New Meningitis Vaccine Being Recommended

• Infections • Aug 22, 05

A new vaccine that protects against meningococcal disease is among the recommended immunizations for adolescents and college students this year.

Menactra, manufactured by Sanofi Pasteur, was approved by the Food and Drug Administration in January.

It will be offered to college freshmen, children at least 11 years old or adolescents who have not been vaccinated prior to high school.

“Meningitis is a bad disease, a brain infection that people die from pretty fast,” said David Rosenberg, a pediatrician with Covenant Medical Group in Fox Point.

Meningococcal disease is a potentially fatal infection of spinal cord fluid or the fluid surrounding the brain. It can be caused by viruses, bacteria or fungi.

What is going on in the body?

There are a number of different organisms that can cause bacterial meningitis. They generally begin growing in a person’s nose and throat. If not stopped by the immune system, the bacteria go on to invade the body. They can enter the bloodstream and travel to the central nervous system.

The infection then settles in the fluid and the membranes around the brain. The resulting inflammation is responsible for many of the symptoms of meningitis. It may also play a role in some of the complications.

Viral meningitis generally is less severe and resolves without specific treatment, while bacterial meningitis can be more severe.

Bacterial meningitis, caused primarily by the bacterium Neisseria meningitis, is serious because its early symptoms can be passed off as the flu, and otherwise healthy people can succumb quickly.

It is spread through intimate or direct exposure, such as kissing, sharing eating utensils or from coughing, sneezing or other exposure to oral secretions from the infected person.

The key to treatment is early diagnosis, which is done by collecting fluid from the spine to allow identification of the type of bacteria and correct antibiotic.

Eddy Bailey, 20, died Nov. 12, 2002, from meningococcal disease less than a day after telling friends that he thought he had the flu.

Neither his mother, Gail Bailey, nor his father, Phil, had heard of meningitis or any vaccine and say that it wasn’t mentioned to them by any health care professionals.

“I know we would have gotten it because I was the most overprotective mother that was born,” said 50-year-old Gail of Jefferson.

She had last spoken to her son the Sunday night before his death. They talked for about 30 minutes. Though Eddy didn’t mention then that he wasn’t feeling well, Gail said that she could tell by his voice that he wasn’t quite himself.

The police arrived at her job on a Tuesday morning to tell her he had died. She has never stopped blaming herself for his death.

“We didn’t do anything to prevent it,” she said.

“Even worse,” she added, “is that I didn’t get a chance to be with him when he died. When I could have helped him because I know he was so scared.”

Menomune, a meningococcal vaccination approved by the FDA in 1991, is 85% effective against four serogroups of Neisseria meningitis (A,C,Y and W-135), but does not offer protection against serogroup B. About 70% of reported cases in college students are attributed to serogroups covered by the vaccination.

Menactra, the new vaccine, protects against the same types but will protect people for at least 10 years, compared with only three to four years on the older drug, Rosenberg said.

There is a national shortage of Menactra, but the state is expected to receive 33,000 doses, said Stephanie Marquis, spokeswoman for the state Department of Health and Family Services. Priority will be given to adolescents ages 11 and 12, college freshmen living in dormitories and high school freshmen, she said.

Meanwhile, Menomune is still available, she said.

Lisa Taylor, clinical coordinator for the Aurora Visiting Nurse Association’s vaccination program, said that the agency has given about 50 meningococcal shots using Menactra in the past month.

The VNA, the largest provider of flu shots in the Milwaukee area, began a meningitis vaccination campaign to coincide with the start of the school year after an Aurora employee’s 20-year-old daughter died last year of meningitis.

The vaccine also will be available through physician offices and clinics in the area.

According to the Centers for Disease Control and Prevention, meningococcal disease infects an estimated 3,000 people each year.

The fatality rate is as high as 12%, depending on the bacteria involved and how soon a patient is started on proper antibiotic therapy. Of those who survive, 15% may have long-term permanent disabilities, including hearing loss, limb amputation or brain damage.

Rates of meningococcal disease are higher in college dormitories and among military recruits, Rosenberg said, but it could also occur in youth summer camps, too.

That’s why it’s important that all people in the recommended groups consider vaccination, he said.

Milwaukee County has seen few cases of meningococcal disease.

Milwaukee Health Department records show five cases in 2003 and three in 2004. So far, two cases have been reported this year.

For the state, there have been 128 confirmed meningococcal disease cases and 15 deaths since 2002. Of those, 42 cases and seven deaths could not have been prevented by vaccination, according to the Department of Health and Family Services.

“We all want to prevent disease. I’m a strong proponent of vaccination, but this is a non-cost-effective vaccine,” said Kelly Henrickson, a professor of pediatrics and microbiology at the Medical College of Wisconsin and a pediatric infectious disease specialist at Children’s Hospital.

“You have to immunize so many people just to prevent a few cases,” he said. Henrickson still recommends the vaccine, though.

For those who are affected, he added, this vaccine is extremely beneficial.

To schedule an appointment through the Visiting Nurse Association, call Lisa Taylor at (414) 328-4495.

Source: Milwaukee Journal Sentinel

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