Flu outbreak

Meningitis: General Guidance

Overview:

Meningitis outbreaks are rare occurrences, but due to the nature of the infectious disease spreading rapidly in large gatherings, college campuses are at higher risk. In attempts to prevent as much of this disease as possible, the Louisiana Legislature has passed a law requiring meningitis immunization for all college students living in residence halls. Unfortunately, the required vaccine does not address the specific strain currently causing illness across US campuses such as Princeton University and UC Santa Barbara. Serotype B, or “strain B,” is responsible for the current 2013 outbreaks, resulting in potential vaccine development targeting specifically “Strain B” to those specific campuses experiencing outbreaks. Medical prophylaxis is also being administered at those campuses to possibly exposed individuals.

Prevention:

Protective measures for this disease is very similar to the common cold and influenza. 

  • Increase hygienic practices (cover coughs and sneezes, wash your hands, limit touching your face, especially your nose and mouth)
    • Wash your hands with warm, soapy water for 20-30 seconds (i.e. sing the Happy Birthday song 2x)
    • Use hand sanitizer when you cannot wash your hands
  • The disease spreads through saliva (such as kissing) and respiratory droplets (such as coughing or sneezing), so use caution and exercise common sense (it is NOT an airborne disease).
  • Do NOT share drinking glasses, eating utensils, smoking materials and other items
    • Alcoholic beverages DO NOT sanitize against the virus. Do NOT share drinking glasses of any type.
  • Limit exposure to known sick individuals, as the disease is spread by close contact, within 3-4 feet, over extended periods.
  • Stay at home when ill to limit exposure to others

Symptoms:

  • High Fever
  • Headache
  • Stiff neck
  • Other symptoms may include:
  • Nausea / vomiting
  • Discomfort looking into bright lights or camera flashes
  • Confusion / altered mental status / stupor
  • Sleepiness / lethargy

Students and other members of the University community should remember these important points about meningitis:

  • Any student with a high fever and/or stiff neck should contact Student Health Services (quick medical attention is critical)
  • You may become ill with meningitis even if you have not been in contact with someone who is sick
  • You can help prevent the spread of disease by increasing hygienic practices, and not sharing drinking glasses, eating utensils, smoking materials and other items

How do I disinfect against meningitis?

Transmission occurs by direct contact with infectious respiratory droplets or oral secretions and does not survive well outside of people.  It has, however, been reported to survive on glass and plastic at room temperatures for hours to days.  Therefore, it is necessary to disinfect bathroom and kitchen surfaces as well as kitchen utensils and dishes. The causative agent of menigitis is highly susceptible to the temperature and duration of an automatic dishwasher cycle, e.g., >65 C for 5 min.

Common household disinfectants can be used against this type of bacteria. These include household bleach (sodium hypochlorite) or ethyl rubbing alcohol 70%.  It is not necessary to use full strength household bleach.  You may dilute one cup into one gallon of water.

Possible response protocol

  • Vaccinating people identified as being at high risk (if the strain is one that can be prevented by meningococcal vaccines)
  • Making sure all close contacts of a patient receive antibiotics to prevent them from getting the disease (this is known as prophylaxis)

State and local health departments take the lead in investigating outbreaks and implementing control measures to reduce spread of the disease and would work closely with the Student Health Services. They often work closely with CDC who has published guidelines to assist with this. To ensure the health of everyone as much as possible in the setting of an outbreak, recommendations for further individual assessment would often include:

  • Close contacts to include people in the same household, roommates, or consistent social acquaintances
  • Anyone with direct contact with the patient's saliva (such as a boyfriend or girlfriend through kissing).

CDC supports state and local health departments in identifying a response that best protects their residents' health.

General Information:

Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ.

  • Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability.
  • For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.

Bacterial meningitis is contagious, but generally is transmitted through direct exchange of respiratory and throat secretions by close personal contact, such as coughing, sharing drinks, kissing and being in close proximity for an extended period.  The bacteria that cause meningitis are not as contagious as the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Although it can be very serious, meningococcal disease can be treated with antibiotics that prevent severe illness and reduce the spread of infection from person to person. Quick medical attention is extremely important if meningococcal disease is suspected.

Quick Facts:

  • According to the CDC, less than 1,000 cases of meningococcal disease occur each year in the United States.

o   In 2011, Lousiana Department of Health and Hospitals reported incidence to be about 3 bacterial cases per 100,000 population (11 viral cases per 100,000)

  • According to Louisiana Department of Health and Hospitals, between the years 2002 and 2012, Orleans Parish (City of New Orleans) reported only 21 cases of viral meningitis, which is more common than bacterial meningitis.
  • An outbreak occurs when there are multiple cases in a community or institution over a short period of time. Specifically, an institution-based outbreak is defined as three or more cases occurring within three months. Sometimes having just two cases in a school or college can meet the outbreak definition. However, about half the time no additional cases will occur beyond the first two.

Please visit the Centers for Disease Control and Prevention for more complete information