THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Wednesday, March 22, 1995 TAG: 9503220257
SECTION: FRONT PAGE: A1 EDITION: FINAL
SOURCE: BY MARIE JOYCE, STAFF WRITER
LENGTH: Long : 114 lines
Phones have been ringing at local health departments ever since two Norfolk Academy students were struck with meningococcal disease, a dangerous bacterial infection that hits children and young people.
Norfolk Academy student D.A. Taylor died Monday from the illness. After a second student at the same school was diagnosed last week, health officials decided to vaccinate all students and staff.
But the recent spate of stories about the illness doesn't mean that something particularly unusual is happening, or that most people are in danger of getting sick. Virginia gets more than a dozen such cases every year, and the number of people who have died this year - two - is exactly the same as last year at this time.
There have been four other local cases, but they aren't the same strain as the type at Norfolk Academy.
Dr. Elizabeth Barrett, an assistant state epidemiologist with the health department, talked with The Virginian-Pilot about the risks.
We've heard a lot about meningococcal disease lately. Why does there seem to be so much more this year?
Actually, in Virginia there is not more than in past years. The beginning of January through today, there have been 18 cases in Virginia, and last year there were 19. We're hearing more this year because some of the people who have gotten it have been in the same school or the same area or whatever.
How is the meningococcal bacteria spread?
It's spread through respiratory secretions, so you have to actually have direct contact with discharges from the nose and the throat. Like sharing food or utensils, or if you were close enough to someone to have them sneeze or cough in your face.
It's not just floating at random through the air.
But the carrier doesn't have to be someone who is actually sick from the bacteria, right?
That's correct. In fact, usually, it is someone who is not ill, which is a little bit tricky.
Can my kid pick this up at school?
This bacteria is not in the environment, so it's not on a book or a desk or on your hand, even. It doesn't survive on those surfaces.
So why take the precaution of vaccinating all the students and staff at Norfolk Academy?
Because that's the second case in this school.
When you look at the risk in the general population, we estimate about 0.5 cases per 100,000 people per year. In Norfolk Academy in a short time, there's been two cases already. You can see just by looking at those numbers how much higher the risk of getting the disease in Norfolk Academy is than in the population at large - it's 300 times.
Suppose my teenager hangs out with kids from Norfolk Academy. Maybe they go out to the mall and share a soda. Should I have my doctor put him on antibiotics or vaccinate him?
We're not even recommending that the parents of children at Norfolk Academy be given (antibiotics) or be vaccinated. So we wouldn't recommend it for casual friends.
Maybe some people think - this vaccine's out there, why not just get a dose? I'll sleep better at night.
We don't think it's indicated. If a person's very concerned, they probably should consult with their own physician.
Why isn't it indicated?
We don't think it will prevent further illness. This bacteria is very common. It lives in the throat or the nose. If you went around and did cultures to check for it, you'd probably find it in anywhere from 20 to 60 percent of the population. I may have it in my nose and throat right now. If you take the (antibiotic) rifampin to get rid if it, the rifampin is only effective for as long as you take the medication. So the antibiotic is not making you immune for the rest of your life, or even three or four weeks.
But most of us don't get sick from it, even though we carry it?
For the overwhelming majority of people, it does not cause illness. It is tragic and horrible that a very small number of people will get what's called invasive disease, like meningitis.
How come only a handful of people actually get sick from it?
We don't really know.
What about the vaccine - there are some that we just take as a matter of course. Why don't we just vaccinate ourselves against meningococcal disease?
It is not effective in young children. And it doesn't last - it only lasts about three years. There are several different types of the meningococcal bacteria, and one of the main types isn't even included in the vaccine, because you can't get a good immune response to it.
It's just not a good enough vaccine to be given routinely.
One of the things that seems to be causing confusion is the use of the term ``meningitis,'' which is one of the conditions caused by this bacteria. Is the meningococcal bacteria the only thing that causes meningitis?
No. Meningitis basically means an inflammation of the lining of the brain. It can be caused by many different things - . . . by viruses, by some chemicals, by other types of bacteria. But the meningococcal bacteria is the one that we're referring to here, so it would be called meningococcal meningitis, or, if it (causes) blood poisoning, it's called meningococcemia.
What are the symptoms of meningococcal disease?
Symptoms for meningitis would include fever, headache, stiff neck, nausea and vomiting, and confusion. If you have the blood-poisoning form, it could be fever, chills, muscle aches. With both types you can have a rash.
Those are common symptoms for a lot of things. If my child wakes up tomorrow feeling sick, when should I suspect that it's meningococcal disease and not something less severe?
Your child would have a sudden onset of fever - high fever. We're talking about 103 or higher. (If you're not sure), it wouldn't hurt to call your doctor. People are anxious, and I think a physician would be understanding.
What is the common treatment?
Antibiotics.
One local student died from this. How often is it fatal?
If a child is diagnosed early and gets treated, the death rate is less than 10 percent. It's a very serious illness. Even people who don't die may be left with other problems. ILLUSTRATION: Color photo
Dr. Elizabeth Barrett
by CNB