Vaccination reduces risk of bacterial meningitis
July 19, 2014 at 2:19 a.m.
Bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss or learning disabilities.
Bacterial meningitis can be treated effectively with antibiotics, but it is important that treatment be started as soon as possible.
Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15 percent, although the risk remains higher among young infants and the elderly.
The most effective protection against certain types of bacterial meningitis is to complete the recommended vaccine schedule.
Symptoms of meningitis infection include sudden onset of fever, headache and stiff neck. Other symptoms might include nausea, vomiting, increased sensitivity to light and confusion.
The symptoms of bacterial meningitis can appear quickly or over several days. Typically, they develop within three to seven days after exposure.
Babies younger than 1 month old are at a higher risk for severe infections, like meningitis, than older children.
In newborns and infants, the classic meningitis symptoms might be absent or difficult to notice. The infant might be slow or inactive and irritable. Other symptoms might include a lack of alertness, vomiting or feeding poorly.
SOURCE: CENTERS FOR DISEASE CONTROL AND PREVENTION
Viral meningitis usually resolves without specific treatment. But it can be severe or fatal depending on the virus causing the infection, the person's age or whether a person has a weakened immune system.
Most viral meningitis cases in the United States, especially during the summer months, are caused by enteroviruses; however, only a small number of people with enterovirus infections actually develop meningitis.
Other viral infections that can lead to meningitis include mumps, measles, influenza and herpes viruses, including Epstein-Barr virus, herpes simplex viruses and varicella-zoster virus, which also causes chicken pox and shingles.
Viruses spread through fecal contamination, respiratory secretions, mosquitoes and other insects (arboviruses), and in rare cases, LCMV (lymphocytic choriomeningitis virus), which is spread by rodents.
Viral meningitis can affect anyone, but infants younger than 1 month old and people whose immune systems are weak are at higher risk for severe infection.
Viral meningitis occurs mostly in children younger than age 5.
Certain diseases and medications may weaken the immune system and increase risk of meningitis, such as chemotherapy and recent organ or bone marrow transplants.
SOURCE: CENTERS FOR DISEASE CONTROL AND PREVENTION
Viral meningitis is often milder and less deadly than bacterial meningitis.
However, the meningitis that claimed the life of Victoria's 13-year-old Alyssa Conchola in July was viral, not bacterial, said Dr. Bain Cate, director of the Victoria City-County Health Department.
Meningitis is the inflammation of the lining around the brain and spinal cord. Thousands of viruses and several bacteria cause meningitis, said Dr. Sidney Ontai, director of the residency program at DeTar Healthcare System.
"Viral meningitis is serious but rarely fatal in healthy people with normal immune systems," according to the Texas Department of State Health Services website. "Usually, symptoms last from seven to 10 days, and the patient recovers completely."
Young adults have an increased risk of contracting meningitis, especially those living in close quarters like dormitories or military barracks.
Teens and young adults are encouraged to get vaccinated for meningitis.
"Pediatricians know about the vaccines and recommend them," Ontai said. "Get the shots you're supposed to get."
Four meningococcal vaccines licensed by the U.S. Federal Drug Administration protect people from three-quarters of bacterial meningitis, Ontai said.
Children ages 11 to 12 should be vaccinated with a meningococcal conjugate vaccine - Menactra or Menveo, according to the Centers for Disease Control and Prevention website. A booster dose should be given at age 16.
For adolescents who receive the first dose between ages 13 and 15, a booster dose should be administered between ages 16 and 18, before the peak in increased risk, according to the CDC.
Adolescents who receive their first dose of meningococcal vaccine at or after age 16 do not need a booster dose, according to the CDC.
Hospitals must report meningitis caused by any amoeba, bacteria that lead to serious conditions such as meningococcal meningitis or an arbovirus, according to the Texas Department of State Health Services website. These are among many conditions listed on the department's notifiable conditions list.
Notifications were not made in Alyssa's case. Therefore, the virus that caused her meningitis did not endanger the public's health, Cate said.
"If the virus had been identified as West Nile Virus, they were supposed to have notified DSHS immediately," Cate said. "If the patient would have had meningococcal meningitis, that also would have required an immediate notification to DSHS."
The state health services department would have contacted the Victoria City-County Health Department immediately to evaluate and treat those who were in close contact with the patient, Cate said.
The bacteria that causes bacterial meningitis does not spread through casual contact or by breathing the air where someone with bacterial meningitis has been, said Chris Van Deusen, a spokesman for the Texas Department of State Health Services.
"It is spread by the exchange of saliva and mucous, generally by kissing," Van Deusen said. "People in the same household, roommates or anyone with direct contact with a patient's saliva or spit, such as a boyfriend or girlfriend, would be considered at increased risk of getting the infection."
No cases of meningococcal meningitis have been reported in Region 8 so far this year, Van Deusen said.
Region 8 is made up of 28 counties including Victoria, Calhoun, DeWitt, Lavaca, Goliad, Gonzales, Jackson and Karnes.
"The statewide average in the five years from 2006 to 2010 was 32 cases," he said.
Citizens Medical Center has treated one case of bacterial meningitis in the past five years, and the hospital treated it successfully, said Shannon Spree, hospital spokeswoman.
"In the early '80s, we were covered up with pediatric meningitis," Ontai said. "We don't get much bacterial meningitis now because the vaccines are so effective."
Alyssa spent a month in a coma at Driscoll Children's Hospital with her mother, Cathy Gomez, constantly by her side. She died in early July after her family made the decision to remove life support.
In a previous interview, Gomez said her daughter had meningococcal meningitis caused by bacteria, as did a Driscoll Children's Hospital spokesman July 9.
The hospital media representative retracted his original statement and invoked the Health Insurance Portability and Accountability Act to withhold further information about the diagnosis.
Numerous attempts to reach Gomez for a second interview were not successful.