An 18-year-old girl and some of her closest high school friends were having a great time at the New Jersey shore during “senior week”. Suddenly she developed the worst headache of her life. Her friends immediately drove her back home to Pennsylvania.
During the car ride she was vomiting and getting disoriented. When her family saw her they rushed her to the local hospital emergency room, where she was diagnosed with bacterial meningitis. Later, it was confirmed to be caused by Neisseria meningitides. Her life was saved by intravenous antibiotics and a breathing machine. She fully recovered, but she is one of the lucky ones.
According to the CDC, meningococcal disease, which is caused by these bacteria, affects about 1,000-1,200 people each year in the U.S. — most often infants and teens/young adults 16 to 21 years old. But anyone can get meningococcal disease. It can cause meningococcemia, a severe bloodstream infection, or meningitis, an infection of the brain and spinal cord—or both. Even when the infection is treated with antibiotics, it still kills up to 14 percent of the victims, and up to 19 percent of the survivors end up with serious complications.
Why teens and young adults are at risk. The bacteria thrive in places where people live in close quarters. That’s why college freshmen living in dormitories are at increased risk. Other people who have higher risk include:
- U.S. military recruits
- Anyone who has a damaged spleen, or whose spleen has been removed
- Anyone with an immune system disorder
- People who might have been exposed to meningitis during an outbreak
It is an infection that is easily spread. The bacteria can be spread by a cough, a sneeze, sharing cups or utensils, or close physical contact with an infected person. It can also be spread in similar ways by “carriers,” people who are not sick but who have the bacteria in their noses or throats. (About 10% of people are carriers, according to the CDC.)
It might just feel like a cold or the flu … at first. The early signs and symptoms of meningococcemia are fever, aches, loss of appetite and a rash. The rash starts as small red dots and progresses to large bruises. The classic symptoms of meningitis are fever, headache and stiff neck. Other symptoms include nausea, vomiting, back pain, confusion and seizures.
The death rate for untreated bacterial meningitis is almost 100 percent. It is a “911” true medical emergency. Within hours, a child can develop shock and organ failure. Intravenous antibiotics must be started as soon as possible. Additional treatments for brain swelling, shock, seizures, or dehydration may be necessary. Much of the damage from a severe meningococcal infection comes from blood clotting in the wrong places and blocking blood flow to large parts of the body. As a result, survivors may lose an arm or a leg, become deaf or mentally disabled, or suffer from seizures or strokes.
Here’s the good news ... Most meningococcal disease can be prevented with a routine vaccination. For kids, the recommended vaccine is meningococcal conjugate vaccine, which is also known as ‘Menactra’:
- a first dose at age 11 or 12 years old
- a second dose (booster) at 16 to 18 years old (within 5 years of starting college)
What are the risks from meningococcal vaccine? The most common side effects of ‘Menactra’ are mild redness or pain at the injection site. Rarely, people can have a severe allergic reaction. The risk of meningococcal vaccine causing serious harm, or death, is extremely small.
Prevention is always the best medicine. Most cases of meningococcal disease among adolescents can be prevented by the vaccine. My advice: I highly recommend this vaccine for my patients. Please talk with your doctor about it.
Rima Himelstein, M.D., is a Crozer-Keystone Health System pediatrician and adolescent medicine specialist.
Has your preteen child received this vaccine ... what about the booster for your older children who may be headed for college?