Case reinforces call to for meningitis shot
http://deseretnews.com/dn/print/1,1442,600112453,00.html

Deseret Morning News, Wednesday, February 16, 2005

By Stephen Speckman
Deseret Morning News

The U.S. Centers for Disease Control last week advised that adolescents and college freshmen living in dorms receive meningococcal immunizations.

The Feb. 10 recommendation by CDC's Advisory Committee on Immunization Practices (ACIP) came just days before the third death of a Utah child in three years that doctors have linked to meningitis.

The ACIP's advice follows the Food and Drug Administration's January approval of France-based Aventis' new meningococcal "conjugate" vaccine called Menactra.

This week East High School sophomore Madeline Hales became the most recent Utah child to die from what health officials say could have been bacterial meningitis, which is an infection of the spinal cord fluid and tissue around the brain.

The Salt Lake Valley Health Department confirmed in January 2004 that a child died from a bacterial form of meningitis.

A month before that, Judge Memorial Catholic High School student Demi Candelaria, 15, also died from what doctors said was one of two forms of bacterial meningitis.

"It's terribly, terribly devastating when you get it, but it's very rare," University of Utah Student Health Service nurse manager Carmine McDonald said.

The CDC reports about 3,000 people each year contract bacterial meningitis or meningococcal disease. About 10 percent die from the disease, and a slightly higher percentage end up with permanent disabilities such as brain damage, hearing loss and loss of limbs. Viral meningitis is generally less severe and resolves itself without antibiotics, according to the CDC.

Schools like Utah State University and the U. do not require that students get a meningitis vaccination, but information is distributed among freshmen about the vaccine and about their increased risk.

Some private schools and some states require incoming college freshmen to be immunized against meningitis.

Brigham Young University spokeswoman Carri Jenkins said officials at BYU's health center are monitoring the CDC Web site daily since the advisory committee's recommendation last Thursday.

For years BYU officials have sent a letter to the parents of incoming freshman to make them aware of meningococcal disease.

"It recommends they consider the vaccination," Jenkins said.

The vaccine costs about $65.

"We ask them to go to the CDC Web site and study the information provided there," Jenkins said.

BYU never has had a reported case of meningococcal disease.

The ACIP and the National Foundation for Infectious Diseases are advising that children ages 11-12, age 15 or entering high school, and college freshmen living in dorms seek the new vaccination, which at this early stage in production will be in relatively short supply. The more expensive vaccine should be available by March.

One reason the younger age-group is targeted for vaccination is that they are already in an environment where schools require certain routine vaccinations. So convenience is a factor there.

Those who are 15 or living in dorms are singled out because of the close quarters they keep with other students or because of increased contact among their peers.

According to the CDC, college freshmen living in dorms are over six times more likely than other people to be infected with the potentially deadly bacterial form of meningitis. Despite the higher risk, occurrences are "fairly" rare, the CDC says.

The new vaccine is thought to last longer than the present product while also allowing for a booster shot to possibly increase immunity, according to Dr. William Schaffner, chairman of Vanderbilt Medical School's Department of Preventative Medicine.

The new conjugate may also eliminate the "carriage," or presence, of the bacteria at the back of the throat that can lead to transmission of the disease, Schaffner said.

Ways of transmitting meningitis include sneezing, kissing and sharing utensils or drinking glasses. Symptoms often resemble the flu.

USU Student Health Center Director Jim Davis said people can be carriers of meningitis but not exhibit symptoms.

Davis recalled the death of his own cousin when they were young. Davis said one day his cousin complained of a headache and neck stiffness — and by 10 p.m. that night, he was dead.

"He was a young, healthy state champion wrestler," Davis said.

It's a disease, he added, that seems to strike mostly young people "out of the clear blue sky."

More information on meningitis can be found by calling a public health nurse at 801-534-4660 or visiting the Web sites www.slvhealth.org or www.cdc.gov.