NFID Initiative Aims to 'S.T.O.P. Meningitis!'

With the start of a new academic year looming, physicians who administer school physicals and wellness checkups for 11- and 12-year-olds should be aware of free resources from S.T.O.P. (Share. Teach. Outreach. Protect.) Meningitis! -- an initiative of the National Foundation for Infectious Diseases, or NFID.

Susan Rehm, M.D., NFID's medical director and an infectious disease specialist at the Cleveland Clinic in Ohio, said during a July 14 webinar that physicians have not done an adequate job of educating parents and adult patients about the seriousness of meningococcal disease, which has resulted in suboptimal vaccination rates. Rehm said the S.T.O.P. Meningitis! materials are designed to help practices ensure that appropriate patients get vaccinated against the disease.

The initiative's updated tools for health care professionals and patient education materials include

Carol Baker, M.D., a professor of pediatrics at the Baylor College of Medicine, Houston, and past president of the NFID, said during the July 14 presentation that the United States averages 1,500 cases of meningitis per year.

Although that number might seem relatively low in a country of more than 300 million people, Baker said the death rate is 11 percent in the general population and 14 percent in adolescents and young adults. As many as 19 percent of survivors face permanent damage, including hearing loss, brain damage and limb amputations, she said.

Quadrivalent meningococcal polysaccharide-protein conjugate vaccine, or MCV4, and meningococcal polysaccharide vaccine, or MPSV4, protect against four of the five serogroups of Neisseria meningitidis bacteria -- A, C, W-135 and Y -- that cause the most disease worldwide.

The majority of U.S. cases are caused by serogroups B, C and Y, according to the NFID website, but neither licensed vaccine protects against type B.

Even so, said Baker, "Vaccination offers the best protection."

Before effective vaccines were widely available, bacterial meningitis was most commonly diagnosed in children, according to the CDC, but the disease is now more commonly diagnosed among adolescents and young adults.

The AAFP and the CDC's Advisory Committee on Immunization Practices, or ACIP, expanded recommendations for meningococcal vaccination in 2007, calling for immunization of all individuals ages 11-18 years with one dose of MCV4 at the earliest opportunity.

Vaccination coverage for MCV4, which is marketed by Sanofi Pasteur as Menactra, increased from 32.4 percent in 2007 to 41.8 percent in 2008 in 13- to 17-year-olds, according to the CDC.

Groups at increased risk for meningococcal infection, say CDC officials, include infants and young children, refugees, household contacts of case patients, military recruits, college freshmen who live in dormitories, microbiologists who work with isolates of N. meningitidis, patients without spleens or with terminal complement component deficiencies, and people exposed to active or passive tobacco smoke.

Meningococcal vaccination is not a requirement for travel to any country except Saudi Arabia, but the CDC said vaccination is recommended for individuals traveling to the "meningitis belt" in Africa from December through June.