|
Meningococcal Disease
Frequently Asked Questions
What
is meningitis?
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. Knowing whether meningitis is caused by a
virus or bacterium is important because the severity of
illness and the treatment differ. Viral meningitis is
generally less severe and resolves without specific
treatment, while bacterial meningitis can be quite
severe and may result in brain damage, hearing loss, or
learning disability. For bacterial meningitis, it is
also important to know which type of bacteria is causing
the meningitis because antibiotics can prevent some
types from spreading and infecting other people. Before
the 1990s, Haemophilus influenzae type b (Hib)
was the leading cause of bacterial meningitis, but new
vaccines being given to all children as part of their
routine immunizations have reduced the occurrence of
invasive disease due to H. influenzae. Today,
Streptococcus pneumoniae and Neisseria
meningitidis are the leading causes of bacterial
meningitis.
Back to Top
What are the signs and symptoms of meningitis?
High fever, headache, and stiff neck are common
symptoms of meningitis in anyone over the age of 2
years. These symptoms can develop over several hours, or
they may take 1 to 2 days. Other symptoms may include
nausea, vomiting, discomfort looking into bright lights,
confusion, and sleepiness. In newborns and small
infants, the classic symptoms of fever, headache, and
neck stiffness may be absent or difficult to detect, and
the infant may only appear slow or inactive, or be
irritable, have vomiting, or be feeding poorly. As the
disease progresses, patients of any age may have
seizures.
Back to Top
How is meningitis
diagnosed?
Early diagnosis and treatment are very important. If
symptoms occur, the patient should see a doctor
immediately. The diagnosis is usually made by growing
bacteria from a sample of spinal fluid. The spinal fluid
is obtained by performing a spinal tap, in which a
needle is inserted into an area in the lower back where
fluid in the spinal canal is readily accessible.
Identification of the type of bacteria responsible is
important for selection of correct antibiotics.
Back to Top
Can meningitis be
treated?
Bacterial meningitis can be treated with a number of
effective antibiotics. It is important, however, that
treatment be started early in the course of the disease.
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.
Back to Top
Is meningitis
contagious?
Yes, some forms of bacterial meningitis are
contagious. The bacteria are spread through the exchange
of respiratory and throat secretions (i.e., coughing,
kissing). Fortunately, none of the bacteria that cause
meningitis are as contagious as things like the common
cold or the flu, and they are not spread by casual
contact or by simply breathing the air where a person
with meningitis has been.
However, sometimes the bacteria that cause meningitis
have spread to other people who have had close or
prolonged contact with a patient with meningitis caused
by Neisseria meningitidis (also called
meningococcal meningitis) or Hib. People in the same
household or day-care center, or anyone with direct
contact with a patient's oral secretions (such as a
boyfriend or girlfriend) would be considered at
increased risk of acquiring the infection. People who
qualify as close contacts of a person with meningitis
caused by N. meningitidis should receive
antibiotics to prevent them from getting the disease.
Antibiotics for contacts of a person with Hib meningitis
disease are no longer recommended if all contacts 4
years of age or younger are fully vaccinated against Hib
disease (see below).
Back to Top
Are
there vaccines against meningitis?
Yes, there are vaccines against Hib, against some
serogroups of N. meningitidis and many types of
Streptococcus pneumoniae. The vaccines against
Hib are very safe and highly effective.
There are two vaccines against N. meningitidis
available in the U.S. Meningococcal polysaccharide
vaccine (MPSV4 or Menomune®) has been
approved by the Food and Drug Administration (FDA) and
available since 1981. Meningococcal conjugate vaccine
(MCV4 or Menactra™) was licensed in 2005. Both vaccines
can prevent 4 types of meningococcal disease, including
2 of the 3 types most common in the U.S. (serogroup C,
Y, and W-135) and a type that causes epidemics in Africa
(serogroup A). Meningococcal vaccines cannot prevent all
types of the disease. But they do protect many people
who might become sick if they didn't get the vaccine.
Meningitis cases should be reported to state or local
health departments to assure follow-up of close contacts
and recognize outbreaks.
MCV4 is recommended for all children at their routine
preadolescent visit (11 to 12 years of age). For those
who have never gotten MCV4 previously, a dose is
recommended at high school entry. Other adolescents who
want to decrease their risk of meningococcal disease can
also get the vaccine. Other people at increased risk for
whom routine vaccination is recommended are college
freshmen living in dormitories, microbiologists who are
routinely exposed to meningococcal bacteria, U.S.
military recruits, anyone who has a damaged spleen or
whose spleen has been removed; anyone who has terminal
complement component deficiency (an immune system
disorder), anyone who is traveling to the countries
which have an outbreak of meningococcal disease, and
those who might have been exposed to meningitis during
an outbreak. MCV4 is the preferred vaccine for people 11
to 55 years of age in these risk groups, but MPSV4 can
be used if MCV4 is not available. MPSV4 should be used
for children 2 to 10 years old, and adults over 55, who
are at risk.
Although large epidemics of meningococcal meningitis
do not occur in the United States, some countries
experience large, periodic epidemics. Overseas travelers
should check to see if meningococcal vaccine is
recommended for their destination. Travelers should
receive the vaccine at least 1 week before departure, if
possible. Information on areas for which meningococcal
vaccine is recommended can be obtained by calling the
Centers for Disease Control and Prevention at
(404)-332-4565.
There are vaccines to prevent meningitis due to
S. pneumoniae (also called pneumococcal
meningitis) which can also prevent other forms of
infection due to S. pneumoniae. The
pneumococcal polysaccharide vaccine is recommended for
all persons over 65 years of age and younger persons at
least 2 years old with certain chronic medical problems.
There is a newly licensed vaccine (pneumococcal
conjugate vaccine) that appears to be effective in
infants for the prevention of pneumococcal infections
and is routinely recommended for all children greater
than 2 years of age.
Back to Top | 
