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MENINGOCOCCAL MENINGITIS FAQs
FREQUENTLY ASKED QUESTIONS
ABOUT MENINGOCOCCAL MENINGITIS
Information
for Students and Parents
I. THE DISEASE
·
What is
meningococcal meningitis?
Meningococcal
meningitis is a bacterial infection that causes inflammation of the membranes
surrounding the brain and spinal cord1. It is caused by the bacterium Neisseria meningitidis, also known as
meningococcus.
·
What are the symptoms?
Symptoms include fever, severe headache, stiff
neck, rash, nausea, vomiting, and lethargy.
The infection can lead to permanent disabilities, such as hearing loss
and brain damage2. Despite
antibiotic treatment, 10% of people with meningococcal meningitis die each year
from the disease3.
·
What is meningococcemia?
Sometimes the meningococcal bacteria can infect
the bloodstream. This infection is
termed meningococcemia. It can lead to
kidney and heart failure, and like meningococcal meningitis, can result in
severe disability and death.4
·
How is the disease spread?
The infection is spread by direct contact with
infected individuals (for example, sharing a glass or cigarette, or kissing) or
through the air via droplets of respiratory secretions (for example, coughing
or sneezing).
·
How common is meningococcal disease?
Neisseria
meningitidis is the second most common cause of bacterial meningitis in
the United States, responsible for 3,000-4,000 cases each year. While meningococcal disease overall remains
relatively rare, the number of outbreaks has been on the rise in recent
years. Whereas there were only 13
outbreaks during the 12-year period from 1980 to 19914,5, at least 33 outbreaks hit in just the 5
years between 1992 and 19964, according to the Centers for Disease
Control and Prevention (CDC).
·
Who is at risk for meningococcal meningitis?
In the past, the attack rate of endemic
meningococcal disease was highest among children 6 to 36 months of age. Lately, however, the risk appears to be
shifting toward older children and adolescents, with a rising number of
outbreaks in schools, universities, and other organization-based settings,
according to the American College Health Association (ACHA). In fact, over half of the outbreaks from 1992
to 1996 occurred in schools, colleges, universities, and similar settings4,5. Also at increased risk for meningococcal
disease are travelers to certain hyperendemic or epidemic countries (such as
part of Sub-Saharan Africa), people with certain immune deficiencies, and
household or institutional contacts of infected individuals.
·
Why are college students at greater risk for meningococcal disease
than the general population?
While the reasons are not yet fully understood,
studies from previous college outbreaks suggest that college students are more
susceptible because they live and work in close proximity to each other in
dormitories and classrooms. Behavioral
and social aspects of college life appear to be risk factors as well, with
smoking, exposure to second-hand smoke, excessive alcohol consumption, and bar
patronage all increasing the chance that one will contract meningitis from an
infected individual.
II. THE VACCINE
·
Is there
any way for college students to protect themselves against the threat of
meningococcal disease?
Yes.
Safe, effective vaccination can provide protection against four out of
the five serogroups of the disease (serogroups A, C, Y, and W-135; there is
currently no vaccine for serogroup B).
These four serogroups cause nearly 85% of meningococcal meningitis cases
on college campuses.
·
Why
should college students consider preventive vaccination with the meningococcal
vaccine?
In the past, vaccination usually has been delayed until an
outbreak of meningitis occurred and had been controlled temporarily by
antibiotics. The problem with this
strategy is that because outbreaks, while rare, are clustered in time1,4,
and because onset of symptoms is extremely rapid, for many students
post-exposure vaccination may be too late to provide real protection. In addition, immunity after vaccination can
take 1-2 weeks to develop1.
Pre-exposure vaccination also eliminates the fear of not being
vaccinated in time.
The Advisory
Committee on Immunization Practices (ACIP) has recently modified its guidelines
for use of the polysaccharide meningococcal vaccine to prevent bacterial
meningitis. Based on the results of two
CDC studies conducted in 1998 which identified the slightly higher risk among
freshman dormitory residents, the ACIP now recommends that those who provide
medical care to this group give information to students and their parents about
meningococcal disease and the benefits of vaccination. Vaccination should be provided or made easily
available to those freshmen who wish to reduce their risk of disease. Other undergraduate students wishing to
reduce their risk of meningococcal disease can also choose to be vaccinated.
The
American College Health Association (ACHA) supports the new recommendation
issued by the ACIP.
·
What are
the side effects of the vaccine? How
safe is it?
The meningococcal vaccine has an excellent
safety profile. Side effects are mild
and infrequent, consisting primarily of redness and swelling at the site of
injection lasting up to two days.
Meningococcal
immunization should be deferred during any acute illness. The vaccine should not be administered to
individuals sensitive to thimerosal or any other components of the vaccine. Please contact your primary care physician or
campus health center regarding thimerosal free vaccine.
·
How
effective is the vaccine and how long does it last?
The vaccine has been shown to create protective
levels of antibodies against the four most common strains of meningococcus in
over 90% of adults studied6,7.
As with any vaccine, meningococcal vaccination may not protect 100% of
susceptible individuals. Protection from
the original polysaccharide vaccine (Menomune ™) lasts for
at least 3-5 years. However, a new
conjugate vaccine (Menactra ™) appears
to offer protection for up to 8 years and possibly longer (it is too new to
know for sure). Emory University Student
Health Services routinely carries the Menactra
·
Can
college students do anything else to reduce the risk of contracting
meningococcal disease?
Maximize your body’s own immune
response. Eat a balanced diet, and get
adequate sleep and exercise. Avoid cigarettes,
excessive use of alcohol and, in particular, sharing drinks and cigarettes.
III.
INSURANCE INFORMATION
·
Will my
insurance company reimburse for this vaccine?
Many insurance companies do not currently
reimburse the cost of the meningitis vaccine.
The reason for this is that the recommendation for meningitis
vaccination is a fairly recent one, and many insurance companies are not aware
of the increased risk which college students face. To help you work with your insurance company
for reimbursement, we have provided this Frequently Asked Questions sheet and
the enclosed letter from the College Medical Director. The student will also receive a copy of
his/her Informed Consent/Encounter Receipt, at the time of vaccination. You may
submit this information as a claim, however, there is no guarantee that you
will be reimbursed.