Meningitis questions

Factual Questions
1

So, tomorrow afternoon, I’m (unfortunately) off to the doctors office for a physical (which I need to go to college), and a menengitis vaccination. THe college I’m attending requires either proof of vaccination or a waiver signed saying you understand the risks. I will turn 18 one freakin’ day after the deadline, and my parents refuse to sign the waiver. So, based mostly on my irrational desire to not have people stick needles in me and inject toxins of one variety or the other, I’ve been wondering:

  1. Why is menengitis such a big deal? As far as I know, it’s an infection of the spinal cord or something. I see why this is bad. However, I’ve been lead to believe that, what with having antibiotics and, you know, modern medicine in general, an infection like that is pretty easy to take care of.

  2. Is it a relatively new disease? I feel like all the sudden, in the past few years, college health folk have been like, “Menengitis! It will kill us all! Vaccines for everyone!” I know it wasn’t around/such an issue when my parents were going into college.

  3. Why is it such a problem (allegedly) at colleges? Two summers ago, I spent five weeks in the backwoods of Kentucky, camping in close quarters with 7 other people. FOr five years before that, I spent three summers a week with others in a college dorm for a summer program. For none of these did I need the meningitis vaccine, and the situation was pretty similar - in Kentucky, without the benefit of indoor plumbing and whatnot, and I know my dorm will have that amenty at least.

2

34 years ago, when I was 7, I had spinal menengitis. It required a spinal tap. They stick a needle into your spine and draw out the fluid. I had to be tied down and three or four nurses had to help keep me still. My mother says that they heard me screaming up and down the hall until it was over. It is the most pain I have ever felt in my life and it is the most vivid childhood memory I have. Get the shot!!!

3

Meningitis is so dangerous because it:

a) infects the meninges (tissues that surround and protect the brain) and cerebrospinal fluid, and causes swelling around the brain and spinal cord as well as seizures if left untreated, and can paralyze you or lead to other permanent nerve damage.

b) does not always respond to antibiotics. 15% of meningitis patients die from it. This mostly includes infants and elderly people, but it can kill young people as well. Earlier this year I diagnosed a case that ended up killing a 15-year-old girl.

c) is spread in close quarters, like college dorms, fairly easily. It’s spread by infected droplets when you kiss, sneeze, or share utensils with someone who’s carrying the bacteria. Many people harbor it in their normal throat microflora, but when you’re in college, you tend to not eat and sleep as well as you normally would, and when you wear yourself down it’s easier for you to develop symptoms.

The meningococcal vaccine protects against all major serotypes of Neisseria meningitidis except the B serotype. As long as no one in your family has a history of bad reactions to the vaccine, please get it.

You can get more info here:

http://www.cdc.gov/ncidod/diseases/submenus/sub_meningitis.htm

… or e-mail me. I diagnose bacterial meningitis for the State of Michigan Microbiology lab, so I do sorta know what I’m talking about. :slight_smile:

4

That’s kind of bizarre. While college freshmen living in dorms have a slightly increased risk of meningococcal disease, it’s usually just offered, not required. On the other hand, of the 2600 people each year who get it in the U.S., 10-15% die, and another 10% lose body parts, body functions, or suffer other serious side effects – despite the availability of antibiotics. It’s not like they’re blowing smoke.

5

A little information for you… Meningococcal Meningitis

From healthscout.com

And dorms are notorious for meningitis outbreaks. One of the major universities in my state had an outbreak in the early 90s. It wasn’t pretty - many kids were very ill and some died. A man in my church is deaf now because he lived in the dorm then.

It’s just a shot.

6

About meningitis.

More about meningitis.

Even more about meningitis.

  1. It’s not just “an infection”: it’s rampant bacterial or viral growth in your spinal fluid, where it is very, very hard for the doctors to get at it and get rid of it.

Why is it such a big deal? Well, (A) because people do die from it, basically. Do a Google search for “meningitis death”. According to the Medline cite, there’s a 5% to 15% mortality rate.

(B) because it’s more insidious than, say, cholera, because in the first stages of the disease, it can just feel like a really, really bad headache, or the flu, and by the time they figure out that you’ve got more than just a really, really bad headache or the flu, and that you need antibiotics, you’re in Intensive Care on a respirator and they’re desperately trying to locate your parents.

