Meningitis: What you need to know

By Jeffrey Holmstrom, Special to the BDN
Posted Oct. 19, 2012, at 1:08 p.m.

By now, you’ve likely heard or read headlines about the latest outbreak of meningitis that has led to at least 20 deaths and infected more than of 250 people.

So far, cases have been reported in: Florida, Idaho, Indiana, Illinois, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas and Virginia, with the majority of the cases to date in Tennessee, Michigan, Virginia and Indiana.

Meningitis is a disease caused by the inflammation of the protective membranes covering the brain and spinal cord known as the meninges. Meningitis may be contracted from exposure to a virus, bacteria and infrequently a fungus.

The severity and treatment of meningitis differ according to type and symptoms, which is why it’s is important to know the specific cause of the disease.

While viral meningitis is serious, it’s rarely fatal for people who do not have other serious medical problems. Bacterial meningitis, however, is one of the most serious and life-threatening forms. There are a number of strains of bacterial meningitis, among them the highly contagious meningococcal meningitis. This strain commonly occurs when bacteria from an upper respiratory infection enters the bloodstream. It affects mainly teenagers and young adults who are sharing close quarters like college dorms and military bases.

This latest outbreak is caused by the rarely seen fungal meningitis, which is not contagious or spread like the bacterial or viral forms. Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body or as a result of the fungus being introduced directly into the central nervous system.

In this case, the patients received back or joint injections with a steroid medication suspected to be contaminated by a fungus. The potentially contaminated medication was given starting May 21 and was recalled on Sept. 26, according to the Centers for Disease Control and Prevention.

Most patients who have contracted fungal meningitis received a contaminated injection in the spine. However, some patients did receive the injections in their joints.

Should you be worried? Not unless you’ve had a steroid shot in your spine or joint to treat pain in the past four months. Ninety percent of those believed to have been exposed to the contaminated injections have been notified by the CDC. Patients who received the injections will have to be monitored by their physicians for months to see if signs and symptoms of meningitis develop.

Signs and symptoms of fungal meningitis may include fever, severe headache, nausea, sensitivity to light, altered mental status and stroke. According to the CDC, symptoms have been appearing between one and four weeks after patients received the shots.

If you believe you or someone you know may be as risk for having contracted fungal meningitis, please contact a physician right away. Fungal meningitis is treated with high-dose antifungal medications, usually given intravenously in a hospital.

Dr. Jeffrey Holmstrom is the medical director of Anthem Blue Cross and Blue Shield in Maine and serves on boards or committees for a number of organizations, including the Maine Quality Forum Advisory Committee and Quality Counts. He maintains an active family practice at Prime Care in Saco.

http://bangordailynews.com/2012/10/19/opinion/contributors/meningitis-what-you-need-to-know/ printed on August 22, 2014