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Meningitis: Managing Meningococcal Disease in College Populations
About Meningitis
How many cases of meningococcal meningitis are seen in the United States?
Meningococcal meningitis in US college students A surveillance study of college students by the Centers for Disease Control and Prevention (CDC) was conducted in 1998-1999. Data from this study revealed:
Can meningococcal disease be mistaken for other health problems? Meningococcal disease is potentially dangerous because it is relatively rare and can be mistaken for other conditions. The possibility of having meningitis may not be considered by someone who feels ill, and early signs and symptoms may be ignored. What are the signs and symptoms of meningococcal disease? Understanding the characteristic signs and symptoms of meningococcal disease is critical and possibly lifesaving. Common early symptoms of meningococcal meningitis include fever, severe sudden headache accompanied by mental changes (e.g. malaise, lethargy), and neck stiffness. Any person with the above symptoms should seek immediate medical attention. In addition, a rash may begin as a flat, red eruption, mainly on the arms and legs. It may then evolve into a rash of small dots that do not change with pressure (petechiae). Treatment of meningococcal meningitis infection Meningococcal disease can be rapidly progressive. With early diagnosis and treatment, however, the likelihood of full recovery is increased. Prompt medical attention, early recognition, performance of a lumbar puncture (spinal tap), hospitalization and prompt initiation of intravenous antibiotic therapy are crucial. Treatment of persons potentially exposed to meningococcal disease Anyone who suspects intimate exposure to meningococcal meningitis should consult a clinician to determine if prophylactic (preventive) antibiotics are indicated. The use of prophylactic antibiotics, such as ciprofloxacin or rifampin, is recommended only for those who have had intimate exposure to a person diagnosed with meningococcal disease. Vaccination As an adjunct to appropriate antibiotic prophylaxis, immunization against the meningococcus bacterium may be recommended for people with casual contact when an outbreak of meningococcal disease has occurred in a defined community (e.g., residential hall). It is important to note that meningococcal vaccines should not be used in place of antibiotic prophylaxis for those with intimate exposure to an infected person: the protection from immunization is generated too slowly in this situation. Meningococcal meningitis vaccines Immunization against the bacterium Neisseria meningitidis (N. meningitidis) may be recommended for persons over 2 years of age if they are members of a population that is experiencing an outbreak of meningococcal disease caused by a serogroup that is included in the current vaccines, e.g. students at a university where an outbreak is occurring. Numerous studies have demonstrated the immunogenicity and clinical effectiveness of meningococcal vaccines. Although protection probably persists in schoolchildren and adults for at least 3 years following vaccination, the need for and exact timing of a booster has not been determined. As with any vaccine, vaccination may not offer 100% protection, yet is estimated to be about 85-90% effective for select serogroups of N. meningitidis. In addition, the currently available vaccines do not afford protection against all types of bacterial meningitis.
Adverse reactions to meningococcal vaccines are mild and infrequent, consisting primarily of redness and pain at the injection site that may last 1 to 2 days. Rarely, fever of short duration may occur. Are the meningococcal meningitis vaccines recommended for college students? The meningococcal vaccines are recommended by the Centers for Disease Control (CDC) for students 11-18 years of age, incoming college freshmen living in dormitories and those 19-55 at increased risk for meningococcal disease. For more information, see http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5631a3.htm?s_cid=mm5631a3_e The American College Health Association supports the CDC recommendation. We recommend that all college students read the information about meningococcal meningitis and the potential benefits of vaccination. The vaccines are available to those wishing to reduce their risk of meningococcal disease. The ACIP also recommends meningococcal vaccines for certain high risk persons:
Getting the Meningococcal Vaccine at Tang The new meningococcal conjugate vaccine, Menactra, is available at the Tang Center. Please call (510) 643-7177 to make an appointment. For Students
For Faculty and Staff:
Disclaimer: The information provided here is not intended to diagnose, treat or provide a second opinion on any health problem or disease. It is meant to support, not replace, the relationship that exists between an individual and his/her clinician. Last reviewed: September 2005 Back to Online Health Materials A-Z
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