's Web site, http://www.cdc.gov.


Links

MedLine Plus Meningitis Tutorial
www.nlm.nih.gov/medlineplus/tutorials/meningitis.html
The National Library of Medicine's Patient Education Institute offers an interactive tutorial on the etiology of meningitis and includes information on treatment and vaccination.


National Foundation for Infectious Diseases (NFID)
www.nfid.org/library/meningococcal/
Confused about the difference between bacterial and viral meningitis? Looking for information about current research on meningitis vaccines and treatments? The NFID's new meningitis site is full of related information on the science behind the disease and the efforts to fight it.


The Meningitis Foundation of America
www.musa.org
Read the first-person accounts of meningitis survivors and participate in an online forum about the disease.


World Health Organization (WHO)
www.who.int/health-topics/meningitis.htm
The WHO provides detailed information on meningitis vaccines currently in use. In addition, you'll find regular reports and statistical analyses focusing on the global incidence of the disease.



Books

Meningococcal Disease
by Keith Cartwright, ed. New York: John Wiley and Sons, 1995.
Experts on the disease from a wide range of fields review major advances regarding the epidemiology, molecular biology, pathogenesis, clinical management, and prevention of the most lethal form of meningitis.


Meningococcal Disease: Methods and Protocols
by Andrew J. Pollard et al. New York: Humana Press, 2001.
An interdisciplinary survey of recent advances in the study of meningococcal disease worldwide.


How the Immune System Works
by Lauren M. Sompayrac. New York: Blackwell Science Inc, 1999.
In her highly readable volume—a favorite among medical students—Dr. Sompayrac describes the overall design of the immune system in layman's terms.


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