Meningitis: A Closer Look

A 20-year-old student was diagnosed with meningococcal meningitis late last week at Penn State University. The affected student who has been receiving medical treatment at Geisinger Medical Center in Danville was first in critical and then serious but has since been upgraded to fair condition.

As a result of the diagnosis, the University Health Services administered a one-time antibiotic treatment to approximately 60 individuals who believed they could have had contact with the affected student. No further cases of meningitis have been reported at Penn State, according to a press release issued by the university.

Meningococcal disease describes any infection caused by the bacteria Neisseria meningitidis, which is also commonly identified as meningococcus, and includes meningitis, an infection of the fluid of a person’s spinal cord and the fluid that surrounds the brain.

Meningitis, often referred to as spinal meningitis, is typically caused by a viral or bacterial infection. The illness’ severity and treatment differ based on the type of infection. Viral meningitis is generally less serious and resolves without specific treatment, while bacterial meningitis, on the other hand, can be quite severe and may even result in brain damage, hearing loss or learning disability, according to the Centers for Disease Control Web site.

While a meningococcal disease’s onset is rapid and the outcome potentially severe, the symptoms vary by site of infection. High fever, headache and stiff neck are all common meningitis symptoms in any individual over two years of age.

According to the Pennsylvania Department of Health Web site, these symptoms can develop over several hours or take one to two days. Other symptoms consist of nausea, vomiting, discomfort looking into bright lights, confusion and sleepiness. As the disease progresses, patients of any age could experience seizures. Even with timely treatment, the severe forms of meningococcal disease are fatal in 10 to 15 percent of cases. Many survivors also experience long term health problems that include mental impairment and hearing loss.

The diagnosis is usually made by growing bacteria from a sample of spinal fluid. Bacterial meningitis can be treated with a number of effective antibiotics. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying below 15 percent, but the risk, however, is higher among the elderly, according to the CDC Web site.

Some bacterial meningitis types are contagious, and the bacteria can be spread through the exchange of respiratory and throat secretions, such as coughing, sneezing and kissing, the Web site states. But none of the bacteria, which cause meningitis, are as contagious as the common cold or the flu. In addition, they are not spread by casual contact or breathing the same air as the affected individual. However, sometimes the bacteria have been transmitted to those who’ve had “close or prolonged contact” with a patient.

Meningococcal disease can be prevented by taking antibiotics. When a case is reported, an investigation is conducted to determine the “close contacts” and to recommend a preventive antibiotic for them. The preventive antibiotic should be prescribed and administered as soon as possible following contact, as it’s not only ineffective after 10 days, but also not recommended, according to the Department of Health Web site.
The CDC lists two vaccinations that are currently licensed in the United States. The meningococcal polysaccharide vaccine (MPSV4 or Menomune®) has been approved by the Food and Drug Administration (FDA) and available since 1981. Meningococcal conjugate vaccine (MCV4 or MenactraT) was licensed in 2005. Both vaccines can prevent four types of meningococcal disease, including two of the three types most common across the country. However, no vaccine is available against the fifth major strain of the disease, serogroup B.

The meningococcal conjugate vaccine is suggested for all college freshmen living in dormitories. Other college students who would like to reduce their risk of meningococcal disease have the option to receive either of the licensed meningococcal vaccines, according to the Department of Health. On June 28, 2002, Act 83, “Providing for vaccination against Meningococcal Disease for students at institutions of higher education,” was signed into law in Pennsylvania.

According to the Department of Health, this Act requires colleges and universities to:

* Prohibit a student from living in a dormitory unless the student has received a vaccination against the disease or signed a waiver for “religious or other reasons,”

* Provide detailed information on the risks associated with and the availability and effectiveness of any vaccine to any student (or his/her parent or guardian if the student is a minor) and

* Maintain records of vaccination or waivers on all students residing in dormitories.

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