Meningitis: How to Protect Your Child

by Kathy Sena

Following the deaths of several children and teenagers from meningitis-related illnesses over the past few years, parents across the country have become increasingly concerned about meningitis and how it is spread -with good reason. About 5,800 cases of bacterial meningitis occur annually in the U.S., involving very young children as well as high school and college students, according to the Meningitis Foundation of America (MFA).

WHAT IS MENINGITIS?

Meningitis is a serious infection that causes inflammation of the membranes that cover the brain and spinal cord. Except in rare cases, it is caused by either a virus or bacteria.

• Viral meningitis, the most common type, is a relatively mild illness that requires no treatment and clears up within two weeks. About 75,000 cases appear annually in the U.S., according to the MFA.

• Bacterial meningitis is a serious, potentially fatal illness requiring immediate medical attention. Lasting effects from bacterial meningitis can include deafness, mental retardation, partial paralysis or seizure disorders. It is the leading cause of acquired deafness in infancy and childhood. Two of the most common types are pneumococcal meningitis and meningococcal meningitis.

Symptoms of both viral and bacterial meningitis include fever, headache and stiff neck. Nausea, vomiting, drowsiness and general malaise also may occur. With viral meningitis, symptoms are generally milder and may resemble flu. With bacterial meningitis, symptoms develop quickly, sometimes over a few hours, and may be followed by drowsiness or loss of consciousness. With meningococcal meningitis, a deep-red or purple rash can appear, which may signal blood poisoning.

HOW IS MENINGITIS TRANSMITTED?

Anyone who spends a great deal of time in group settings, such as children in day care and students living in dormitories, may be at increased risk for meningitis. The bacteria and viruses that cause meningitis are spread through coughing, sneezing, kissing, sharing drinking glasses, etc. The bacteria can't be shared by casual contact or by simply breathing the air where a person with meningitis has been, the MFA notes.

Of course, babies and toddlers in a group setting will always share a certain amount of saliva - and teens and young adults will always be interested in kissing. But parents can help educate their children, from an early age, about covering coughs and sneezes and about not sharing drinking cups, eating utensils, etc.

DIAGNOSIS AND TREATMENT

Early diagnosis and treatment is crucial. A lumbar puncture (also known as a spinal tap) is the only definitive way to diagnose meningitis, according to the MFA. No specific treatments exist for viral meningitis except for supportive care in treating symptoms. But recovery from viral meningitis is usually rapid and without side effects.

Bacterial meningitis can be treated with antibiotics, but treatment must be started as soon as possible to prevent permanent damage or death. Pneumococcal meningitis is becoming more and more difficult to treat because many strains of pneumococcus are becoming increasingly antibiotic-resistant. This is yet another reason for all of us to make sure we take antibiotics only when needed.

PREVENTION IN INFANTS AND YOUNG CHILDREN

Pneumococcal conjugate vaccine was the first vaccine designed to prevent infants and young children from getting invasive pneumococcal disease. It was approved by the U.S. Food and Drug Administration in February 2000.

The U.S. Centers for Disease Control and Prevention's (CDC) Childhood and Adolescent Immunization Schedule for 2005 recommends that infants and toddlers receive the pneumococcal conjugate vaccine as part of their immunization schedule. This schedule also has been approved by the AAP and the American Academy of Family Physicians. Visit www.cdc.gov and type "immunization schedule" in the search box to view the recommended schedule.

NEW RECOMMENDATIONS FOR OLDER CHILDREN AND TEENS

The AAP recently released new recommendations for routine meningococcal vaccination, with quadrivalent meningococcal vaccine (MCV4), for older children and adolescents. This vaccine helps protect against meningococcal disease, a common cause of bacterial meningitis. The guidelines call for the vaccine to be given at the following ages:

• Young adolescents (11-12 years of age)

• Adolescents at high school entry or 15 years of age (whichever comes first) for those who have not previously been vaccinated

• All college freshmen living in dormitories

• Other groups at high risk, such as those with underlying medical conditions or travelers to areas with high rates of meningococcal disease

"About one in every 10 people who get the disease dies from it, and many others are affected for life," says AAP president Carol Berkowitz, M.D. "That is why preventing the disease through use of meningococcal vaccine is important for the high-risk groups."

The CDC's Advisory Committee on Immunization Practices (ACIP) says that establishing the target age at 11 years may give lasting immunity through college. The committee also notes that studies have determined that the disease peaks in 16- to 18-year-olds, supporting vaccination of 15-year-olds who have not previously been vaccinated.

FOR MORE INFORMATION

Meningitis Foundation of America - 800-668-1129 or www.musa.org

American Academy of Pediatrics - 847-434-4000 or www.aap.org

National Foundation for Infectious Diseases - 301-656-0003 or www.nfid.org

The Centers for Disease Control and Prevention - National Immunization Hotline (English) 800-232-2522; National Immunization Hotline (Spanish) 800-232-0233 or www.cdc.gov

- Kathy Sena is a freelance writer specializing in health and parenting issues and is the mother of a 9-year-old son. She writes for the Los Angeles Times, Woman's Day, USA Today and many other publications. Visit her Web site at www.kathysena.com.

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