Body Wise

Deadly Meningitis: Often Preventable

by Susan Stopper

Nancy Ford Springer’s 14-year-old son Nick was at summer camp when he came down with meningococcal meningitis, the most common form of bacterial meningitis. “It nearly took his life,” Nancy says. Nick survived, but underwent amputations of both hands and both legs. “We’re lucky to still have him,” Nancy says.

Each year, meningococcal meningitis strikes nearly 3,000 people in the U.S. This past September, two area college students — one at the University of Pennsylvania and one at the Universal Technical Institute in Exton, PA —died of meningococcal meningitis. It can be extremely deadly, but there is a vaccine that can prevent the disease. So why are students still dying from it?

Preteen Vaccines

Even if healthy, your 11- or 12-year-old can benefit from a doctor’s visit. In addition to a check-up, your child can receive important vaccinations.
Along with the meningitis vaccine, the CDC recommends that preteens receive Tdap, a booster against tetanus, diphtheria and pertussis (whooping cough), all potentially deadly diseases.

For girls, the CDC recommends the human papilloma virus (HPV) vaccine, which protects against the most common types of cervical cancer. Approximately 3,700 women in the U.S. die from cervical cancer each year.

“The pre-adolescent appointment is also a good time to make sure your child has had all of the vaccines recommended earlier in childhood,” says Anat Feingold, MD of Cooper University Hospital in Camden, NJ.

For the current CDC Childhood and Adolescent Immunization Sched-ule, visit www.cdc.gov/vaccines.

What Is Meningitis?
Meningitis is an infection that causes inflammation of the membranes that protect the brain and spinal cord. Bacterial meningitis is fatal in 10 to 12 percent of people who contract it. Those who survive often have lasting effects, including brain damage, hearing loss, seizures and loss of limbs.

There is a viral form of the disease, but it tends to be a milder illness that often clears up without treatment. Both bacterial and viral meningitis are spread by respiratory droplets, which can be exchanged through coughing, sneezing, kissing and sharing drinks or utensil

.At greatest risk are children younger than age 2, adolescents and young adults, especially those living in dormitories or other close quarters.

“In the early phases, meningitis can look like a case of the flu,” says Kate Cronan, MD, chief of emergency medicine at Alfred I. duPont Hospital for Children in Wilmington, DE. The symptoms include fever, headache, nausea, vomiting, exhaustion, neck pain or stiffness and occasionally a red or purple rash.

Prevention and Treatment
While meningococcal meningitis can be treated with antibiotics, the disease often progresses too rapidly for treatment to be effective.

Early detection is crucial, but what is more important is prevention. In 2005, a new vaccine for meningococcal meningitis came into widespread use. The new vaccine, Menactra, is now the preferred vaccine and is longer lasting than the earlier vaccine, Menomune, which has been used since 1981.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that all children age 11 to 18 be vaccinated against meningococcal meningitis.

Pennsylvania and Delaware have laws requiring college students to receive the vaccination or sign a waiver after receiving information on the benefits of the vaccine.

New Jersey requires all college students living in dormitories to receive the vaccination unless they have a medical condition or a religious conflict.

Because meningitis can strike adolescents of all ages, the National Meningitis Association states that the pre-adolescent health care visit is a good time for parents to talk to their child’s doctor about immunization.

The FDA also recently approved Menactra for kids ages 2-10 who are at high risk for contracting meningococcal meningitis. This high-risk group includes children traveling to parts of Africa where there is a high rate of meningococcal disease or who have a compromised immune system or a damaged or removed spleen.

Why Are Students Dying?
There are limits to the vaccine’s effectiveness. “The vaccine only protects against four of the five types of meningococcal disease. It does not protect against type B, which accounts for a third of the disease in adolescents,” explains Paul Offit, MD, chief of infectious diseases at The Children’s Hospital of Philadelphia.

At least one of the recent cases of meningococcal meningitis in the area was believed to be a type not covered by the vaccine. Therefore, it is important to remind your children not to share things like drinks, eating utensils, lipstick and other items where the bacteria can be exchanged.
Another reason that children are still contracting meningococcal meningitis is that many people simply aren’t getting vaccinated. According to the CDC’s National Immunization Survey, just 12 percent of eligible adolescents received the vaccine in 2006.

“Meningitis can be a devastating disease, and the vaccine is very safe,” says Anat Feingold, MD, infectious disease specialist at Cooper University Hospital in Camden, NJ. “Not only do I tell my patients to get vaccinated, I had my own children vaccinated.”

The side effects reported for Menactra appear to be similar to those of other vaccines, including fever, pain and headaches. A more severe side effect could be Guillain-Barré syndrome (GBS), a neuro-log-ical disorder characterized by a loss of reflexes and temporary paralysis.

Although a link to Menactra has not been proven, 19 cases of Menactra recipients contracting GBS have been reported to the CDC since the vaccine came into use in 2005.

Many researchers estimate the risk of GBS for vaccine recipients to be close to one-in-a-million. “Your chances of being hurt by meningitis are far greater than being hurt by the vaccine,” says Dr. Offit.

Nancy Ford Springer didn’t know there was a vaccine that could protect her son Nick from meningococcal meningitis, nor did she know that her son was at risk for contracting the disease.

“I never thought this disease would affect my family,” Nancy says. “But with the vaccine, there is a way to protect yourself.”

Susan Stopper is a local freelance writer.