Meningitis

Viral Meningitis

Viral meningitis is caused by an infection with one of several types of viruses. A group of viruses called enteroviruses cause 90% of viral meningitis cases. It is serious but rarely fatal. The symptons are similar to bacterial meningitis and often present themselves initially as headache, stiff neck, fever and vomitting. Differentiating between viral and bacterial meningitis is important to determine the treatment needed. No specific treatment is available for viral meningitis. Most people recover fully with bed rest, lots of fluids and medication for relief of headache and fever. People who are close contacts of viral meningitis patients do not need to be treated with antibiotics.

Bacterial meningitis

A study by the Center for Disease Control has determined that overall, college students are not at higher risk than others for contracting Bacterial Meningitis but that college freshmen living in dormitory settings may have a 3-6 times higher risk of getting this infection than other college students.

The bacteria that causes this infection (Neisseria Meningitis), effecting the lining of the brain and spinal cord, is transmitted through saliva (by sharing glasses, water bottles, toothbrushes, eating utensils, cigarettes, lipstick, kissing, etc.)

Hallmark symptoms - severe headache, vomiting, high fever, stiff neck and disorientation - do not always manifest themselves together and can initially present like those of the flu. Any of these symptoms are monitored closely by health care providers on college campuses.

The American College Health Association recommends that students and parents be made aware of the dangers of Meningitis and that college students be vaccinated prior to admission.

The vaccine Menomune is designed to be effective against serogroups A, C, Y and W-135. In addition to not protecting against B-strain, the vaccine may be only 85% effective in those serogroups it protects against and is effective for only 3-5 years. The New Hampshire Bureau of Communicable Disease, the CDC and the American Academy of Pediatrics Do Not recommend blanket immunization for college students nor do they feel it necessary to require vaccination prior to admission to college. However, the Advisory Committee on Immunization Practices (ACIP) has revised its recommendation for use of the meningitis vaccine in college students. The major points of the recommendation are as follows:

1. Practitioners who provide medical care to freshmen, especially those who live in or plan to live in dormitories: Should inform students and their parents about meningococcal disease and the benefits of vaccination. The vaccine should be provided or made easily available to those freshmen who wish to reduce their risk of the disease. Other undergraduates under 25 years wishing to reduce their risk of disease may choose to be vaccinated.
2. Colleges and Universities should provide information about meningicoccal disease and vaccination to freshmen, especially those planning on living in dormitories or residence halls.
3. Public Health Agencies will serve as a resource regarding meningicoccal disease and vaccination for providers and colleges., including providing information on how to obtain vaccine.

Should there be a confirmed report of meningitis on campus, any individual who suspects they may have been exposed (through direct contact with saliva as previously described) should contact their health care provider immediately. Since the vaccine is not 100% effective, this applies to everyone, whether they have been vaccinated or not.

In view of the information available to us in Health Services and in compliance with the beliefs of our Health Services physician (and with the assurance that we all are both educated and acutely aware of the concerns of individuals and the possibilities of this disease), we provide the following advice and assistance:

• Discuss this issue with your primary care provider.
• Should your provider advise the vaccine, have he/she write a prescription for the vaccine - obtain the vaccine and instruct your student to come to Health Services (3rd floor, Elliot Hall, M-F 8-4:30).
• Health Services will administer the vaccine for a $5.00 fee.

Should you wish to discuss this issue further, please feel free to call Health Services at 603-358-2450.

Signs and Symptoms

• Fever
• Severe headache
• Stiff neck
• Vomitting
• Changes in consciousness progress through irritability, confusion, drowsiness, stupor, and coma.

Diagnosis and Treatment

Patients who receive prompt treatment for bacterial meningitis usually recover. Diagnosis is made through a lumbar puncture and examination of the cerebrospinal fluid. Treatment requires large doses of antibiotics.

Prevention

Vaccination may be valuable in controlling an epidemic. This has achieved limited success as the vaccine is effective against only some of the organisms responsible for bacterial meningitis. It is used mainly in epidemic areas and closed populations where epidemic spread is feared. With the exception of the cost, there is no good reason not to immunize college freshmen living in dormitories or residence halls with the meningitis vaccine.