(C) it moves really, really fast, human spinal fluid being nearly ideal growth medium for bacteria. You don’t have, like, days before you decide, “Oh. I’m sick. I should probably go to a doctor” like you do with a middle-ear infection. You sometimes have more like hours between the time you decide you have the flu and you skip class and go back to bed, and the time you’re found, comatose, on your dorm bed and the RA calls 911.

(D) even if you don’t die from it directly, the complications can leave you permanently brain damaged, or in a coma.

Modern Medicine can’t fix everything, and meningitis happens to be one of the things that isn’t an automatic no-brainer “oh, gee, just give her some antibiotics and send her home” fix.

  1. No, I don’t think it’s a “new” disease as such, it’s just that Modern Medicine has progressed to the point of more awareness of it before it kills you and they do an autopsy and find tons of bacteria or virii in your spinal fluid and they go, “Oh. She had meningitis.”

  2. It is indeed a Very Big Deal for college dorms, because some forms of it are contagious. Athlete’s foot is also a Very Big Deal for college dorms, but you don’t generally die of athlete’s foot.

Get the vaccination as soon as you turn 18. Do your folks a favor. :smiley:

Your college will understand why it’s after the deadline if you explain the problem to them. They would really rather have you get vaccinated late than have you be a potential meningitis victim.

7

Modern plumbing won’t protect you from meningitis. If it did, then nobody living in American college dorms would get it. It’s not spread on privy seats. :wink:

8

I’d just like to add that not everything clears up with a round of antibiotics…

also more and more diseases are becoming resistant to antibiotics…

Much easier if you just don’t get sick!

9

Sadly, it’s not unusual for someone with a bad case of bacterial meningitis to lose fingers, toes, hands, feet, or even entire limbs. NOVA had a fascinating documentary on it a while back that would have you pounding on the door to get the vaccine.

It can be very very difficult to treat, and even with treatment, the aforementioned amputations are a very real possibility. As has been said, by the time a patient decides to go to the hospital, it’s often too late.

As for why it’s been such a big deal lately, well, it’s only within the last couple of decades that it’s spread to become a major threat to young people. It used to attack mainly the elderly and infants. It’s still not terribly clear why it’s shifted to the young and healthy. It’s also quite contagious.

10

I think she means that she either has to have her parents sign the waiver (which they won’t) or get the vaccination as she can’t sign it herself until she is 18 and that happens the day after the deadline.

I say get the shot, a couple years back up here they were vaccinating all the young people because we were going through an outbreak. I think about 5 people died before it finally stopped at least one of them was a teenager who was fine one day, dead the next. It’s VERY bad and it masks itself as the flu so you may think you’re fine and will recover but you just might not.

All it is is a quick bit of discomfort vs the possibility of death or at the least being extremely ill.

I even got it, though it was entirely voluntary.

11

Okay it seems I was off according to this it was more like 3 who died and it doesn’t give details but I’m pretty sure I’m right about the teen and there were a lot more who were infected.

This info includes a section specifically about college/university students.

12

Meningitis can be famously difficult to diagnose and treat. Certain strains are rapidly fatal, and it kills many people each year. It is very serious and can hardly be compared to a bladder or throat infection. Modern medicine does have a solution for meningitis, and that is for people in high-risk close quarters to get the vaccination – the fact that children are vaccinated for Hib has saved many thousands of lives.

Dr_P. Chief Emergency Medicine

13

my 6 year old son just recovered from viral meningitis last month. i’ve never seen him sicker. he could have a temp of 104 and would still run around. with this, he wouldn’t even sit up.

had to go to the emergency room and they spinal tapped him (he didn’t even flinch!) the next night, his back was swollen such that where it normal arches, it bowed. back to the emergency room. he was walking like an old man, with his hand on his lower back and hunched over.

i don’t recommend it. i am just thankful it was viral, which is less deadly and less contageous. it could’ve been much worse.

14

True story from my residency days:

15 month old, previously healthy male infant, right on track developmentally, wakes up one morning with a slight fever. Mom gives him some Tylenol, leaves him in the care of his father, and goes to work, since he doesn’t seem very sick (just a little cold). Over the next several hours, the father notices his son is becoming fussier and his fever’s a bit higher, so he finally calls his wife and asks her to come home. When she gets home, she agrees they should probably take the boy in to a doctor as soon as possible. They bundle their little boy up and set off for the ER, since it’s late afternoon and their regular doctor’s office is now closed.

