Bacteria rarely causes serious illness

By MICHAEL VAN SICKLER, Times Staff Writer
Published September 25, 2007

Delta Gamma sorority members mourn at a memorial service held at the Martin Luther King Plaza on campus for USF student Rachel Futterman, 19, who died Monday of bacterial meningitis. Video: Memorial service Video: USF officials speak View photos Sudden death stuns campus Timeline
	[Brian Cassella | Times]

Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain. Much of the pain is caused by inflammation, which, as it expands, puts pressure on and irritates nerves and nerve tissue, leading to a stiff neck and headaches.

What causes it?

Meningococcal meningitis is caused by Neisseria meningitidis, a leading cause of meningitis and blood poisoning in U.S. teens and young adults. The bacterium lurks in the noses and throats of 5 to 10 percent of the population but rarely causes serious disease. Viral meningitis is generally less severe and doesn't need to be treated.

So why does it cause serious disease for only a tiny fraction of those who have the bacterium?

The bacteria are triggered by stress that weakens the body's defenses. Examples are lack of sleep, consumption of large amounts of alcohol, an unsteady diet, an illness or surgery.

How is it transmitted?

Very close contact, including kissing or oral contact with shared items such as cigarettes or drinking glasses. People face a very low risk of contracting the disease from simply being in the same room as an infected person, officials said. Rachel Futterman was a waitress, but people she served don't need to worry about becoming ill, said Warren McDougle, epidemiology program manager for Hillsborough County's Health Department. "You have to share bodily fluids," he said. Even then, the risks are low. About four in 1,000 people who swap saliva with an infected person stand a chance of getting the disease, according to Dr. Michael Deichen, associate director of clinical services for the University of Central Florida.

Who is at risk?

Nationally,freshman living in campus housing run a four in 100,000 chance of contracting meningitis, a rate that's four times that of the general population, Deichen said.College students, however, have a lower risk of contracting the disease than adults ages 18 to 23 who are not in college. University of South Florida officials cited figures that 100 to 125 cases occur annually on college campuses and five to 15 students die as a result.

When was the last meningitis death in the Tampa Bay area?

October 2005. A 21-year-old Marine recovering from combat wounds at the James A. Haley VA Medical Center in Tampa died unexpectedly of bacterial meningitis. USF's last case was in 1993, but the student survived.

Why wouldn't those living in close quarters in the military get meningitis at a similar rate as those in college housing?

Until 1971, military personnel got the disease at rates of up to 25 per 100,000. But then all new recruits started getting vaccinated, and large outbreaks no longer occur. According to the Centers for Disease Control and Prevention, rates in the military are among the lowest in the population, at about 0.51 per 100,000.

Are incoming college students required to get vaccinated against meningitis?

In some cases. In 2003, state lawmakers required students living in campus housing to either get the vaccine or sign a waiver that allowed them to skip it. Those living off campus aren't required to do either.

USF requires its 4,400 students living in campus housing to get vaccinated or sign the waiver, as the University of Central Florida does with its 7,000 student residents.

Dr. Egilda Terenzi, director of Student Health Services at USF, said she's considering whether the policy should go further.

"Many of the same living conditions apply" for off-campus students, Terenzi said. "We will be having conversations."

The University of Florida and Florida State University require all students, no matter where they live, to get the vaccine or sign the waiver.

"Meningitis isn't aware of the ownership of student housing," said Lesley Sacher, director of FSU's Thagard Student Health Center. "We feel very strongly that all students take it."

So are universities being negligent by not requiring all students to take the vaccine or sign the waiver?

Not really, UCF's Deichen said. He said the rates of contracting it for off-campus students are one in 100,000 -- about the same as the general population.

"The freshmen have a high risk, but for all the other college students, it's the same risk as you and me," Deichen said. "So why would you require it? It can be costly."

How well does the vaccine work?

Medical experts laud Menactra, the latest version of the vaccine, which was introduced in 2005. Of four strains that the vaccine covers, it provides 70 to 85 percent protection, health officials said. But there are some strains it doesn't cover.

It wasn't clear what strain Futterman had, and USF's Terenzi said she couldn't disclose whether or not she took the vaccine. Once taken, it's good for four to five years.

Are there any side effects of the vaccine?

It's rare, but patients can get what is called ascending paralysis, UCF's Deichen said. From the feet on up to the torso, paralysis creeps in, but it's only temporary, he said.

"That's a rare phenomenon," he said. "The benefits outweigh the risks."

Compiled by Michael Van Sickler. Times staff writer Casey Cora and researcher John Martin contributed to this report. Michael Van Sickler can be reached at mvansickler@sptimes.com or (813) 226-3402.

The symptoms

High fever, headache and stiff neck are common in anyone over 2 years old. Symptoms can develop over several hours, or one to two days. Other symptoms include nausea, vomiting, discomfort with bright light, confusion, drowsiness and seizures.

To get vaccine

Hillsborough County Health Department clinic, 4951 Adamo Drive, Suite 210, Tampa

University Clinic, 13601 N 22nd Street, Tampa

USF Student Health Services (for students), 4202 E Fowler Ave., Tampa.

Price of vaccine

Free for those 18 and younger. $92 at county clinics for 19 and older.

Sources: USF, Florida Department of Health, Hillsborough County Health Department

[Last modified September 25, 2007, 00:26:11]