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Meningococcal disease is caused by the bacteria neisseria meningitidis

ent.  Our universities—many universities have very high coverage with the licensed and recommended vaccine that protects against serogroup C and Y. So we started to see fewer cases of serogroup C and Y meningococcal disease and more cases of serogroup B disease.

Reports of this disease is more common in the winter months.  Typically almost all cases of meningococcal disease are sporadic.  Very few cases occur as part of our -- as part of an outbreak in terms of the total number of cases we see in the United States.  But we do see a couple of meningococcal disease outbreaks typically every year.

Meningitis is an infection of the protective membranes covering the brain and spinal cord, which is known as the meninges. 

Septicemia is an infection of the blood stream, and septicemia causes bleeding in the skin and organs and is often when we see complications from meningococcal disease that are not neurologic, it's frequently caused by septicemia.

bout 15 percent of survivors have long term disabilities such as loss of limbs, deafness, nervous system problems, or brain damage.  Early recognition and early treatment of meningococcal disease is key to reduce the long-term sequelae. 

ten difficult to diagnose meningococcal disease because often the first signs and symptoms are similar to the flu

even with antibiotic treatment, people die in about 10 to 15 percent of cases of meningococcal disea

Vaccination is the best way to prevent meningococcal disease when it's a vaccine preventable strain.  Hand washing and covering your coughs or sneezes is also a good practice to follow.  It's critical everybody be aware of the signs and symptoms of meningococcal disease and to seek treatment immediately. 

igns and symptoms of meningococcal disease include rapid onset of high fever, headache, and stiff neck.  And when we say headache, we mean it's among the worst headaches that somebody's had in their life.  And with the stiff neck, they really can't move their neck, or they can't, for example, touch their chin to their neck.  Towards their chest, excuse me.  Other symptoms include nausea, vomiting, increased sensitivity to light, confusion, exhaustion, and sometimes a rash.

eningococcal bacteria are harder to spread than viruses

don't live long outside the body. 

pread through the exchange of respiratory secretions. 

oommates who spend a lot of time together, are potential close contacts of a case of meningococcal disease.

about 10 percent of people, not just in outbreaks, but all over in the United States, carry these bacteria in the back of their nose or throat and don't ever develop symptoms.  This is known as carriage or being a carrier.

nce a person becomes a carrier, most people develop immunity and the bacteria disappear from their nose and throat and then they're no longer a carrier.  But rarely, the bacteria invades the blood stream and this is what happens when a person develops the disease.

most cases of meningococcal disease appear to be random and aren't directly linked to each other.  Even in the case of an outbreak—the cases are not occurring among close contact with each other, it's happening in an organization or community. 

he most common one circulating in the United States are serogroups B, C and Y. 

e don't have a vaccine in the U.S. licensed to protect against serogroup B, which is the cause of the cases at Princeton University and UC Santa Barbara. 

Cases are reported quickly, meningococcal disease is highly recognized, and reported to health departments. 

CDC defines an outbreak of meningococcal disease of three or more cases in three months that can't be connected to each other.

these outbreaks occur in a certain population, like school or organizations.  Most outbreaks of this disease are self-limited and no more than three or four cases occur.  However, when cases continue to occur over several-month period, like what is happening at Princeton University, intervention is required to reduce the length of the outbreak. 

equesting use of vaccine for additional outbreaks when needed.

Partners are working hard to organize potential serogroup B vaccine campaigns at Princeton University as quickly as possible. 

o there's all sorts of quality things that are happening to make sure that the vaccine arrives and can be used safely and effectively.

Therefore, we are sending out a health alert to providers and state and local health departments, which will hopefully increase awareness for providers to consider meningococcal disease in their differential diagnosis, if a student presents with symptoms from one of these two universities. 

