Meningococcal disease can cause death or severe brain damage in infants and young children. The U.S. Food and Drug Association has now approved a vaccine against the disease for children as young as 9 months old.
Dr. Karen Midthun, director of the FDA's Center for Biologics Evaluation and Research, says neisseria meningitidis is a leading cause of meningitis in young children -- it progresses rapidly and can cause death within hours although early symptoms are often difficult to distinguish from influenza and other common illnesses.
Even with appropriate antibiotics and intensive care, between 10 percent and 15 percent of people who develop the disease die and another 10 percent to 20 percent suffer complications such as brain damage or hearing loss, Midthun says.
The safety of Menactra in children as young as 9 months was evaluated in four clinical studies in which more than 3,700 participants received the vaccine.
Injection-site tenderness and irritability are the most common adverse events reported in the youngest study participants. Occurrence of fever was comparable to other vaccines routinely recommended for young children, Midthun says.
Menactra, manufactured by Sanofi Pasteur Inc., was originally approved January 2005 for use in those ages 11-55 years and was approved in October 2007 for children age 2 and older.
Meningitis is an inflammation of the membranes that cover the brain and spinal cord. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ depending on the cause. Viral meningitis is generally less severe and clears up without specific treatment. But bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disabilities. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people.
Common symptoms of meningitis in anyone over the age of 2 are high fever, headache, and stiff neck. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect. Infants with meningitis may appear slow or inactive, have vomiting, be irritable, or be feeding poorly. As the disease progresses, patients of any age may have seizures.
Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. The diagnosis is usually made by growing bacteria from a sample of spinal fluid. The spinal fluid is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where fluid in the spinal canal can be collected. Identification of the type of bacteria responsible is important for selection of correct antibiotics.
The bacteria can mainly be spread from person to person through the exchange of respiratory and throat secretions. This can occur through coughing, kissing, and sneezing. Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.
However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or daycare center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of getting the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease.