Meningitis - Does the Vaccine Work?

Parent Cafe
1

<p>Read in our paper today that three Penn kids are in the hospital with meningitis (two in critical condition) and that all parties/socials have been canceled this weekend.
I remember that my s got a vaccine -does anyone know if that works?
Son does not go to Penn - but his college just suffered from a norovirus outbreak which is becoming more common on campuses these days. Scary stuff going around!</p>

<p>[Third</a> Penn student hospitalized for meningitis-like infection - News](<a href=“http://media.www.dailypennsylvanian.com/media/storage/paper882/news/2009/02/13/News/Third.Penn.Student.Hospitalized.For.MeningitisLike.Infection-3630216.shtml]Third”>http://media.www.dailypennsylvanian.com/media/storage/paper882/news/2009/02/13/News/Third.Penn.Student.Hospitalized.For.MeningitisLike.Infection-3630216.shtml)</p>

2

<p>Which vaccine did your son get? The older Menimmune vaccine provided reasonable protection but wore off after about 3 or 4 years. The newer Menactra vaccine provides better and longer lasting protection. </p>

<p>Also, both of these vaccines are for bacterial meningitis. They provide no protection for viral meningitis.</p>

3

<p>hmmm…I don’t know specifics but he got a vaccine for meningitis during the summer before starting college - about 3 years ago. I guess I should check in with our doc…
Seems like the Penn outbreak is bacterial</p>

4

<p>This is another time to remind all our kids about washing their hands religiously, and especially in winter months. Also remember to do so when they use hand rails on stairs, frequently touched places like door handles, elevator buttons, and cafeteria tables (that may not frequently be wiped off like restaurant tables). </p>

<p>S2 caries hand sanitizer and Clorox wipes in his book bag. He uses the sanitizer regularly and keeps the Clorox wipes for the piano keyboards in the practice rooms (He may be becoming a bit of a germophobe. I had to talk him out of the anti-bacterial body wash). </p>

<p>I also noticed while traveling this weekend that several airport restrooms now had hand sanitizer dispensers just at the exit.</p>

<p>Just a little care will present a whole host of student illnesses.</p>

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<p>Hand sanitizers are nice, but they not as effective as good ol’ soap and water. For example, spores from Clostridium difficile are killed and removed by soap and water but not by most sanitizers. (FYI: C. difficile is a particularly intractable and unpleasant intestinal bacterial infection. Its name gives a hint: “difficile” is French for difficult.)</p>

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<p>There was also a case at Duke. A kid who was “tenting” in K’ville. Dukes letter to parents suggested the vaccine decreased odds of getting it to less then 20%, if I’m not mistaken.</p>

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<p>^^^
Interesting on the hand sanitizer …my son recently got hit with the Norovirus (nasty stomach virus hitting campuses) and he has a large bottle of hand sanitizer in his room that he uses multiple times per day.
I’ll tell him about the soap and water!</p>

<p>Sending my prayers for the Penn kids - a couple of them are in really bad shape.</p>

8

<p>The vaccine is very effective, but does not work against all strains of the bacteria that causes meningitis (but DOES work against the ones most likely to cause disease).</p>

<p>If he got vaccinated about 3 years ago, it was probably with Menactra, the more effective vaccine.</p>

<p>Regarding norovirus: it can last on surfaces for a long time. Also, the period of being contagious lasts beyond the disease. That’s why it spreads so easily. Remember, it’s a virus, not bacterial in origin.</p>

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<p>so cleveland, can you get REINFECTED with the norovirus? Should I tell my son to clean his room with a bleach solution?
He’s home this weekend (still not feeling great) and I’m washing my hands a LOT.</p>

10

<p>There are many noroviruses, so, yes, you can get infected with another one of them. (Just like there are many viruses that cause the common cold) </p>

<p>Cleaning surfaces with a bleach solution helps, but may not eliminate the problem, since it can be on just about anything.</p>

<p>Here’s a good website about them:</p>

<p>[CDC</a> - Norovirus: Q&A](<a href=“http://www.cdc.gov/Ncidod/dvrd/revb/gastro/norovirus-qa.htm]CDC”>http://www.cdc.gov/Ncidod/dvrd/revb/gastro/norovirus-qa.htm)</p>

11

<p>This is really scary. Bacterial form is more serious than viral (a girl in my elementary school died from bacterial meningitis just a few hours after being rushed to ER).</p>

<p>coureur, soap does not kill *C. diff *spores which are spread through contact with fecal matter; it just removes them (which hand sanitizers do not do). Only bleach takes care of the spores according to some studies.</p>

12

<p>Here’s a link to the Duke Parents bulletin</p>

<p>[Duke</a> Student Diagnosed With Meningitis](<a href=“http://www.dukenews.duke.edu/2009/02/meningitis.html]Duke”>http://www.dukenews.duke.edu/2009/02/meningitis.html)</p>