Serogroup is definitely a scientific word to describe the type of capsule around the meningococcal.  You can use the word strain when we describe different serogroups.  The word strain would be the b strain or c strain.  When we're talking about whether or not strains are linked to each other, there we do additional molecular testing which looks at more than the capsule to see if the strains are the same.  For example, we know that the strains that have caused all of the cases in -- at Princeton are identical.  That's what helps us understand if an outbreak is being caused by one strain.  And that doesn't necessarily mean you could have the same serogroup, but the strains could look a little different. 

f anything, it's just sorting reminding people to use good normal hygiene practices, such as washing your hands and coughing and sneezing into your arm.  And sort of having increased awareness for good hygiene practices. 

ases really do occur in this university setting where there's probably a very specific pattern of transmission among college students.  So we really don't have evidence to suggest that kids going home for Thanksgiving will be spreading the strain into those communities. 

here have been seven confirmed serogroup B cases at Princeton University, and one additional case in which additional testing is being conducted right now.  And there are three cases at UC Santa Barbara. 

But more people are carriers than there are actually cases.  I see what your question is, why are we not then worried about it spreading into the community.  We don't have a good -- we don't have a great understanding of the organism and how it spreads.  But what we do understand is that outbreaks really haven’t spread from universities into communities in the past.  There have been community outbreaks of meningococcal disease.  But we haven't seen cases occurring in universities expanding into those communities. 

So in most of our outbreaks, we see about three or four cases occur in a couple of month period of time and then we don't see additional cases.  Depending on the size of the college or organization in which the outbreak is occurring, those attack rates usually range anywhere from 10 to 20 per 100,000.  So one to two cases per 1,000 people at the university. 

Health officials follow up with a patient to see if they've come into close contact and then they recommend preventive antibiotics to close contacts.

the microscopic ameba (a single-celled living organism) Naegleria fowleri.

Risk Factors

Bodies of warm freshwater, such as lakes and riversGeothermal (naturally hot) water, such as hot springsWarm water discharge from industrial plantsGeothermal (naturally hot) drinking water sourcesSwimming pools that are poorly maintained, minimally-chlorinated, and/or un-chlorinatedWater heaters. Naegleria fowleri grows best at higher temperatures up to 115°F (46°C) and can survive for short periods at higher temperatures.2, 3SoilNaegleria fowleri is not found in salt water, like the ocean.

Prevention

Infection is rare and typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. Very rarely, infections have been reported when people submerge their heads, cleanse their noses during religious practices, or irrigate their sinuses (nose) using contaminated tap or faucet water. Naegleria fowleri can grow in pipes, hot water heaters, and water systems, including treated public drinking water systems.

Naegleria fowleri infects people when water containing the ameba enters the body through the nose.

4,100 cases of bacterial meningitis,

500 deaths,

within 3-7 days after exposure.

abies younger than 1 month

The most effective way to protect you and your child against certain types of bacterial meningitis is to complete the recommended vaccine schedule.

Age GroupCausesNewbornsGroup B Streptococcus, Escherichia coli, Listeria monocytogenesInfants and ChildrenStreptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type bAdolescents and Young AdultsNeisseria meningitidis, Streptococcus pneumoniaeOlder AdultsStreptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes

ually severe.

Bacterial meningitis is us

Sudden onset of fever, headache and stiff neck Nausea and/or vomiting Increased sensitivity to light, and/or mental confusion

Certain diseases, medications, and surgical procedures may weaken the immune system and increase your risk of getting fungal infection, which can lead to fungal meningitis. Premature babies with very low birth weights are also at increased risk for getting Candida blood stream infection, which may spread to the brain.

FeverHeadacheStiff neckNausea and vomitingPhotophobia (sensitivity to light)Altered mental status (confusion)

Fungal meningitis is treated with long courses of high dose antifungal medications

it is important to know the specific cause of meningitis.

Having meningitis doesn't always mean you have meningococcal disease

having meningococcal disease doesn’t necessarily mean you have meningitis

 Meningococcal disease is any infection caused by the bacterium Neisseria meningitidis, or meningococcus

Bacterial meningitis is contagious

spread through the exchange of respiratory and throat secretions (i.e., kissing

or using the toilet and not properly washing hands afterwards), but enteroviruses can also be spread via eye, nose, and mouth secretions (such as saliva, nasal mucus, or sputum), or blister fluid.

, are most often spread from person to person through fecal contamination

can occur when changing a diaper

contamination

Meningitis

Meningitis is a disease caused by the inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord.Meningitis may develop in response to a number of causes, usually bacteria or viruses, but meningitis can also be caused by physical injury, cancer or certain drugs.The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis.

