Transcription:

Melanie Cole (Host):  Meningitis can be a very serious disease. Outbreaks of bacterial meningitis at colleges have grabbed the headlines because otherwise healthy, young adults can quickly become ill and even die from this contagious illness. My guest today is Catherine Martin. She's a Certified Nurse Practitioner at Allina Health Blaine Clinic. Welcome to the show, Kate. First tell us what meningitis is and what causes it?

Catherine Martin (Guest):  Well, thank you. Well, first you've got to know the anatomy. The meninges are kind of a clear covering that lie over the brain and your spinal cord. They're the last protection, kind of, of the central nervous system to the outside world. There a few different types of things that can cause those to be inflamed:  viruses, bacteria and a couple of other forms, which results in meningitis.

Melanie:  So, people hear about bacterial meningitis. They hear about viral meningitis. What's the difference?

Catherine:  Well, viral meningitis tends to be a little less serious and have more significant outcomes, however, it is still a significant illness. People usually recover without specific treatment as far as a viral illness. We just kind of support them as needed. The viral meningitis is not preventable with a vaccine. However, fortunately, the most common forms of bacterial meningitis, which are the most serious, do have a vaccine to help our bodies fight against that disease.

Melanie:  So, if somebody gets the vaccine, is this vaccine 99%, 100% preventable for meningitis?

Catherine:  I couldn’t give you an exact number but it's a very high percentage rate of persons who have received the vaccine. Their body creates antibodies which are like little soldiers that are kind of on board, ready to go if you come in contact with the bacteria. So, it just kind of pounces on it.

Melanie:  How would someone who hasn't been vaccinated get meningitis?

Catherine:  Well, it's not just kind of spread through casual contact or through the air. You get it, usually, with close or prolonged contact with an infected person. It can also be exchanged by respiratory secretions. So, kissing, sharing  drinks, eating off the same utensils. Keeping in mind that the disease can incubate in a person, meaning they're not showing any signs of the illness for 2 – 10 days before they develop symptoms and about 3 days after someone who is exposed to the bacteria contracts it, they can start spreading it without any symptoms.

Melanie:  What are the symptoms of bacterial meningitis? They can be confused with the flu and it's quite scary, if some of these happen.

Catherine:  You're absolutely right. It is a flu-like illness at first. But, there are a few things that are very specific to a meningitis: sudden high fever, a severe headache and a stiff neck. Those will be kind of earlier in the illness. If you wait to seek treatment, you may start developing seizures or even get kind of an altered mental status--become a little bit confused.

Melanie:  So, now, what do you do if somebody's experiencing these symptoms? If you have a teenager or college-aged kid and they've got a stiff neck and their fever jumps up and they've got a really bad headache, do you call 911 or do you take them to the doctor?

Catherine:  I would get them to the closest emergency room. If they're not having any seizures or altered mental status, I think you can get them to the closest emergency room. I wouldn't take them into the clinic, because we'll just end up sending them to the emergency room from there. If they're lethargic and not very responsive and confused, I would definitely not hesitate to call 911 and have them bring them to the hospital for you.

Melanie:  How is it treated?

Catherine:  Bacterial meningitis can be treated with antibiotics. It's very important to start the treatment early on in the illness. You have a better success rate and a more likelihood of treating it with that. However, there can be long-term complications for patients that do survive the illness, as far as losing fingertips, toes and other chronic issues.

Melanie:  Who is most at risk for bacterial meningitis, Kate?

Catherine:  The population that's most at risk for dying from meningitis is infants and the elderly. However, you see the most common cases in anyone under 20.

Melanie:  So now, tell us a little bit about the vaccine. We know that before our kids go to college is one time that it's very important that this vaccine be given.

Catherine:  Yes. This one's for the meningococcus and it is given at, usually, age 12 and then repeated again at age 15. That will kind of protect against the most specific and more serious meningococcal disease that often we see the outbreak on college campuses. You know, a couple of kids wake up, they don't feel great and either they're in the ICU that evening or even possibly passed away from it.

Melanie:  Is there anyone who shouldn't be getting the vaccine?

Catherine:  Usually, people who have decreased immune systems should not be having the vaccine; anyone who's had a severe allergic reaction to a previous dose and anyone who has a significant allergy such as eggs. Usually, we avoid this one in children under 6 weeks old and anyone with a moderate or severe acute illness with or without a fever. We usually avoid vaccinating them.

Melanie:  Now, tell us a little bit about vaccines in general and the pneumococcal vaccine and maybe even traveling--people that need vaccines for different reasons.

Catherine:  Okay. Basically, the CDC recommends the meningococcal vaccine for all children 11-18 or certain younger high risk children. Usually, the first dose is at 12 and 16, like I said before, and that's for the one that we try to prevent you against when you go to college. Anyone who has been exposed to a diagnosed case of meningitis should be vaccinated. Anyone traveling or living where meningitis is common, so such as in South Sahara and military recruits. The HIB vaccine and the pneumococcal vaccines are what we give to little children but we're also giving that pneumococcal vaccine to geriatric patients as well. So, 65 and older. The HIB vaccine and the pneumococcal, which is the PCV13, is given at 2, 4, and 6 months old in infants and children. And, again, that is the time when they are the most vulnerable for that which is why we try not to delay that vaccine schedule and that's the Haemophilus influenza B again and then the strep pneumonia bacteria.

Melanie:  Are you seeing more bacterial meningitis because some people are altering their vaccine schedules? Do you think, in just your opinion, that there might be more of an outbreak in meningitis than we've seen in a while?

Catherine:  Well, I think vaccinating, in general, the less we do it, the more outbreaks we'll see in any disease that is vaccine preventable.

Melanie:  Tell us in just the last few minutes, Kate, some final advice--best advice--for those that are at risk, such as college students and the meningitis vaccine and the disease itself.

Catherine:  Okay. The biggest thing is to practice good personal hygiene. You learn it in school. The best thing you can possibly do is really good handwashing. You want to wash for at least 20 seconds getting the front of the hands, the back of the hands, between the fingers and under the fingernails. Don't share personal items: lipstick, Chapstick, food, glasses, water bottles, eating utensils and don't share towels. And, again, keeping in mind a person with meningitis can remain contagious for up to 24 hours after they have started treatment or be contagious for several days before they even develop symptoms. 

Melanie:  Thank you so much. It's really great advice and such important information. Thank you so much, Kate. You're listening to The WELLCast with Allina Health. For more information, you can go to AllinaHealth.org. That's AllinaHealth.org. This is Melanie Cole. Thanks so much for listening.