<p>"Although health experts are taking a number of precautions, they say this disease cannot be transmitted by casual contact and additional cases are considered unlikely. The risk of contracting meningitis is extremely low, on the order of 5 in 100,000, even for those exposed to it, according to Duke Hospital infectious disease experts who have been responding to this event.</p>

<p>People who have received the vaccination for meningitis have an even lower risk…"</p>

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<p>[HMI</a> World | Around Harvard](<a href=“http://www.hmiworld.org/hmi/issues/May_June_2007/around_c_difficile.html]HMI”>http://www.hmiworld.org/hmi/issues/May_June_2007/around_c_difficile.html)</p>

<p>Excerpt:</p>

<p>"There’s some speculation that alcohol-based hand gels contribute to the spread of C. difficile. Staff in many hospitals are required to use these products because they help prevent the spread of many multi-drug-resistant organisms. But they don’t kill C. difficile spores. Soap and water does. "</p>

14

<p>the most important part of hand-washing is friction which is often missed with hand sanitizers. When washing hands sing happy birthday to yourself so you provide at least 15 seconds of friction.</p>

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<p>My older sister had the old meningitis vaccine before she left for college in 2003. She got bacterial meningitis last year, December 2007. She was really, really sick and we’re lucky that her boyfriend made her go to the hospital - she was arguing not to, but he had a feeling something was really wrong. I don’t like to think about what would have happened had she not gone.</p>

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<p>coureur, media spreads too much misinformation. Search for C. Diff and bleach in PubMed. I’m noit saying that soap is ineffective, it does remove the spores from the hands, but it does not kill them. I’m not against hand washing; if your wash the spores off the hands, they do not make their way in to your mouth.</p>

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<p>I have a good friend who had a heart/lung transplant so he has to be really careful about every bug and virus. His doctor says that he should wash his hands and use hand sanitizer, but to be absolutely sure to use the hand sanitizer.</p>

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<p>In terms of human health and hygiene, that’s definitely a distinction without a difference.</p>

19

<p>Wow…lots of close but not quite information here. As a soon to be newly minted MD (less than 11 weeks!) I certainly don’t know everything, but I can shed some light.</p>

<p>On bacterial meningitis - definitely very serious. In the overall scheme of things, viral meningitis is usually more of a nuisance than a serious situation for most otherwise healthy teens and adults. If you’ve ever had a cold with a pretty bad headache, that’s likely sub-clinical viral meningitis. </p>

<p>On the meningococcal vaccine - it works. However, this, like most vaccines (ie Gardasil or Haemophilus Influenza) is only aimed at the **most common strains ** of meningococcal bacteria. Therefore it is certainly possible to still get very serious meningitis from strains that aren’t covered but the idea is to manage and reduce the risk of getting an infection. It is unfortunate that there are cases of meningitis, but that doesn’t mean the vaccine is ineffective.</p>

<p>On the C. Diff issue - realize that C.Diff infection outside of the hospital is VERY rare. First a very small portion of the population is actually colonized with bacterium. Second you have to have had a very recent course of high powered, broad spectrum antibiotics to get it. </p>

<p>Basically C.Diff is a very hearty bacterium but it grows and reproduces very slowly in the colon. In healthy adults who haven’t been on antibiotics, the rapid growth of other bacterium in the colon takes away resources and nutrients from C. diff bacteria, keeping their numbers in check. When someone takes an antibiotic that kills a great many types of bacteria, the hearty C.diff is able to survive and in the now “empty” colon, suddenly has unfettered access to the nutrients it needs and is able to multiply. When a certain density of bacteria is reached it begins producing a toxin which leads to pseudomembranous colitis and problematic diarrhea. </p>

<p>On the bleach vs hand washing - again, far more important in hospitals. But in that situation, since we’re concerned with transmission - whether you kill them or simply wash them off, as long as you get rid of them that’s better than nothing. If there was 100% rates of handwashing after every patient even without bleach, rates of C. diff transmission would decrease (along with doctors and nurses having ridiculously raw hands - sanitizer is very helpful in that regard - especially in winter). That said, there’s actually a growing amount of data suggesting that concomitant use of probiotics with antibiotics helps decrease the incidence of C.diff and I believe that this will eventually become the standard of care for most hospitalized patients on antibiotics in the future.</p>

<p>Bottom line, as far as parents of college aged children are concerned - they need the vaccine but it doesn’t prevent every case, and basic hygiene concepts are always advisable. If the use of hand sanitizer means they’ll clean their hands more often, that will help keep them healthy.</p>

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<p>Bigredmed, thank you for getting this back on topic. It is great to hear that newlyminted docs are well-informed. There is a parallel thread on this topic in the Parents forum, and the issue of viral vs. bacterial meningitis was brought up there, too. May be you should post there, too.</p>

<p>(You are right on C. Diff, too. There is no solid data on how prevailent it is in the general population, although some recent data from the UK suggests that it could be more common that we think. The reason I brought up C. Diff in here was because someone stated that soap “kills it”. Not true. Bacteria that turns into spores are hard to kill with just soap. I wish hospital staff would also understand this :rolleyes:, but that’s a different topic.)</p>