Meningitis is an inflammation of the lining of the brain and spinal cord caused by either a virus or bacteria.
Viral Meningitis is more common than bacterial meningitis and usually occurs in late spring and summer. Signs and symptoms of viral meningitis may include stiff neck, headache, nausea, vomiting and rash. Most cases of viral meningitis run a short, uneventful course. Since the causative agent is a virus, antibiotics are not effective. Persons who have had contact with an individual with viral meningitis do not require any treatment.
Bacterial Meningitis occurs rarely and sporadically throughout the year, although outbreaks tend to occur in late winter and early spring and may be caused by one of many different types of bacteria. Bacterial meningitis in college students may be due to an organism called meningococcal bacteria or Neisseria Meningitides. Because meningococcal meningitis can cause grave illness and rapidly progress to death, it requires early diagnosis and treatment. Persons who have had intimate contact with someone who has been diagnosed with meningococcal meningitis should seek medical attention so that they may get prophylactic therapy, which is a course of antibiotics. Untreated meningococcal meningitis can be fatal.
Neisseria Meningitidis is a bacterium that may be found throughout the community. About 5-20% of people carry these bacteria in their noses and throats and do not get sick from them. These people are called "carriers." In rare cases the bacteria may get into the blood or tissue surrounding the spine and brain and cause severe illness - meningitis or meningococcemia.
How is meningitis spread?
Many of the viruses that cause meningitis are spread through saliva or feces. Bacteria are spread from person to person through saliva (spit). Most people may already have immunity (natural protection) from many of these germs. You must be in close contact with a person's saliva in order for the bacteria to spread. Close contact includes activities such as kissing, sneezing or coughing on someone, sharing water bottles, lipsticks, mouthpieces on musical instruments, sharing eating/drinking utensils or sharing cigarettes with someone who is sick.
Most of the germs that cause meningitis can spread from person to person, but they will not cause the disease just by getting into the throat. Classmates and co-workers are not normally considered to be at high risk for getting bacterial meningitis, unless they have special, close contact with a person who is sick from bacterial meningitis. Recent studies, however, show an increased risk for college freshmen living in residence halls.
College Students and Meningitis Risk
Research has shown that students residing on college campuses in residence halls appear to be at higher risk for meningococcal disease than college students overall. The Center for Disease Control (CDC) reports freshmen living in dormitories are six times more likely to contract meningococcal disease than college students overall.
Although anyone can come in contact with the bacteria that causes meningococcal disease, data also indicates that certain social behavior, such as exposure to passive and active smoking, bar patronage and excessive alcohol consumption may put students at increased risk for the disease. Students with respiratory infections, compromised immunity, those in close contact to a known case and travelers to endemic areas of the world are also at increased risk. Cases and outbreaks usually occur in the late winter and early spring when school is in session.
How is meningococcal disease diagnosed?
People showing signs and symptoms of illnesses are diagnosed by culturing their spinal fluid (meningitis) or blood (meningococcemia). Results may take up to 72 hours, however, sometimes a doctor can make an earlier diagnosis by looking at spinal fluid under a microscope.
ANYONE SUFFERING FROM THE FOLLOWING SYMPTOMS SHOULD SEEK IMMEDIATE MEDICAL ATTENTION:
Meningococcal Meningitis - Sudden onset of high fever, stiff neck or neck pain, headache, nausea, vomiting, and/or mental confusion, changes in behavior, such as confusion, sleepiness and being hard to wake up, are important symptoms of this illness. A rash may appear, often involving the palms of the hands and soles of the feet. In babies, the only signs of illness may be appearing more tired than usual, acting more irritable than usual and eating less than usual. Babies with meningitis will usually have a fever, but this is not a reliable sign of illness.
Meningococcemia (bacterial infection in the blood) - Sudden onset of fever, chills and feeling unusually weak or tired may be indications. A rash may be present, often involving the palms of the hands and soles of the feet.
How are these illnesses treated?
Antibiotics are used to treat people with both the meningococcal meningitis and meningococcemia. People who have come in close contact with the sick person any time during the two weeks before s/he became ill may also need to take antibiotics. Preventive treatments of all close contacts should be implemented up to two weeks after onset of the first case, but preferably as soon as possible within the first 24 hours. Close contacts of a sick person who has meningococcal disease may need antibiotics because the bacteria may spread from the sick person to other people through contact with the saliva (spit) of the sick person. The antibiotics will kill the bacteria and prevent illness.
What should I do if I have had a close contact with a person who has a meningococcal illness?
If you have had a close contact with a person who has been diagnosed with a meningococcal illness, you should call your health care provider and get an antibiotic. If you have had contact with an ill person, but have not had close contact, you should be aware of the symptoms of illness and contact your doctor immediately if you have any of these symptoms.
Meningitis can be caused by different organisms, including other bacteria and viruses, therefore only certain types of meningitis require treatment of the sick person's close contacts.
If you have questions about meningitis or your exposure to a sick person, contact your doctor.
- Avoid contact with the nasal or oral secretions of others
- Wash your hands frequently
- Get lots of sleep, exercise and good nutrition, which will boost your immune system
- If you drink alcohol, do so responsibly and in moderation. Excessive alcohol consumption is believed by some health authorities to increase susceptibility to meningococcal meningitis.
- Do not smoke
Is there a vaccine that prevents these illnesses?
There are now two vaccines to protect against meningococcal disease. Both vaccines have been shown to provide protection against the most common strains of the disease. The vaccines have few side effects and those that occur are usually mild, consisting primarily of redness and pain at the site of the injection.
How long does the vaccine last?
The duration of the meningococcal vaccine - Menomune's efficacy - is approximately three to five years. Menaetra is the newest vaccine, so we do not have long term studies to demonstrate its effectiveness, but it is believed it will provide longer protection, at least five to ten years.
Who should be vaccinated?
As of October 20, 1999, the Advisory Committe on Immunization Practices (ACIP) of the CDC recommends that college freshmen, particularly those who live or plan to live in dormitories or residence halls, should consider the benefits of vaccination with their health care provider. ACIP further recommends that immunization should be made easily available to those who wish to reduce their risk for meningococcal disease. Other undergraduate students wishing to reduce their risk for meningococcal disease can also choose to be vaccinated.
Is the vaccine available on campus?
As of August 2005, the Massachusetts Department of Public Health has mandated that all new college students receive one of the Meningococcal vaccines, or sign the Department of Public Health's waiver form. This waiver form is not available online and cannot be signed electronically.
The University will offer the meningitis vaccine on campus at the end of each Orientation session. Students will be able to receive a vaccine that can provide protection against four of the five most common strains of meningococcal disease, which together account for nearly 70% of meningococcal cases on college campuses. This program will be sponsored by University of Massachusetts Lowell Health Services, which is working with VACCESSHealth, a company that specializes in direct access immunization programs.
As part of this access program, parents of undergraduates will receive a letter explaining why college students are at increased risk of contracting bacterial meningitis and details on the safety and effectiveness of the vaccine. In addition, a list of frequently asked questions will be included with the mailing along with information on where and when the access program will take place. Students will also be made aware of the program through a comprehensive educational campaign on campus.
The fee for the immunization is $85.00 and must be ordered in advance and be paid by cash, check or money order. No credit cards will be accepted. A receipt will be provided for possible insurance reimbursement.
For more information, contact:
- Student Health Services, McGauvran Student Center, Rm 335 978-934-4991
- Your family doctor
- Your local Board of Health (Listed in the telephone book under local Government)
- Massachusetts Department of Public Health Epidemiology Program 617-983-6800