Meningitis vaccine recommended, often ignored

Camp or dorm poses increased risk for deadly disease

Issue of August 15, 2008

About 10 out of every 100 victims of bacterial meningitis will not survive the experience. Another 15 or so will be left physically or mentally impaired. There is a vaccine, routinely recommended for all 11 to 18 year olds, and usually given at the 11 or 12 year old check up. Yet, most eligible teens have never had it — ­­ just 12 percent did as of 2006, according to a recent report in The Wall Street Journal.

Meningitis is an infection of the fluid around the spinal cord and brain. The viral form of the disease is usually less severe and subsides on its own. The bacterial form is a different story. While not considered common in the U.S., up to 2,800 Americans contract it each year, and it can be fatal in 24 to 48 hours.

"It's a very severe illness," said Dr. Mitchell Weiler of South Island Pediatrics in Cedarhurst. "I absolutely recommend the vaccine because kids and adults in close quarters in a lot of situations, such as camps, and in sports have a chance of contracting meningitis. It's a small chance but still a chance."

According to the Centers for Disease Control and Prevention the symptoms of bacterial meningitis include fever, headache and stiff neck as well as nausea, vomiting, difficulty looking at bright lights, confusion, and sleepiness. It can cause neurological damage, leading to amputation or death.

Bloodstream and other local infections are also possible. Symptoms of a bloodstream infection, meningococcal bacteremia, include fever, small red or purple spots or red or purple areas on the skin. Meningococcal bacteremia can cause pneumonia, joint infection, organ system failure, shock and death. Proper treatment with antibiotics brings the risk of death to under 15 percent. Some forms of bacterial meningitis are contagious through close or prolonged contact with respiratory secretions, coughing, sneezing.

"It used to be reserved for kids to leave for college, especially in a dormitory situation, but was only good for five years," said Dr. Deborah Saunders of Pediatric Healthcare of Long Island. "We didn't recommend shots to kids going to commuter colleges, only kids in a dorm or living abroad where they didn't know what the disease situation was like. Now it's recommended by the American Academy of Pediatrics from age 11 and up and it lasts for ten years. We've been giving it to all 11 year olds within the past year. There was a case in Massapequa of some high school students who contracted meningitis. We were getting a lot of calls from parents regarding the vaccine."

The vaccine, known by the brand name Menactra, is used to prevent infection by causing the patient to produce his own antibodies or protection against the disease with the use of an active immunizing agent. The groups A, C, Y and W-135 of meningococcal bacteria are the cause of most of the meningococcal meningitis in the U.S. and are covered by this vaccine but it will not protect against other groups.

The side effects common for the vaccine are sore arm and low grade fever. Guillain-Barre syndrome was reported as a rare side effect, Dr. Saunders said. GBS is a rare neurological disorder where the feet, legs, arms and hands become weak. The majority of people recover completely, though sometimes it causes paralysis.

"The general feeling is that it is less likely to get GB than to actually have a problem getting the infection. It's worth the risk to get the shot," said Saunders.

"It's a very appropriate vaccine for people to take," said Rabbi Dr. Aaron Glatt, president of New Island Hospital in Bethpage and spokesperson for the Infectious Disease Society of America. "There's no question. It's not risky. It's wonderful the vaccine is available; there is no reason not to take it. The disease is very serious, it's so fast, there is no good treatment for the disease; people die very quickly. It's an effective way to prevent meningococcal disease."

He noted that the risk was in close quarters such as a dormitory, military barracks and residential facilities. Other recommended vaccines for someone going to college or Israel for a year of study would be hepatitis A vaccine, if the child has underlying heath problems, the pneumococcal vaccine, and chicken pox, if the child didn't get it beforehand, he added.

The United States does not normally have epidemics of meningococcal meningitis but some countries do. If it is recommended to have the vaccine for travel to a particular location it should be administered at least one week before. For information on locations where the vaccine is necessary call the CDC at (404) 332-4565. The website is: www.cdc.gov <http://www.cdc.gov> .