Campus Chronicle

Issue date: 9/22/08 Section: Pulse

Dr. George

Q: Would the meningitis vaccine really be effective to take now that I'm already a junior in college? Is there a sensitive period for the vaccine to work?

A: Strictly speaking, you survived the traditional period when you were most vulnerable to that kind of meningitis, but you still may want to get the vaccine. Meningitis is an infection of the fluid that bathes the brain and spinal cord. Called spinal fluid, it is normally sterile. There are a variety of different bacteria and viruses that can infect that fluid, often with disastrous results. Meningitis is one of those elite medical emergencies that always get medical peoples' attention.

Viral meningitis is the milder form of the disease. All types of meningitis present with fever and stiff neck. The viral types usually resolve without treatment in a few days and seldom cause any lasting problems. The bacterial kinds can rapidly progress to seizures, coma, and death. Before you go out and flood the Emergency Departments with symptoms you think might be meningitis, you should know that virtually everyone with a fever will have muscle aches in various groups, sometime including the neck muscles. The kind of neck stiffness with meningitis is a different kind that has you virtually unable to touch your chin to your chest without severe pain.

Neisseria meningitides or Meningococcemia is the kind of meningitis that we usually worry about with college students or any group of young people that are living in close proximity, like a dorm. Although you have survived the dorms, that is just one situation that is high risk. There are other situations that you haven't even thought about that could also make you high risk. You may end up in an occupation like microbiology, nursing, or medicine where you can be occasionally expected to come into contact with the Neisseria bacterium. You may also travel internationally to countries that have had periodic epidemic outbreaks of Meningococcal meningitis. You may become ill or injured in ways that make you predisposed to infections like this. Finally, you may decide you want to serve your country in the military-an occupation that I truly feel is a noble and selfless calling for which we all owe thanks. Fact is that the world is very rapidly becoming a smaller place all the time. Diseases that used to be found only in isolated, remote locations are now just a plane ride and a matter of hours away.

Not too many years ago, there was another form of bacterial meningitis that was more common and caused more deaths and morbidity than other types. That was the one caused by the bacteria, Haemophilus influenza. Since the 1980's (I assume most of you have had this vaccine), children have been routinely vaccinated with what is commonly referred to as the "Hib" vaccine. Like the polio, diphtheria, pertussis (whooping cough), measles, mumps, and rubella (German measles) vaccines before it, the "Hib" vaccine has saved countless lives and some very disabling disabilities. In fact, vaccines are one of the greatest contributors to the longer and healthier life spans we now have relative to our grandparents. Take a moment in your busy lives today to silently thank our vaccine pioneers.

The Neisseria meningitis vaccine that is most often used today is known as the MCV4 vaccine. It can be given to almost everyone age 11-55. There is a different vaccine that is used for the ten and under and older than 55 patients. A single dose gives lasting immunity (we think), and there are almost no side effects of significance. There are still about 2,600 people a year contracting the disease, 10% of which die. Others lose use of arms, legs, become deaf, or suffer nervous system injuries. I've seen patients with this form of meningitis, including a young nurse at the hospital where I practiced. She went from no symptoms to death in less than a day. Getting the vaccine probably seems like a pretty good idea after you've seen that.

Don't despair. After discussions like this, it's easy to feel almost paranoid about the various agents that are even now plotting to get you. While the eventual outcome of our lives is predetermined (unless one of you is able to become the first to never die), everything else between here and there is yet to be written. Enjoy the ride, and never miss a chance for an adventure. You may not pass this way again.

Send your anonymous questions to pulse@chicagoflame.com.

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