If you have a question which has not been answered on these webpages, check the Frequently Asked Questions below. If your question is not answered by one of the FAQ, then ask our medical expert at AskTheExpert@meningitis.ca
- Hib Meningitis
- Meningitis Vaccines
- Group B Strep [GBS]
- Viral Meningitis
Q. Can tell me what is the period from getting the germ to the time meningitis becomes fatal to the person?
A. We do not know the time interval from acquiring the bacteria to developing meningitis. It is thought to be relatively short - 1-2 days after the bacteria infects the nose and throat. Most deaths from meningitis occur very rapidly - in less than a day from onset of the fever. Fortunately, such rapidly fatal cases occur in only a small proportion of all cases.
Q. Is meningitis contagious? Should I get tested if my boyfriend has been infected?
A. It depends what caused the meningitis. If the infection was caused by a bacteria called meningococcus then it is contagious from person to person by close, direct physical contact as occurs between people who live together or by such activities as kissing, sharing drinks, cigarettes, etc. Close contacts of persons with meningococcal meningitis are at a small but definite risk of getting the disease and should be treated with antibiotics to prevent the infection.
Q. What after effects are there in adults who had spinal meningitis when they were infants?
A. The damage caused by meningitis occurs during the acute illness. Meningitis does not caused delayed problems which first appear years later. It may be difficult to detect the damage in infants, as the brain is not yet fully developed at that age. Problems with language and learning may not become apparent until the child is older and in school. But problems do not first appear many years later in adult life.
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Q. My daughter got Haemophilus influenzae meningitis and bacteremia. Why did she contract this?
A. Haemophilus influenzae type b, or Hib for short, is a bacteria that can cause as meningitis, bacteremia (infection of the blood), pneumonia, and other serious infections. It has become very rare in Canada and other countries which use the Hib vaccine. The Hib vaccine is part of the combined vaccine recommended for all infants and given at 2, 4, and 6 months of age, with a booster at 18 months of age. The vaccine is very effective in preventing Hib disease. However, it is not 100% effective.
Hib infects only humans. It lives in the back of the nose and throat. People who are immune to Hib can still carry the bacteria in the nose and throat and can spread the bacteria to others. The Hib bacteria is spread by close contact through coughing, sneezing, talking, kissing - by any activity that spreads droplets of secretions from the nose or throat. It is not possible to know exactly how your daughter was exposed to Hib, but someone in close contact with her was a carrier of Hib. There is no way for a person to know they have Hib in their nose or throat because it does not make you sick if you have protective antibodies.
Most babies are born with protective antibodies which they get during the last trimester of pregnancy. The antibodies are transported across the placenta from the mother to the baby. Most mothers have antibody to Hib which is why most babies are protected for a few months after birth. If a mother does not have any antibodies or if a baby is born prematurely (before 32 weeks of pregnancy) then the baby will not have any antibodies either and will be at risk of Hib infection if exposed to the bacteria.
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Q, Can you please tell me what the difference is between these two vaccines: Prevnar and Menjugate (or Meningitech or NeisVac-C) and Menactra?
A. Prevnar is the brand name for the vaccine against a bacteria called pneumococcus. Pneumococcus is a major cause of meningitis and also caused other infections such as pneumonia. It is also the major cause of ear infections in children. Prevnar is composed of 7 separate vaccines against the 7 most common strains of pneumococcus.
Menjugate C is the brand name for the vaccine used in infants against a bacteria called meningococcus, group C. Group C strains of meningococcus cause meningitis and blood stream infections. Two other similar vaccines are available in Canada: NeissVac-C and Meningitech.
Menactra is the brand name for the new vaccine against groups A, C, Y, and W135 strains of the meningococcus. It is approved for use in children 2 years and older, adolescents, and adults.
Q. Is meningococcal vaccines safe?
A. All of the meningococcal vaccines are very safe.. Many million doses of the group C vaccine have been administered in England over the past 8 years without any serious side effects being noted. The group C vaccine has been used routinely for infants and adolescents trhoughout Canada without any serious reactions being reported. The new group A-C-Y-W135 conjugate vaccine (Menactra) has been administered to several million adolescents in the USA.
Q. How long is the shot against menincoccal meningitis group C good for?
A. Protection has lasted 4-5 years in children vaccinated at 2 years of age or older. In infants vaccinated at less than two years of age, the protection is very high for one year, but then begins to wane. It is expected that children vaccinated before 2 years of age will need a booster about 2 years of age in order to maintain immunity until adolescence.
Q. My 20 year old daughter was given a prescription of menjugate C. Is there a test to check to see if she has developed her own immunity before vaccinating her?
A. Blood tests for determining immunity to meningococcal disease are not routinely available. Only a few research laboratories perform such tests. Since the vaccine is extremely safe and very effective, I would recommend it for your daughter.
Q. Should I have my daughter get the shot for attending college as a freshman?
A. The simple answer is: Yes.
The risk of meningitis in college students is increased compared to adolescents and young adults of the same age who do not attend college. The increased risk is not very large, but the vaccine is so safe and so effective that I recommend that college freshmen be vaccinated. Many states require vaccination.
