Protect Your College Student From Meningitis On Campus

By John Voket

When you sent your child off to college this fall, especially if it was for the first time, you probably made a long list:. Bedding…MP3 player…snacks…bulletin board…bean bag chair…laptop…meningitis vaccine…..meningitis vaccine?

If you left that last one off the list, maybe it is time to pick up the phone and call your son or daughter to see if their college health office can offer them a meningitis vaccine. And if they cannot, put it on your list of to dos for their next visit home, because that $60–$80 vaccine could save your family a world of heartache, and possibly your child’s life.

According to Nancy Springer, one of the co-founders of the National Meningitis Association (NMA), meningitis is difficult to recognize, understand, and diagnose. She should know, she is the mother of a meningitis survivor.

“You mostly hear it referred to as spinal meningitis, bacterial meningitis, or viral meningitis,” she related in a recent interview. “The scariest and most insidious thing about the disease is, you may suddenly be stricken by it, receive antibiotics to treat it, and never know what type you had. Even if you have had one of the vaccines that are now recommended, you may not have had all of the ones that can protect you. So you need to understand this disease and know how to protect your children and yourself.”

Ms Springer began her crash course in meningococcemia biology, when her then 14-year-old son Nick came down with the disease in August 1999.

“He was away at camp up in the Berkshires, but within 24 hours Nick was on full life support and kidney dialysis,” she recalled.

Nick survived, but both his legs and hands had to be amputated. At the time, Ms Springer did not think there was much she and her husband could have done to prevent the tragic situation from occurring.

“I had no awareness about this disease or the vaccine that could have prevented it,” Ms Springer said. “The first time my husband heard about the vaccine that could have protected him was when Nick was in intensive care and dying. You could imagine our anger and our shock when we learned more about a vaccine that could have prevented him from getting meningococcal meningitis.”

According to the NMA, there are two major divisions of meningitis — viral (caused by a virus) and bacterial (caused by one of several types and strains of bacteria residing in the throat or nasal passages). The bacterial form of meningitis is extremely dangerous, fast moving, and has the most potential for being fatal. For many survivors the long-term effects also can be debilitating, recurrent, and include multiple amputations.

While viral meningitis has similar symptoms to bacterial meningitis, it is neither as deadly nor as debilitating for the most part. And there is no vaccine protection against viral meningitis. But many (but not all) types of bacterial meningitis can be prevented by vaccination.

In Connecticut, parents may be somewhat relieved to know that a first-of-its-kind pilot program to provide meningitis vaccines to resident state college and university students was recently established thanks to a class-action settlement negotiated by Attorney General Richard Blumenthal.

In mid-August, Mr Blumenthal announced that a $401,000 settlement against Medco, one of the world’s largest pharmaceutical benefits management (PBM) companies, would fund several state pilot health initiatives. Among them is a $50,000 pilot providing a meningococcal vaccine program for low-income young adults planning to live in college dormitories in Connecticut.

Mr Blumenthal told Health Monitor that the vaccine against meningitis costs about $60 per dose and is not funded by the state, which poses a barrier for students who cannot afford the vaccine.

“This pilot is a huge step and I hope it will be followed by others,” Mr Blumenthal said. “Many students don’t have insurance that will cover the cost, so many are faced with the decision to pay $60 out of pocket.

“We all know that young students, in their first year, have a lot of financial challenges. And unfortunately this vaccine may be down on the list. But if the student contracts this disease, it may be transferred to others,” he said.

Mr Blumenthal is not ready to initiate action to try to force insurers and health agencies to provide the vaccine at low or no cost today. But he is not ruling out the possibility that if the pilot program is successful, it may inspire legislation or voluntary vaccination programs through insurers.

“These pilot programs target real health care needs that hopefully will be met more broadly. And if a legislative mandate is necessary, I am prepared to work with the department of health and other agencies that have an interest in it,” he said.

But what about all the young people like Nick Springer who may become exposed to meningitis before they reach college age?

At Southern Connecticut State University, noted epidemiologist and consultant to the World Health Organization Dr John Wangu is instructing other doctors and students seeking their master of public health degrees. Dr Wangu has some interesting and progressive ideas about just how early in life a meningitis vaccine regimen should be administered.

“It is much safer to prevent meningitis than to allow someone to get the disease and then try to cure it. Because there is no guarantee they will have success in curing the disease,” he said. “I advocate that every year during pediatrician visits, children of any age are evaluated for whatever vaccines they may need.”

Typically, Dr Wangu recommends parents begin considering a meningitis vaccine program for children as young as 2 years old. And when the child may be in an environment of potential increased exposure, even children as young as 1- or 2-month olds can be better protected by the vaccine.

The Centers for Disease Control reports that those most at risk for contracting meningitis include infants and young children (for endemic disease), refugees, household contacts of case patients, military personnel, college freshmen who live in dormitories, and people exposed to active and passive tobacco smoke. The CDC also reports that certain trends in the United States show an increased incidence of the disease among adolescents and young adults.

The NMA website states that meningitis is spread through close contact where saliva is transmitted such as coughing, sneezing, kissing, or sharing drinks or cigarettes. The bacteria cannot live outside the body for very long, so the disease is not as easily transmitted as a cold virus. Ways to help prevent spreading the disease include following good hygiene practices such as washing hands, not sharing water bottles or other drinks, avoiding cigarettes, and generally not transmitting or sharing items that have been in one’s mouth.

Meningitis starts out presenting like a flu or a migraine and progresses quickly. Some, but not all of these symptoms may be present:

*Headache — May seem like the worst headache you have ever had.

*Fever — Can get very high. Does not respond to tepid bath or aspirin.

*Vomiting

*Numbness / cold extremities / loss of feeling

*Stiff neck

*Avoiding light

*Disoriented / confused

*Seizures

*Purple spots or rash — This means blood poisoning is underway. (Pressing a clear glass on the spots does not cause them to turn white.)

“Remember that only one or two of the symptoms may be present,” Ms Springer warns. “You need to be aware and don’t be afraid to call a doctor or head to the emergency room if you are concerned. This disease can move quickly, sometimes killing in a matter of hours.”

Health care must be immediate and aggressive to prevent death and/or serious side effects. Once bacterial meningitis is suspected or diagnosed, heavy doses of antibiotics are used for treatment. As of 2002 there is a new drug on the market called Xigris, which helps fight septicemia and may help avoid amputations. Only a spinal tap will help doctors determine for certain whether the disease is meningococcal and what serogroup is involved.

People who have been in close contact with the victim may be provided with an oral antibiotic to help protect them and reduce the probability of spreading the disease over the near term.

So whether your son or daughter is old enough to be away at college, or young enough for you to start thinking about a college fund, talk with your doctor about the benefits of a meningitis vaccine. It costs a lot less than an MP3 player, and Ms Springer knows from experience, it can be a true lifesaver.