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more articles by Klepack, William A , MD  |  author's bio

Meningococcal Disease: Deadly Dangerous

Meningococcal Disease: Deadly Dangerous

By William Klepack, M.D., Medical Director, Tompkins County Health Department

Meningococcal meningitis is one of those diseases that give physicians nightmares. This potentially fatal bacterial infection starts out with symptoms similar to those of the flu. Within a matter of hours, however, this disease can cause inflammation of the brain and spinal cord and widespread infection throughout the body. Even with the advantage of modern medicine and powerful antibiotics, meningococcal (bacterial) meningitis has a high fatality rate: in this country, five to fifteen percent of those who contract it will die from it, even with medical treatment.

By comparison, viral meningitis is relatively benign and much more common. While it is unpleasant, viral meningitis is not nearly as serious as bacterial meningitis.

Who is most at risk for meningitis?

While bacterial meningitis is not a common disease, it occurs most often in organizational settings where people live in close contact. This trend is especially significant in Tompkins County, where thousands of college students live in dormitory settings.

The risk peaks in late winter and early spring. Data from the CDC show that college freshmen living in dorms are six times more likely to contract the disease than other college students are.

What are the symptoms of bacterial meningitis?

The onset of symptoms is typically sudden and strongly resembles the flu. Early symptoms include headache, fever, nausea, and fatigue. As the infection progresses over the course of just a few hours, symptoms include a stiff neck and intense headache, extreme fatigue, sensitivity to light, and often a fairly distinct rash of either tiny dots or big blotches. If you push on the skin, the color does not blanch as it does with most other rashes. If left untreated, a person with bacterial meningitis may become delirious, sleepy, and eventually slip into a coma.

How is it diagnosed and treated?

Early diagnosis is critically important and involves culturing blood and spinal fluid because that is where the infection is. Treatment is the urgent use of antibiotics. People with bacterial meningitis are treated in the hospital because the infection's rapid progression requires significant medical support and intravenous fluids. Falling blood pressure and rapid pulse can send people into shock, which can be fatal.

Why is bacterial meningitis so dangerous?

This disease can be fatal even in healthy young adults. It affects the meninges, which are the membranes that cover the brain and spinal cord. As the infection spreads, it can lead to an overall infection of other body organs and systems. The bacteria behave differently in different people, and while most people recover fully from bacterial meningitis with treatment, as many as one in five may suffer from permanent disability.

How is bacterial meningitis prevented?

Hygienic measures are an excellent first line of defense against many diseases, including meningitis. Frequent hand washing is important. The bacteria can be passed through saliva, so the sharing of drinking glasses, bottled water, and soda cans should be avoided. If you have been exposed to someone diagnosed with bacterial meningitis, you should see a doctor immediately to begin a course of antibiotics as a preventive measure.

One of the best steps you can take for prevention is to consider being vaccinated before you go off to college and for certain types of travel. And don't wait until the last minute to be vaccinated because some vaccines take a month or two to be fully protective.

This is a frightening disease with a well-earned reputation. Keep yourself safe by following good hygiene practices, and talk with your doctor about your own risks. Above all, if you experience the sudden onset of the symptoms of bacterial meningitis, seek medical care immediately.

Dr. Klepack is on the medical staff of Cayuga Medical Center and is in practice with Dryden Family Medicine, where he can be reached at (607)844-8181.

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