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Meningitis Information
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The Disease
What is meningococcal meningitis?
Meningococcal meningitis is a bacterial infection that
causes inflammation of the membranes surrounding the brain and spinal
cord. It is caused by the bacterium Neisseria meningitides, also
known as meningococcus.
What are the symptoms?
Symptoms include fever, severe headache, stiff neck,
rash, nausea, vomiting, and lethargy. The infection can lead to permanent
disabilities, such as hearing loss and brain damage. Despite antibiotic
treatment, 10% - 15%of people with meningococcal meningitis die each
year from the disease.
What is meningococcemia?
Sometimes the meningococcal bacteria can infect the
bloodstream. This infection is termed meningococcemia. It can lead to
kidney and heart failure, and like meningococcal meningitis, can result
in severe disability and death (20% of patients with meningococcemia
die from the infection).
How is the disease spread?
The infection is spread by direct contact with infected
individuals (for example, sharing a glass or cigarette, or kissing)
or through the air via droplets of respiratory secretions (for example,
coughing or sneezing).
How common is meningococcal disease?
Neisseria meningitides is a leading cause of
bacterial meningitis in the United States, responsible for 1400 - 3000
cases each year. In the United States, >98% of cases of meningococcal
disease are sporadic; however, the number of outbreaks has been on the
rise in recent years. Whereas there were only 13 outbreaks during the
12-year period from 1980 to 1991, at least 33 outbreaks hit in just
the 5 years between 1992 and 1996, according to the Centers for Disease
Control and P revention (CDC).
Who is at risk for meningococcal meningitis?
Anyone can get meningococcal disease. Certain groups,
though are at higher risk. These include infants, adolescents and college
students, particularly freshman living in dormitories. Disease rates
decline after infancy, but begin to rise again in early adolescence,
peaking between the ages of 15 and 19 years.
People with certain medical conditions as those who
have a damaged spleen, or whose spleen has been removed, or those who
have certain immune system disorders (terminal complement component
deficiency) Other individuals as military recruits, and persons who
travel or reside in countries in which N. meningitidis is hyper endemic
are also at increased risk.
Why are college students at greater risk for meningococcal
disease than the general population?
While the reasons are not yet fully understood, studies
from previous college outbreaks suggest that college students are more
susceptible because they live and work in close proximity to each other
in dormitories and classrooms. Behavioral and social aspects of college
life appear to be risk factors as well, with smoking, exposure to second-hand
smoke, excessive alcohol consumption, and bar patronage all increasing
the chance that one will contract meningitis from an infected individual.
The Vaccine
Is there any way for college students to protect
themselves against the threat of meningococcal disease?
Two meningococcal vaccines are available in the US
- Meningococcal Polysaccharide vaccine (MPSV4) also known as
Menomune has been available since the 1970's
- Meningococcal Conjugate vaccine (MCV4) also know as Menactra
licensed in 2005
Both vaccines can prevent 4 types of meningococcal
disease (A, C, Y and W-135). In persons 15 - 24 years of age, 70% -
80% of cases are caused by potentially vaccine-preventable strains.
Both the vaccines work well, and protect more than
90% of those who get it. MCV4 (Menactra) is expected to give better,
longer-lasting protection and should also be better at preventing the
disease from spreading from person to person.
Why should college students consider preventive
vaccination with the meningococcal vaccine?
Meningococcal vaccination is recommended by the Centers
for Disease Control and Prevention (CDC) and the American College Health
Association (ACHA) for all first-year students living in residence halls.
Data also show and increased incidence of meningococcal disease among
adolescents and young adults, including college students. Additionally,
in persons 15 to 24 years of age, 70 - 80 percent of cases are caused
by vaccine-preventable strains.
What are the side effects of the vaccine? How safe
is it?
The meningococcal vaccines have an excellent safety
profile. Side effects are mild and consist primarily of redness and
swelling at the site of injection lasting up to two days.
Meningococcal immunization should be deferred during
any acute illness. The vaccine should not be administered to individuals
sensitive to any of the components of the vaccine.
How effective is the vaccine and how long does it
last?
The MPSV4 vaccine (Menomune) has been shown to create
protective levels of antibodies against the four most common strains
of meningococcus in over 90% of adults studied. As with any vaccine,
meningococcal vaccination may not protect 100% of susceptible individuals.
Protection from the vaccine lasts for about 3-5 years.
The MCV4 vaccine (Menactra) has been shown to create
equally effective levels of protection. Duration of protection, although
not currently known, is expected to be longer than with the MPSV4 vaccine.
Studies are underway to further determine duration and to guide recommendations
on revaccination.
Can college students do anything else to reduce
the risk of contracting meningococcal disease?
Maximize your body's own immune response. Eat a balanced
diet, and get adequate sleep and exercise. Avoid cigarettes and excessive
use of alcohol. In particular, do not make a habit of sharing drinks
and cigarettes.
Insurance Information
Will my insurance company reimburse for this vaccine?
Many insurance companies do cover the cost of the meningitis
vaccine. To help you work with your insurance company for reimbursement,
we have provided this Frequently Asked Questions sheet. The student will
also receive a copy of his/her Encounter Receipt, at the time of vaccination,
with the following insurance billing information:
- Procedure Code 90733 (Menomune) or 90734 (Menactra)
- Diagnosis Code V03.89
You may submit this information as a claim for reimbursement.
However, there is no guarantee that you will be reimbursed.
STATE OF MARYLAND REQUIREMENTS
A waiver form must be signed for those students living
in on campus housing choosing NOT to receive the vaccine. This is found
on Residence Life Contract Form.
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