Oct. 11, 2000 -- Three children in the Detroit area have died recently of bacterial meningitis -- an inflammation of the membranes around the brain and spinal cord -- and some students in the community are alarmed enough to skip school and worry about school food services as a transmission site.
Meningitis can send shockwaves through a community affected by it and raise the concerns of parents and adults nationwide over its potentially deadly outcome. But a little bit of knowledge can often help dispel some of the fears associated with the illness. For instance, in Michigan, experts say these deaths seem to be a tragic coincidence and that the community should exercise only the usual precautions, such as frequent hand washing.
"Our investigation determined that there was no connection between these fatal cases. There was additional DNA testing done by the Michigan Department of Community Health and the Centers for Disease Control and Prevention," says Kevin Lockar, MD, MPH. "They were all different types of pneumococcal bacteria." The deaths, involving three children under 12 years of age, "were an unfortunate random occurrence," says Lockar, the medical director of the Macomb County Health Department, the county in which the deaths occurred.
"We absolutely do not have an outbreak or epidemic or even a cluster," Geralyn Lasher, spokeswoman for the Michigan Department of Community Health, tells WebMD. "Anytime a situation involves young children, it raises concern. However, the public should know that bacterial meningitis is relatively common. We've had 145 cases reported in Michigan this year. Numbers for this year are consistent with the past few years. The fact that these fatal cases occurred in the most populous area of the state is not unique."
Should you be concerned for yourself or your children? How contagious is meningitis; how severely ill do people get? How can you protect yourself and your family against infection?
It's important to know that meningitis is not as contagious as colds or influenza, which travel widely on droplets following a cough or sneeze. For meningitis, the route of transmission is close and more direct. You need to have immediate contact with the droplets. The infected person needs to cough or sneeze directly in your face, or you need to share a drinking glass, athletic water bottle, or dinner utensil with the person. Kissing would be another example of the direct, close contact typically involved in meningitis transmission.
"You can't get meningitis by just being in the same room with an infected person," CDC spokesman Tom Skinner tells WebMD. "Why some people become ill from the bacteria is not fully understood. Some people carry this bacteria and never develop illness."
One of the major preventive actions to take is the simplest: Wash your hands often and thoroughly with soap and warm water, Skinner says. If you do this, and avoid drinking after others and sharing their eating utensils, you reduce your chances of being exposed to the organisms that can cause meningitis.
Meningitis, or the inflammation of the meninges, the membranes that surround the brain and spinal cord, is caused by either viruses or bacteria, and bacterially caused infections are typically more severe. The scientific term for pneumococcal bacteria, which was involved in the Michigan deaths, is Streptococcal pneumoniae. This organism more often causes ear and sinus infections than meningitis. Other bacterial causes of meningitis include Haemophilus influenzae type B and Neisseria meningitidis.
According to information published on the CDC's web site, the symptoms to watch for in people 2 years old or more, are a high fever (101.5° F. or more), a headache, and a stiff neck. Patients also may be nauseated or vomit, they may be sensitive to bright lights, or they may be confused and sleepy. Anyone who has such symptoms should be seen promptly by a physician. Infected infants may be slow, inactive, or irritable, or they may vomit or show little interest in eating.
There are some vaccines available. In February 2000, a vaccine called Prevnar hit the market for S. pneumoniae, the bacteria that caused the Michigan deaths. It is recommended for children with chronic medical conditions. There is another vaccine available for adults.
In addition, the vaccine against Haemophilus influenzae type B (HiB) is recommended for children under 2 years old. A vaccine also is available against four strains of N. meningitidis, which is recommended before travel to certain countries, and some experts recommend it for college freshman living in dormitories.