by Dr. Mark H. Shapiro
"An ounce of prevention is worth a pound of cure."... ...Henry de Bracton, De Legibus, 1240.
Commentary of the Day - September 15, 2002: Got Shots? Guest commentary by Eric Eaton.
If you thought that the vaccinations you received as a child were all you ever needed to live a long, healthy life, think again. Bacterial meningitis poses an increasing, but understated, threat to college freshmen. Dormitories, and similar group living arrangements, foster the potential spread of this disease. Students coming together from far-flung points of origin increase the susceptibility of one student to the infections of another. Since severe cases of bacterial meningitis are rare (3 to 8 per 100,000 students), there has been no widespread publicity of the potential danger. In fact, the Centers for Disease Control (http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm) have concluded the disease does not pose enough of a risk to to warrant mandatory immunizations.
Tell that to the families and friends of students who have died overnight, or the victims who have lost limbs, their hearing, or had kidney failure. Initially masquerading as a bad case of the flu, the disease can take a turn for the worse within hours. A tell-tale stiffness in the neck is sometimes the only indication of something other than an ordinary, non-life-threatening illness. Lethargy, severe headache, fever, nausea, and vomiting are other symptoms. The appearance of a purplish rash, caused by the hemorrhaging of blood vessels at the surface of the skin, is the alarm bell. Inside the victim's body, the same thing is happening to vital organs. The kidneys and lungs can cease functioning in a few hours. Without immediate hospitalization, the unfortunate soul is destined to die or experience severe long-term effects. (http://www.pbs.org/wgbh/nova/meningitis/) [Ed. Note: The rapid progression of meningitis represents the greatest danger to the patient. Even with aggressive treatment with antibiotics, the death rate from meningitis approaches 15%.]
Ordinarily, the bacteria that cause meningitis reside harmlessly in the lining of the throat in about ten percent of the population. For reasons not yet clear, the bacteria sometimes find their way into the bloodstream. Perhaps alcohol and tobacco use weaken the lining of the throat, increasing the chances of infection. Once in the blood, the bacteria release a poison called endotoxin that initiates a series of immune responses ultimately leading to the rupture of blood vessels, or inflammation of the membranes around the brain and/or spinal cord.
Five varieties of meningococcal disease are found around the globe: A, B, C, Y, and W-135. Different groups impact different populations. Groups A, C, Y, and W-135 account for about 70% of the cases of bacterial meningitis affecting 15-24 year olds here in the U.S.
Thankfully, there is a vaccine against these strains available for the asking. It is about 85% effective, and immunity lasts three to five years, enough time to get through college, or at least past the most dangerous period of exposure (freshman year). Few universities, however, require immunization against meningococcal diseases, and it will come out of the student's pocket to the tune of about $65. What a small price to pay, though, for a degree of protection against a potentially fatal illness. Indeed, the incidence of bacterial meningitis appears to be rising. There were 310 cases reported in 1991, but 621 cases in 1996. (http://www.acha.org/projects_programs/men.cfm)
Science has much to learn about meningococcal diseases, including why the bacteria is normally dormant, but in the meantime we cannot afford to fall asleep in our vigil of prevention. What policy does your university have regarding meningococcal diseases? If it does not require immunization, does it make incoming freshmen aware of the danger? I urge you to run, don't walk, to your student services office and alert them to this if they are not already aware. It is a worthwhile exercise if it saves one life, or prevents one lawsuit in the aftermath of a death or hospitalization.
©2002, Eric Eaton
Eric Eaton is a freelance writer and entomologist from Portland, Or, who now resides in Tucson, AZ. More of Eric's writing can be found on his web site: Bug Eric.
The IP encourages readers who may be concerned about their risks for contracting meningitis to confer with their physician or student health service about the benefits (and possible side effects) of vaccination.
© 2002 Dr. Mark H. Shapiro - All rights reserved.