453.36
MENINGITIS – MENINGOCOCCAL DISEASE
Meningitis is an infection and resulting inflammation of the meninges, the membranes
that surround the brain and spinal cord.
Meningitis is most commonly caused by bacteria or viruses though it may also be caused
by a fungal infection, a reaction to certain medications or medical treatments, an
inflammatory disease such as lupus, some types of cancer, or a traumatic injury to the
head or spine.
Knowing whether or not the infection is caused by a virus or bacteria is important
because the severity of the illness and treatment differ depending on what type of
meningitis an individual has.
A. Bacterial meningitis is a rare but sometimes fatal disease. Bacterial meningitis is
commonly caused by three bacteria:
1. Pneumococcal meningitis is the most common form of meningitis and the most
serious form of bacterial meningitis. Six thousand cases of pneumococcal
meningitis are reported in the U.S. annually. The disease is caused by the
bacterium Streptococcus penumoniae which also causes pneumonia, blood
poisoning, and ear and sinus infections. Children under age 2 and adults with
weakened or depressed immune systems are at higher risk than others.
Aftereffects include neurological problems ranging from deafness to severe brain
damage.
2. Meningococcal meningitis, caused by the bacterium, Neisseria menigitides,
affects about 2,600 individuals a year and is common among children ages 2 - 18.
Ten to fifteen percent of cases are fatal with another 10-15 percent experiencing
brain damage or other serious side effects. High risk groups include infants under
age 1, people with suppressed immune systems, travelers to foreign countries
where the disease is endemic, and college students, especially freshmen, who live
in dormitories.
3. Haemophilus meningitis caused by the haemophilus influenzae bacteriaum (Hib)
Until introduction of Hib vaccines into routine childhood immunization programs
in the 1990s, Hib disease, mainly meningitis and pneumonia in young children,
was a significant public health concern in developed as well as developing
countries. Since introduction of the Hib vaccines, the Hib-related meningitis has
largely disappeared from the United States.
B. Viral or aseptic meningitis is the most common form of meningitis in the U.S. It is
rarely fatal in individuals with a healthy immune system. It is frequently not
diagnosed because it is thought to be the flu. It is usually caused by enteroviruses –
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viruses that enter the body through the mouth and travel to the brain and surrounding
tissues. Enteroviruses are present in mucus, saliva, and feces and can be transmitted
through direct contact with an infected person or infected object or surface.
Individuals infected with viral meningitis usually recover without specific treatment
within 7 to 10 days
C. Signs and symptoms
1. Hallmark signs of meningitis are sudden fever, severe headache, and a stiff neck.
In more severe cases, neurological symptoms may include nausea and vomiting,
confusion and disorientation, drowsiness, sensitivity to bright light, and poor
appetite.
2. Meningitis often appears with flu-like symptoms that develop over 1-2 days.
3. In newborns and infants, typical symptoms of fever, headache, and neck stiffness
may be hard to detect. Other signs in babies might be inactivity, irritability,
vomiting, and poor feeding.
4. Since the symptoms of viral and bacterial meningitis are often similar, persons
who believe they have been exposed should seek medical help as soon as
possible.
D. Diagnosis
Early diagnosis and treatment are important. If symptoms occur, the patient should
see a doctor immediately. Bacterial meningitis can be treated with a number of
effective antibiotics but treatment must start early.
The diagnosis of bacterial meningitis is usually made by growing bacteria from a
sample of spinal fluid. The spinal fluid is obtained by a spinal tap. A doctor inserts a
needle into the lower back and removes some fluid from the spinal canal.
Identification of the type of bacteria responsible for the meningitis is important for
the selection of correct antibiotic treatment
E. Treatment
Viral meningitis has no specific treatment at this time. Most patients recover on their
own. Physicians may recommend bed rest, plenty of fluids, and medicine to relieve
fever and headache. Persons with severe viral meningitis may be hospitalized for
supportive care. The physician may prescribe anticonvulsants such as dilantin or
phenytoin to prevent seizures and corticosteroids to reduce brain inflammation. If
inflammation is severe, pain medicine and sedatives may be prescribed to make the
patient more comfortable.
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Bacterial meningitis: strong doses of general antibiotics may be prescribed first,
followed by intravenous antibiotics in more severe cases.
F. Prevention
1. Good personal hygiene reduces the risk of getting the disease from an infected
person. Avoid sharing food, utensils, glasses and other objects with a person who
may have or been exposed to the infection.
2. Wash hands often with soap and rinse under running water.
3. People who live, work, or go to school with someone who has been diagnosed
with bacterial meningitis may be asked to take antibiotics for a few days as a
preventive measure.
4. Several vaccines protect against bacterial meningitis but their effectiveness varies
depending on the type of bacteria.
a.
Vaccines against Hib are considered safe and effective. By six months of
age an infant should have received three doses of the Hib vaccine. A
fourth dose (booster) should be given to children 12 to 18 years of age.
b.
The vaccine against meningococcal meningitis (Neisseria menigitides) is
ineffective on children under the age of two but considered safe as well as
effective against most causes of meningococcal disease in older children
and adolescents. The Advisory Committee on Immunization Practices and
the American Academy of Pediatrics recommend that students entering
college, especially those who will be living in dormitories be informed
about the risks of meningococcal disease and the possible benefits of
vaccination. New vaccines are also under development.
c.
Vaccines against Streptococcus pneumoniae are ineffective against
children under the age of two but is recommended for all persons over 65
and younger persons with certain medical conditions.
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For additional information contact the following sources:
Meningococcal disease and vaccine information sheet
www.health.state.ny.us/nysdoh/immun/meningococcal/fact_sheet.htm
The Centers for Disease Control and Prevention:
www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm
The National Meningitis Association:
www.nmaus.org
Wisconsin Department of Health and Social Services
www.wisconsin.gov
http://dhfs.wisconsin.gov/communicable/Communicable/factsheets/PDFfactsheets/Menin
gococcal_42072_0504l.pdf - The Wisconsin Department of Health and Family Services
communicable disease fact sheet.
http://dhfs.wisconsin.gov/communicable/Communicable/factsheets/Meningococcal.htm Another Wisconsin Department of Health and Family Services communicable disease
fact sheet.
http://dhfs.wisconsin.gov/LocalHealth/index.htm - A list of local Wisconsin public health
departments and contact information.
American Academy of Family Physicians, www.aafp.org
American Academy of Pediatrics, www.aap.org
Meningitis Foundation of America, www.musa.org
CROSS REFERENCE:
453.2 Student Immunizations
453.3 Illness and Communicable Diseases
453.36 Exhibit A Parent Letter
Adopted:
FRIESS LAKE SCHOOL DISTRICT
Hubertus, Wisconsin