Disease can be stopped if diagnosed, treated early

April 10, 1992|By Frank D. Roylance | Frank D. Roylance,Staff Writer

The form of meningitis suspected of killing a University of Maryland senior this week may start with headache, fever and a stiff neck, public health officials say. But the symptoms can escalate within hours or days to life-threatening shock and coma.

"If the disease is diagnosed early and treated promptly, most people will recover fully," said Carmela Groves, chief of outbreak investigation for the state Department of Health and Mental Hygiene.

But if not, "it may lead to . . . neurological problems, brain damage, deafness . . . and death," she said.

A preliminary examination by the Prince George's County medical examiner indicated that Jennifer Lynn Jones, 21, of Merritt Island, Fla., died from meningococcal meningitis. It is a bacterial infection that inflames the meninges -- the tough membranes that enclose the brain and spinal cord.

Another form of meningitis caused by viral infections is more common, but less serious, health officials say.

Friends reported Miss Jones had gone to bed in her sorority house at 10 p.m. Tuesday after complaining she wasn't feeling well. Her body was discovered in bed shortly before 6 p.m. the next day.

Such a rapid progression is "characteristic of the fulminant form of meningococcal disease," said Dr. Anne Schuchat, a medical epidemiologist with the Centers for Disease Control in Atlanta.

"It's rare, but it's fast and deadly. We could be talking hours or days, depending on the individual case," she said. Just why the disease kills some people so quickly isn't understood.

State health officials said 24 people in Maryland became ill with forms of meningococcal meningitis in 1991, an incidence slightly lower than the national average. Two of those 24 people died.

Nationally, the Centers for Disease Control said, about 2,600 people become ill with meningococcal meningitis each year. Of those, about 14 percent die.

Years ago, before antibiotics, 70 percent died.

Most vulnerable to both bacterial and viral meningitis are the very young, the very old, and people with suppressed immune symptoms.

Meningitis is usually not life-threatening. It is less easily caught than the common cold or flu, but can be passed among people living in close and prolonged contact, as in day care centers or college dormitories.

Most cases are caused by viruses that somehow invade the brain or spinal column. Viral meningitis is relatively mild, doctors say, and its symptoms usually clear up in a week or two on their own, with no lasting effects. The viruses, depending on their type, are spread by coughs or poor bathroom hygiene.

Bacterial meningitis is more serious, but it responds readily to antibiotics if it is diagnosed in time.

The bacteria responsible are carried in the nose and throat and spread by coughs, kissing and sharing eating and drinking utensils. Symptoms usually appear three to four days after exposure.

"People can be carriers of the germ . . . and not have symptoms," said Ms. Groves. Other healthy people get sick, but no one knows why.

The symptoms of both viral and bacterial meningitis include severe headache, fever and vomiting, which may at first seem flu-like.

But, when headache and fever are accompanied by a stiff neck, Dr. Schuchat said, "that should certainly make a person concerned" about meningitis. In severe cases of meningococcal disease, people can also get a rash that looks "like bruises that spread rapidly over the skin."

As the bacterial inflammation gets worse, the brain may swell, causing neurological symptoms, such as double vision and sensitivity to light, drowsiness and confusion, progressing to coma. The infection may also spread through the blood stream, causing organ damage, bleeding and falling blood pressure.

The antibiotics used are "extremely effective," Dr. Schuchat said. "It's a question of getting on the antibiotic quickly. With that [fast-moving] form, sometimes there's no time. . . . They cannot make it to the hospital."

Research has focused on developing better meningitis vaccines. The sole licensed vaccine has limited effectiveness, Dr. Schuchat said.

When outbreaks occur, health officials usually urge those close to the victims to take oral antibiotics as a preventive measure.

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