Q. We would like to know what is in the meningitis vaccine and if there is any blood or blood derivatives in it?
A. There are three different meningitis vaccines available for infants against the three most common bacteria causing meningitis. The three types of vaccines are:
- Haemophilus b conjugate vaccine [ActHIB] which is part of the combined baby short PENTACEL. This protects against disease caused by the bacteria, Haemophilus influenzae type b
- Pneumococcal conjugate vaccine [Prevnar] protects against disease caused by the 7 most common types of Streptococcus pneumoniae, also known as pneumococcus. It must be given as separate injection.
- Meningococcal conjugate C vaccine [Menjugate C or NeisVac C or Meningitech] protects against group C strains of the bacteria Neisseria meningitis, group C, also known as meningococcus. Group C strains cause 30-60% of all cases of meningococcal meningitis and are responsible for outbreaks in school children, adolescents, and young adults.
The three vaccines are similar. The active part of the vaccine which induces protective immunity is a complex sugar or polysaccharide which makes up the outer capsule or coat of the bacteria. The polysaccharide is chemically extracted and purified from the bacteria. It is then chemically combined with a protein (either tetanus toxoid or a protein similar to diphtheria toxoid). The polysaccharide-protein combination is called a conjugate vaccine. The conjugate vaccine, unlike the polysaccharide by itself, is very effective in young infants.
* Meningococcal conjugate A-C-Y-W135 vaccine [Menatra] protects against groups A, C, Y, and W135 strains of the meningococcus. It is approved for use in children over 2 years of age, adolescents, and adults. The 4 polysaccharides are each linked to diphtheria toxoid to form the conjugated vaccine.
No blood or blood derivatives are present in any of these vaccines. They are among the most highly purified vaccines available.
Q. Are there any dangers in receiving 2 meningitis vaccinations in a 3-4 year period?
A. No. There is no danger to being vaccinated again. In fact, revaccination is recommended for persons traveling to countries where outbreaks are occurring. The recommended interval between vaccinations is five years. However, the only problem reported to occur after revaccination is an increase in the frequency of pain and swelling at the site of the injection in a small proportion of people.
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Group B Strep [GBS]
Q: I am a GBS carrier and have been told I should get antibiotics during labor. Are there harmful side effects if antibiotics are given during labor?
A: The antibiotic most often used to prevent GBS infections of newborn babies is called ampicillin. Treatment of GBS carriers has been shown to be the most effective method of preventing severe disease in newborns. Ampicillin is an extremely safe antibiotic. Since it is given only for the duration of labor, anywhere from 1 to 4 doses may be administered. The short duration of treatment reduces the risk of side effects in mothers. Treatment of the mother reduces the risk of spread of GBS to the baby during labor and delivery, thereby protecting the baby.
Although the risk of severe GBS infection in newborns born to mother carrying GBS is small, the disease is so severe when it does occur that prevention seems to be the wisest choice, especially as the risk of such treatment to mother and baby is so very small.
Q: Does antibiotic treatment during labor prevent all forms of GBS disease of newborns and infants?
A: Unfortunately not. In some cases, the GBS bacteria has move up the birth canal and invade the amniotic fluid before labor begins. The unborn fetus may become infected and already be severely ill when born. In addition, the antibiotic treatment during labor is effective only against the early-onset form of GBS disease, that is, the illnesses that develop within 1 week of birth. Infants who exposed to and become infected with GBS after being born will not be protected by the antibiotics given during labor.
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Q. One of my employees called this morning to say he was hospitalized with viral meningitis. I have 3 pregnant ladies in my office. Are they in any danger and should they see their doctors?
The many different viruses which can cause viral meningitis are not highly contagious between adults. In most people, the viral infection causes a cold or flu-like illness; only a small percentage of those infected actually get meningitis - about 1 in every 100 infected persons.
Pregnant women are not at unusual risk from the viruses which cause viral meningitis. However if a pregnant woman becomes infected a few days before the baby is delivered, the newborn baby is at risk of severe illness
If any of your employees are close to the expected date of delivery, they should notify their doctors of the possible exposure.
Q. How rare is it that a person dies from viral meningitis?
A. It is very unusual to die from viral meningitis. It is usually an infection which makes one sick for 1-2 weeks, followed by complete recovery. Most deaths occur either in newborn infants or in persons with serious underlying medical problems, especially disorders with the immune system.
Sometimes, the virus which causes meningitis also invades the brain, causing what is called encephalitis, which is a much more serious form of the illness and can cause death.
Q. If six people catch the virus and it develops into meningitis in only one of the six, why only the one and not the rest?
A. It is not known why only a small proportion of people infected with a virus develop meningitis. For most of the viruses that cause meningitis, the proportion is actually as small a 1 in 100.
Although it is not known for human infections, in animals, there appears to be a genetic susceptibility to developing meningitis. The first step in any virus infection is attachment of the virus to the surface of the cell. The virus must attach to a very specific protein on the surface of the cell in order to be able to enter the cell. If it cannot attach to the cell, it can get inside and multiply. It appears from the animal experiments, that some animals do not make the specific protein receptor on the cell surface so the virus cannot infect the cells of this animal. The same may be true in the human viral meningitis infections. Only a small proportion of people may have the receptor protein that allows the virus to enter cells in the lining of the brain to cause meningitis.
Q. Is there a vaccine against viral meningitis?
A. The measles-mumps-rubella (MMR) vaccine prevents meningitis and encephalitis (a much more severe infection of the brain than meningitis) caused by the measles and mumps viruses. There are no vaccines available against the common causes of viral meningitis.
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