Question of the Week

March 7, 2005

When bacterial meningitis is the suspected cause of an illness or death, health officials move quickly to stop the potential spread of the disease -- and the fear associated with it.

"WASHINGTON (AP) - City health officials believe a 6-year-old boy probably died from bacterial meningitis, and they moved Wednesday to calm jittery parents of his
classmates. ... He died Friday and District of Columbia Department of Health officials were notified of the death Saturday. 'We immediately contacted the family to begin our investigation,' said Interim Deputy Health Director Dr. Karyn Berry. ... His family members are receiving antibiotics as a precaution. But health officials stressed that it was unlikely any classmates are at risk. ... Although a final confirmation of bacterial meningitis has not been made, officials are working under the suspicion that that's what it was."

Not all bacterial meningitis cases end in death, but it is an illness that needs to be taken seriously.

"Published: March 1, 2005 ...
A Summerville High School student has been diagnosed with bacterial meningitis -- the fourth case in Tuolumne County since Dec. 3. The student, diagnosed Saturday, is
recovering, health officials said. 'She was quite ill for a while,' said Kathy Amos of the Tuolumne County Health Department, 'but she's recovering and doing fine now.' Health officials can't identify the student because of confidentiality laws, Amos said, but she urges everyone to be on the alert for symptoms. Symptoms are fever, headache, stiff neck and/or a purple rash that looks like dots from an ink pen. Amos said family members and close contacts of the student have already received antibiotics to prevent spread of the disease. It is transmitted by direct contact with an actively infected person -- such as intimate household contacts, sharing food, drinks or cigarettes, or prolonged close proximity."

Why would you share a drink or a bite of food with someone who is obviously sick? Unless you are dating or living in the same room with the person (such as a dorm or roommate situation) wouldn't this be a fairly difficult disease to catch? Even if you catch the bacteria, you may not get sick.

"Many people may carry the bacteria in their noses and throats, and they will not become ill -they are healthy carriers. These carriers can spread the germ to other

Even if you are not sick, you may carry the bacteria.

"Meningococcal disease is a rare but life threatening illness, caused by the bacterium (germ), Neisseria meningitidis. It is the leading cause of bacterial meningitis (an infection of the brain and spinal cord coverings) in children 2-18 years old in the United States. The most severe form of the disease is meningococcemia, infection of the bloodstream by this bacterium. It also causes serious infections of other normally sterile body sites (e.g., joints). These Infections may lead to death."

So, when someone is actually diagnosed with meningitis, what does that mean?

"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. ... [B]acterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability. ... Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly."

Bacterial meningitis can be fatal, but early treatment is the key to survival.

"Tuolumne County Public Health Officer Dr. Todd Stolp stressed that early medical treatment is effective, and antibiotics can protect people who have been in close
contact with an infected person. He said people need to be aware of the symptoms and seek immediate medical help if they get them."

In the past, some have recommended that high risk individuals be vaccinated. Others have required it:

"Effective June 1, 2000, Maryland law requires that an individual enrolled in an institution of higher education in Maryland who resides in on-campus student housing must be vaccinated against meningococcal disease."

Living in a small, enclosed environment; sharing food and drink; not getting enough sleep: college life is a recipe of risk factors. With some schools (even some states) asking students to get vaccinated, it was never public policy to recommend the vaccine to all those entering college.
Times have changed, and it is not just college students who will be affected.

"(Atlanta-AP, Feb. 11, 2005 6:42 AM) _ A government panel has recommended that all college freshmen who live in dorms receive a new meningitis vaccine that lasts years longer than the old one and prevents people from being carriers of the bacteria. The recommendation Thursday was an about-face from previous policy and was prompted largely by a new vaccine, Menactra, made by Sanofi Pasteur. ... The panel also is advising doctors to give the shot to all 11- to 12-year-old children and that it be provided to at least 4 million children eligible under the federal children's vaccines program. ... Because each dose is expected to cost about $100 and only 3,000 cases of meningococcal meningitis are reported each year, 'it won't save money,' said Mark Messonier, an economist with the CDC who helped develop a cost effectiveness study of the plan. 'It is a strategy that will save lives,' he said."

This is a deadly disease, but one that affects a small percentage of the population. Each year, roughly 3,000 cases of meningococcal meningitis are reported. Researchers, economists, doctors, patients, and parents of patients. are all involved. Researchers have found a better vaccine; economists have decided that the lives saved are worth the enormous price tag; doctors with offer (even recommend) the vaccine. The government is getting involved to recommend the vaccine; the insurance companies will likely be asked to help with the costs.

What will the patients, and the parents of patients decide to do?

Questions of the Week:
With the information you now have, why do you think your peers would (or would not) want the vaccine? Why do you think parents would (or would not) support this vaccine for their children? What else would you like to know about meningitis? Do you think your parents and peers need to know more about the disease? How should the schools get involved? For what reasons would schools require the students to get vaccinated for meningitis before they are allowed to begin the school year? For what reasons would schools not require (but possibly recommend) the vaccine? Who should be asked to pay for millions of doses offered at about $100 each? Where will that money come from?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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