During the 20 minute drive to the ER, the child becomes increasingly lethargic, and Mom notices that he’s beginning to develop small purple sots on his arms and legs. Byt the time the family arrives at the ER, the kid is unresponsive, the small purple spots are becoming large purple blotches, and his fever is soaring. The ER staff takes one look at him and knows this is meningcoccemia - they IMMEDIATELY dose him with the appropriate antibiotic, start fluid resuscitation, and call for my university hospital’s helicopter to transport the boy to our pediatric ICU. Despite the immediate apropriate care and the transfer to our ICU with its sophisticated supportive technology, the child is dead by the following morning. I’ll never forget performing that autopsy - the poor kid’s entire body was bloated and purple, and he’d bled into all his major organs (because the infection messed up his blood’s ability to clot normally). This poor baby went from toddling around and speaking his first words to dead in less than 24 hours, despite the best care medical science could offer.

Meningococcus is a killer. Get the vaccine.

15

What vaccine are you talking about - I thought they(?) were still developing one? Possibly in Australia?
This is a huge problem in the low socioeconomic areas of our biggest city - it is fairly common to have Pacific island families live around 10 people to a 3 bedroom house. We have posters up everywhere telling people what the symptoms are. Quite regularly we see cases in the news - babies with the purple blotches all over them etc.

16

I have two questions for the experts, one more related ot the OP than the other :wink:

  1. First question is a three part question. As some of you have mentioned, and as I have heard, some people carry the bacteria around in their throats where it is harmless until it manages to get under the skin through a wound, or a weakened immune system. First part of the question is: Is it MOST people, SOME people, or ALL people have this? And also, is there a way to determine if you carry it? Lastly, I’m a 27 year old woman, with no plans on moving to a dorm, is the vaccine recommended for someone like me? Is it recommended to one and all?

  2. More of a general question on vaccines: It’s been a while since I’ve had any booster shots, and my mother (all the way in Germany) really doesn’t have any paperwork on the type of vaccines I’ve gotten when I was younger. Therefore I’m planning to go to the doctor’s office sometime withint the next few months to get the works :slight_smile: What vaccines should I have done on me? Are there any that my doctor might overlook?

17

Is there a way to determine if you have meningitis before it becomes fatal?

18

I had viral meningitis last fall–now this is nowhere near as serious as bacterial meningitis; it won’t kill you. In fact many people come in contact with the viral form without coming down with the horrible symptoms. But if you do get the typical symptoms you may wish it kills you. So if bacterial meningitis is anything like the viral in terms of how a body feels, it’s worth the vaccine, even though the vaccine is expensive. I’m talking from a sheer misery perspective, not even the very real risk to life and limb.

I felt horrible. HORRIBLE. I thought I had a brain tumor. The headache wouldn’t go away for days, despite three kinds of painkillers. When it really flared, there was no relief from the dizziness and pounding.

19

So is the vaccine for viral not bacterial?

20

Just some people, not everyone. And it comes and goes; those people who do have it aren’t generally permanent carriers.

Nasopharyngeal cultures (the organism is a bit fastidious, though, so it won’t grow out and be detected on the ordinary throat culture medium; you have to plate the culture out on special plates).

The vaccine is recommended for people living in crowded communal living situations, such as dorms and military barracks - those are the settings where the group C meningococcus serotype (the one the vaccine targets) spreads readily, and for people who’ve lost their spleen or who are immunocompromised. For immunocompetent people not living in a dorm-like setting, the vaccine is not recommended.

You can learn more about meningococcal disease and the meningococcus vaccine at the CDC website. (The section on meningococcal diseases is halfway down the page.)

This is hard to answer without knowing more about your health history. In general, these are the important ones for adults:

Measles, mumps, rubella (MMR) - if you don’t have a childhood history of these illnesses

Diphtheria/tetanus

Polio

Chicken pox - if you’ve not had the disease as a kid

Hepatitis B - if you have risk factors for this illness (such as working in the healthh care field where you’re exposed to other people’s body fluids)

If you have chronic health problems, are immunosuppressed, or have had a splenectomy, the pneumococcal vaccine is worth considering; if not, this one can wait until you’re over 65.

In late fall, strongly consider getting the influenza vaccine.

Here’s the CDC’s recommendations on adult vaccinations.