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Meningitis (Meningococcal disease) is an inflammation of the membranes that cover the brain and spinal cord and may be caused by a variety of pathogens, including bacteria, viruses, fungi, environmental toxins like heavy metals and reactions to medications. Meningitis case fatality rates have been as high as 50% in endemic countries although now they hover between 10%-15%. Regardless, serious permanent side effects like deafness, mental retardation and amputation of limbs occur in 11%-19% of survivors. Although bacterial and fungal meningitis require extended hospitalization, viral meningitis is typically less severe and clears up without specific treatment.
Meningitis is transmitted by air droplet, kissing, sharing of items, utensils that may have been infected and nasal secretions.
Meningitis symptoms include high fever, headache and stiff neck in anyone over the age of 2 years. Other symptoms may include vomiting, nausea, confusion, sleepiness and discomfort looking into bright lights. In small infants and newborns, headache, fever and neck stiffness may be difficult to detect or completely absent. Infants with meningitis may be feeding poorly, be irritable, appear slow or inactive and have vomiting episodes. Meningitis symptoms can develop within hours or they may take 1 to 2 days. As the disease progresses, patients of any age may have seizures.
Meningitis in North America most commonly occurs in dorms, schools or other areas where individuals will have long-term close contact with one another. Because of this, many high schools, colleges and universities throughout North America mandate meningitis vaccination in order to attend. The increased prevalence of meningitis among younger individuals has led the CDC to recommend meningitis vaccination to those in their teens and early 20's as part of the routine vaccination schedule.
Outside of North America, meningitis can be prevalent. The disease is endemic throughout the sub-Saharan Meningitis Belt, which extends from Senegal to Ethiopia, travelers visiting the region during the dry season are advised to receive the meningitis vaccine especially if prolonged contact with the local population is likely. Thus, meningitis vaccine is recommended for travelers going to countries in the meningitis belt: Senegal, The Gambia, Mauritania, Mali, Guinea Bissau, Guinea, Sierra Leone, Cote D'Ivoire, Burkina Fasso, Ghana, Parts of Togo, Benin, Niger, Nigeria, Chad, Cameroon, Central African Republic, Sudan, Ethiopia, Parts of Kenya, Parts of Uganda and parts of Eritrea.
An outbreak of group W-135 meningococcal disease occurred in the year 2000 associated with the annual Hajj pilgrimage to Mecca and caused the Saudi Arabian government to mandate that all travelers receive the meningitis immunization prior to pilgrimages to Mecca.
There are two types of meningitis vaccinations available in the U.S. One protects against A, C, W and Y strains and other other against only B strains.
Serogroup B meningitis immunization is recommended for youth age 16 to 23 to provide short term protection against meningitis B. It is also recommended as a routine vaccination for some individuals over the age of 10 if: there has been an outbreak of meningitis B, they have a damaged or removed spleen, certain immune conditions among other similar indications.
The meningitis B vaccine comes in two brands:
Vaccination against serogroups A, C, W and Y is considered a routine vaccination and is recommended for adolescents 11 to 18 years old. Generally, the first dose is given at 11 or 12 with a booster at 16. If the first dose is given after an individual is 16, a booster is not needed. There are two types of A, C, W and Y vaccines:
Both provide equal levels of protection against potential meningitis contact in the United States and other regions of the world an individual may travel to.
The meningitis vaccines are available at all Passport Health travel clinic locations.
Adolescents are most at risk for contracting meningitis. The CDC recommends all teens 11 through 18 receive the meningitis A, C, W and Y vaccine and between 16 and 23 receive the meningitis B vaccine. Many high schools and colleges now require proof of meningitis vaccination before starting the school year. Additionally, the Advisory Committee on Immunization Practices (ACIP) suggests that teens receive the vaccine less than 5 years before starting school.
The CDC recommends adults with the following risk factors be vaccinated as well:
Meningitis vaccines, both A, C, W, Y and B vaccines, are available and in stock at all Passport Health travel medicine clinics. Schedule an appointment today with your local Passport Health travel medicine clinic, to help keep you and your family safe whether going to school or abroad.
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