Understanding meningococcal meningitis can help prevent spread of deadly disease

Meningococcal meningitis is a rare disease in the United States, usually occurring as isolated cases. And while it is contagious, it is not as contagious as the common cold or the flu according to Dr. Kate Hendricks, director of the Infectious Disease Epidemiology and Surveillance Division at the Texas Department of Health (TDH). “People cannot get it just by being in the same room for a few hours with someone who has it.” Reports of even isolated cases of meningitis can create public concern. But understanding the illness, its symptoms and method of transmission can help ease worries and help prevent infections, Hendricks said. Anywhere from 100 to 250 people a year in Texas will get meningococcal meningitis, with the highest number of cases occurring in late winter and early spring. In 2000, 146 cases were reported in the state, with nine deaths. Preliminary figures from TDH show 173 cases in 2001 with 16 deaths. The illness, an infection of the layers of tissue covering the brain and spinal cord, is caused by the bacterium Neisseria meningitidis. The infection is spread through sneezing or coughing directly in someone’s face, kissing, sharing eating or drinking utensils or in other ways that allow saliva or respiratory droplets from an infected person to get into the mouth or nose of another person. Meningococcal meningitis is neither an airborne nor a foodborne illness. According to Hendricks, to reduce the risk of getting or spreading the illness cover your nose and mouth when coughing or sneezing, wash your hands frequently and do not share eating or drinking utensils. Early symptoms of the bacterial illness include: ‘ Sudden onset of fever; ‘ Intense headache; ‘ Stiff neck; ‘ Nausea often accompanied by vomiting; and ‘ A skin rash that looks like small, purplish red spots. “Anyone with these symptoms should see a doctor immediately,” Hendricks said. “It can be lifesaving. Also, an infant with a fever of 101 degrees or higher and who is not easily wakened should be seen by a doctor.” People with meningococcal meningitis also may be confused or drowsy and sometimes may go into a coma from which they cannot be awakened. Those with the illness must be hospitalized and treated with antibiotics. “Family members or close contacts will usually be advised to take antibiotics to reduce their risk of getting meningitis,” Hendricks said. About 10 percent to 20 percent of infected people die, many within hours of the first symptoms. Others may suffer complications such as brain damage, blindness, loss of hearing, kidney failure or amputations. With proper treatment, however, many people recover fully. The bacteria lives in the noses and throats of humans, usually without making people sick. The incubation period, or time between exposure and development of symptoms, ranges from two to 10 days but is typically three to four days. TDH and the U.S. Centers for Disease Control and Prevention do not recommend restricting travel, school or group gatherings such as at sporting or cultural events when meningitis occurs in the community. “The risk is very small in those settings because transmission of the bacteria requires very close exposure,” Hendricks said. A vaccine that protects against four strains of meningococcal meningitis is available for people over age 2 but is not routinely given in the United States. It is not helpful for treating close contacts of cases because it takes at least two weeks for the protection to begin. In addition, the vaccine’s protection lasts only a few years; and if a person ever needs to be vaccinated again, the immune system may not respond as well the second time.

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