Meningitis is a disease caused by the inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord.

NauseaVomitingPhotophobia (sensitivity to light)Altered mental status (confusion)

f you have close contact with a person who has viral meningitis, you may become infected with the virus that made that person sick. However, you are not likely to develop meningitis as a complication of the illness.

n infant

FeverIrritabilityPoor eatingSleepiness or trouble waking up from sleepLethargy (a lack of energy)

n adults

FeverHeadacheStiff neckSensitivity to bright lightSleepiness or trouble waking up from sleepNauseaVomitingLack of appetiteLethargy (a lack of energy)

n most cases, there is no specific treatment for viral meningitis. Most people who get viral meningitis completely recover on their own within 7 to 10 days. However, people with meningitis caused by certain viruses such as herpesvirus and influenza, may benefit from treatment with an antiviral medication.

PreventionThere are no vaccin

Wash your hands often with soap and water, especially after changing diapers, using the toilet, or coughing or blowing your nose.Avoid touching your face with unwashed hands.Avoid close contact such as kissing, hugging, or sharing cups or eating utensils with people who are sick.Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.Stay home when you are sick.

Non-freshman college students who want to reduce their risk of infection should consider the vaccine also

Meningitis is rare. 

But when it strikes, this potentially fatal bacterial disease can lead to swelling of fluid surrounding the brain and spinal column as well as severe and permanent disabilities, such as hearing loss, brain damage, seizures, limb amputation and even death.

  This can include coughing, sneezing, kissing or sharing items like utensils, cigarettes and drinking glasses.

Symptoms of meningococcal meningitis often resemble the flu and can include high fever, severe headache, stiff neck, rash, nausea, vomiting, lethargy and confusion.

Other undergraduates living in College resident halls, who have not been recently vaccinated, should also consider vaccination to reduce their risk for the disease.

The vaccine may be available from health care providers or county health departments.

Meningococcal conjugate vaccines (Menactra®, MenHibrix® and Menveo®)

Meningococcal polysaccharide vaccine (Menomune®)

Serogroup B meningococcal vaccines (Bexsero® and Trumenba®)

Trade name Type of Vaccine Meningococcal Serogroups Covered Bexsero® Recombinant B Menactra® Conjugate A, C, W, Y MenHibrix® Conjugate C, Y (and Haemophilus influenzae type b [Hib]) Menomune® Polysaccharide A, C, W, Y Menveo® Conjugate A, C, W, Y Trumenba® Recombinant B

The following vaccines help prevent meningococcal disease: meningococcal conjugate, meningococcal polysaccharide, and serogroup B meningococcal vaccines.

As with all vaccines, there can be minor reactions, including pain and redness at the injection site, headache, fatigue or discomfort after meningococcal vaccines.

Who Should Not Be Vaccinated?

Vaccine Recommendations

The infection can cause the tissues around the brain to swell. This in turn interferes with blood flow and can result in paralysis or even stroke.

Sometimes meningitis occurs for no known reason. Other times it occurs after a head injury or after you have had an infection and your immune system is weakened.

Children between the ages of one month and two years are the most susceptible to bacterial meningitis

higher risk if you abuse alcohol, have chronic nose and ear infections, sustain a head injury or get pneumococcal pneumonia.

Adults with certain risk factors

Outbreaks of bacterial meningitis also occur in living situations where you are in close contact with others, such as college dormitories or military barracks

In older children and adults, you may see confusion, irritability, increasing drowsiness. Seizures and stroke may occur.

become

CDC recommends the meningococcal vaccine

young children,

vomiting and they may refuse to eat.

treated with antibiotics.

In addition to antibiotics, it will be important to replenish fluids lost from loss of appetite, sweating, vomiting and diarrhea

most people recover.

10 percent death rate

Unfortunately, if treatment is not undergone immediately, there may be permanent damage. Seizures, mental impairment and paralysis may be life long.

Anyone who you have had casual contact should not be affected.

a vaccine is available,

most common form

All children and adolescents ages 11 through 18 College freshmen living in dormitories

Anyone with a damaged spleen or who has had his or her spleen removed Anyone who has terminal complement component deficiency (an immune system disorder)