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Go off to college and then die? Why? - (8/6/2019)

By Dr. Ron Gasbarro

Bob came into the pharmacy for his diabetes supplies. The pharmacist asked him if his daughter was ready to go off to college in a few weeks. “Yes, she is eager to go but has some hesitations,” Bob said. “She is nervous about living in a dorm with other students. This will be her first time away from home.” Bob continued, “She heard about a student at another college who died from meningitis right in his dorm room. That has her spooked!” 

College can be a scary first experience for a freshman. Everything is new: the school, the people, the living arrangements, and even exposures to health risks. Across the US, meningitis outbreaks have hit colleges and other schools. In 2013, at the University of California, Santa Barbara, 4 cases of meningitis B occurred in one month in 2013. All of the students survived. However, one, a male lacrosse player, had both feet amputated. The typical environment that comes with co-ed life — living in close quarters, sharing drinks and utensils, kissing, coughing — are just a few ways meningitis B can be spread.
 
Meningitis is an inflammation and swelling of the membranes (meninges) surrounding the brain and spinal cord. Typically, the swelling triggers symptoms such as headache, fever and a stiff neck. Viruses cause most cases of meningitis in the US, but bacteria, parasites, and fungi are other causes. Some cases of meningitis improve without treatment in a few weeks. Others can be life-threatening and require emergency antibiotic treatment. Never wait for more than a few hours after symptoms appear before seeking a diagnosis.

“Has she had a vaccine for meningitis B?” asked the pharmacist. “I think she had a meningitis shot when she was 16,” Bob said. “But was it for meningitis B or for another type?” asked the pharmacist. Two types of meningitis vaccines are available. Each type protects against the different antigens, or toxins, that characterize the various meningitis bacteria. Meningococcal conjugate – also called MenACWY because it produces antibodies to fend off types A, C, W, and Y (brands Menactra® or Menveo®) – is usually given at age 16 years. Serogroup B meningococcal (MenB) (Bexsero® or Trumenba®) may be given at 16 through 23 years in 2 doses. About 40% of bacterial meningitis cases are caused by the B serogroup. The MenACWY vaccine does not protect against serogroup B meningococcal disease. Thus, Bob’s daughter and any child going off to school will also need the B vaccine as well as the MenACWY. 

The symptoms of meningitis are often mistaken for other less serious illnesses such as the flu. Common symptoms include fever, a flat, a pink to red to purple rash that is noticeable on any part of the skin, a stiff neck along with headache, and sensitivity to light. Getting immediate medical treatment is crucial. Meningitis can worsen quickly, even within a few hours from the start of symptoms. If untreated, the infection can be fatal in up to 20% of cases or cause kidney failure, hearing loss, or limb amputation.

The pharmacist told Bob that a healthy lifestyle can reduce the risk of getting meningitis. Lower the threat by avoiding smoking, drinking alcohol, stress, and upper respiratory tract infections. Strengthen the immune system by getting enough sleep, exercise, and nutritious foods. Do not share eating utensils or drinking glasses, and wash hands often. Get familiar with the school’s student health services. Find out who to call or where to go if one gets sick. And get the vaccine to kick that disease in the butt! 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com


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