The Dangers of Meningitis Can Be Prevented
By Megy Karydes
Kaitie Mayberry Hauser wasn’t overly concerned when she felt a migraine coming on while in college in 1996. She crawled into her bed, turned off the lights and planned to sleep it off.
She woke up a few hours later, hardly able to get out of bed. With weak legs, she crawled her way to the bathroom down the hall, barely making it before she got sick and lost control of her bodily functions. “That’s when I felt everything change,” she says. “I could feel the fear of my roommate as she assured me it would be OK. I knew she didn’t believe that, and neither did I.”
Hauser, who now lives in Warrenville, wasn’t suffering from a migraine. She had contracted bacterial meningitis, and without a proper diagnosis and fast-acting medical assistance, the disease could have proven fatal within hours.
What exactly is meningitis?
Meningococcal meningitis is caused when the protective membranes around the brain and spinal cord become infected. Each year 2,600 people in the United States contract meningitis, a highly contagious disease, according to the National Institute of Neurological Disorders and Stroke. Between 10 and 15 percent of cases are fatal, with another 10 to 15 percent causing brain damage and other serious side effects such as limb damage or hearing loss.
“Meningitis may not be easy to diagnose because often initially the symptoms are not very specific and can be mistaken for flu.” says Tina Tan, MD, a pediatrics-infectious diseases physician at Ann & Robert H. Lurie Children’s Hospital of Chicago, and professor of pediatrics at Northwestern University Feinberg School of Medicine.
“It depends on the age of the patient, but classically, when people think of meningitis, it’s a person who develops high fevers, the worst headache of their life, usually a stiff neck, some nausea or vomiting, sometimes seizures depending upon the person, and usually muscle aches or, depending on type of meningitis, hands and feet being kind of tingly and cold,” Tan says.
Meningitis has many different causes, says Allison Bartlett, MD, MS, pediatric infectious disease specialist at the University of Chicago Medicine. “The term ‘meningitis’ means inflammation of the lining of the brain [the meninges],” she explains. “It can be caused by bacterial infections, viral infections, fungal infections and noninfectious causes such as chemical irritation.”
“There are five common strains of meningococcus that cause the vast majority of disease,” Bartlett says. “However, when people refer to ‘bacterial meningitis’ in an otherwise healthy young person, they are referring to meningococcal meningitis” caused by the bacterium Neisseria meningitidis.
Meningococcal infections most often occur in children younger than 2 years old, with infants younger than 1 year old being at highest risk.
“There is another peak of infections in adolescents (16–21 years old), where it can occur in outbreaks in settings such as dorms or military barracks, where young adults live in close quarters,” Bartlett says. “However, most cases (95 percent) are not associated with outbreaks.”
The bacterium that causes meningococcal meningitis is spread from person to person through droplets from the respiratory tract, Bartlett says. “The droplets cannot travel very far through the air, so close contact is needed for the germ to spread,” she adds.
People who live in the same house or dorm room, or those who have come in direct contact with a patient’s secretions through kissing, shared toothbrushes or eating utensils, are considered close contacts, she says.
Vaccination is key
Hauser’s mother, Doogie Mayberry of Geneva, says she and her husband sent their daughter off to college with up-to-date vaccinations including all required by the school. “We had never heard of bacterial meningitis, nor did our doctor tell us about a vaccine that could prevent it,” she says. “We have five children. All of them went to college without this vaccine.”
Many health organizations, including the American Academy of Pediatrics (AAP), now recommend vaccination as the best protection against the infection. In 2014, the AAP recommended that all adolescents be routinely immunized at 11 to 12 years of age and given a booster dose at 16. The Illinois Department of Public Health now requires that students receive the meningococcal vaccine prior to beginning 6th and 12th grades.
According to Tan, some day care centers and schools are requiring that children get vaccinated before they begin kindergarten. Adults can also get immunized with pneumococcal and meningococcal vaccines and can ask their primary care physician for details.
Hauser is grateful she’s still alive, thanks to hospital personnel who quickly identified that she had meningococcal meningitis. She is now a vaccine advocate and a T.E.A.M. (Together Educating about Meningitis) member with the National Meningitis Association. In her role, she tells her story to educate others on the signs and symptoms of this deadly yet vaccine-preventable disease.
Meningitis does not discriminate based on age, race or religion, Hauser says.
“From newborn babies to those in their elder years, every person is at risk for this disease and the potential [for] carrying it,” she says, adding that education and vaccination are the only ways to end this disease. “It is the only way to protect yourself and those that you love. If it does not take your life, it will take you little by little, limb by limb, until there is not much left. Educate and vaccinate.”
Meningitis Quick Questions
Provided by Henry “Elie” Schwartz, MD, Schwartz Pediatrics
Who is at risk for meningitis?
Those at an increased risk for meningitis include people with incomplete immunizations, recent exposure to someone with meningitis, penetrating head trauma, cochlear ear devices and certain medical conditions and immunodeficiencies.
Are there any long-term effects of meningitis?
Younger children who have bacterial meningitis are at risk for developmental delays and hearing problems. Most patients with viral meningitis recover completely without long-term complications.
How is meningitis treated?
Bacterial meningitis needs to be treated with antibiotics. Viral meningitis is treated with supportive care consisting of pain medicines to control headaches, rest in a dimly lit room and hydration.
Is there anything I can do to prevent my child from getting meningitis?
The most important thing you can do is to vaccinate them. There currently are three vaccines that prevent the most common types of bacterial meningitis. For younger children, these include the Haemophilus influenzae type b (Hib) and pneumococcal disease (PCV13) vaccines, which are routinely given at 2, 4 and 6 months old with a booster at 12 to 15 months. The meningococcal disease (MCV4) vaccine is given at 11 years old with a booster after the age of 16. The MCV4 vaccine protects against four of the five most common types of meningococcal disease but does not, however, protect against type B, a leading type of meningitis. Fortunately, there is now a Serogroup B meningococcal (MenB) vaccine, which protects specifically against type B. Although this vaccine is now available, it is not yet considered to be part of the routine immunization schedule. Ask your physician for more information.
What should I do if I am exposed to someone with bacterial meningitis?
Alert your doctor if you or your child are exposed to someone with bacterial meningitis. Antibiotics may be prescribed for those persons in close contact with people who have certain types of meningitis to prevent disease and stop the spread of infection.
What defines close contact?
Close contact is defined as having prolonged contact (greater than eight hours) in close proximity (less than three feet) to the patient or being directly exposed to the patient’s oral secretions. These include household members, intimate contacts (kissing or sharing toothbrushes, eating utensils and water bottles), contacts at a childcare center, students exposed in dormitories and military recruits.
If I was exposed to meningitis, how soon afterward must I get on antibiotics?
It is best to receive antibiotics within the first 24 hours of exposure to prevent disease. If the first 24 hours is not possible, you should not wait more than two weeks to get on antibiotics.
Do I have to take special precautions after I have received antibiotics for meningitis exposure?
No. College students in affected dormitories do not need to leave school. Military recruits do not need to return home. Parents can still care for their children. Those in close contact need to speak with their physician immediately in case they develop symptoms suggestive of meningitis.
Originally published in the Spring 2016 print edition.
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