RTQ POSSIBLE BACTERIAL MENINGITIS CASE

 

Background:  On Thursday, November 13, 2008, a 20-year-old male U.S. Naval Academy midshipman fourth class (freshman) began receiving treatment at Baltimore Washington Medical Center for possible bacterial meningitis.  The midshipman was taken by ambulance to the hospital Wednesday evening.   The Naval Academy is ensuring the midshipman has the best medical care available and are closely monitoring his condition.   The identity of the midshipman and details his medical condition are being withheld due to privacy restrictions.

 

The Naval Academy is also aggressively following established medical protocols to ensure this remains the only case aboard the Academy. As a precautionary measure, the Academy’s medical personnel have identified midshipmen who have may have been exposed to the illness.  These midshipmen are being provided prophylactic antibiotics (which are very effective in stopping the illness), and being interviewed and monitored by the Academy’s medical staff.  

 

 

Qs&As:

Questions and Answers:

 

Q1.  What is Bacterial Meningitis?

 

A1.   Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain.  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.  Bacterial meningitis can be quite severe and may result in brain damage or even death.

 

Q2.  How does someone get or contract Bacterial Meningitis?

 

A2.  In most people with bacterial meningitis, the infection has no obvious source. However, since the disease is contagious, if there is more than one case identified, it is important to determine the initial or index case. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as things like 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.

 

Q3.  What are the symptoms of Bacterial Meningitis?

 

A3.  Symptoms include high fever, headache, and stiff neck. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect.  The infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.

 

Q4.  How is Bacterial Meningitis diagnosed?

 

Q4.  Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. The diagnosis is usually made by growing bacteria from a sample of cerebrospinal fluid (CSF). The CSF is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where CSF in the spinal canal is readily accessible.  Identification of the type of bacteria responsible is important for selection of correct antibiotics.

 

Q5.  How does Navy Medicine treat their patients with Bacterial Meningitis?

 

A5.  Navy Medicine follows established medical protocols in treating patients with bacterial meningitis. It generally involves hospitalization and initiation of broad spectrum antibiotic therapy on a presumptive diagnosis since the disease can be rapidly fatal.

 

Q6.  What is being done to prevent U.S. Naval Academy midshipmen and staff from contracting Bacterial Meningitis?

 

A6.  The Naval Academy is aggressively following established medical protocols to ensure this remains the only case aboard the Academy. As a precautionary measure, the Academy’s medical personnel have identified midshipmen who have may have been exposed to the illness. These midshipmen are being provided prophylactic antibiotics (which are very effective in stopping the illness) and being interviewed and monitored by the Academy’s medical staff.

 

Q7.  Is Bacterial Meningitis contagious?

 

A7.  Yes, some forms of bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as things like 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.

Sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or day-care center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiring the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib meningitis disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated against Hib disease.

 

Q8.  Are there vaccines that protect against Bacterial Meningitis?

 

A8.  Meningococcal vaccines protect against most types of meningococcal disease, but they do not prevent all cases.  Midshipmen at the Academy receive a meningococcal vaccination within their first two weeks of training.  There are two vaccines against Neisseria meningitidis available in the United States: meningococcal polysaccharide vaccine (MPSV4 or Menomune®), and meningococcal conjugate vaccine (MCV4 or Menactra®).

 

 

Additional information on Bacterial Meningitis may be found at: