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MENINGITIS AND THE EFFECTS ON EDUCATIONAL SETTINGS Kasey McCusker DR. HOBAN MPH - 510 Viral meningitis is the most common form of the disease meningitis. More specifically, meningitis is “an inflammation that covers the brain and spinal cord” (CDC, 2014). Viral meningitis can be defined as the “inflammation of the leptomeninges as a manifestation of central nervous system (CNS) infection” (Wan & Roos, 2013). This is one of the main forms of meningitis that affects children and those in the field of education. An example of how an educational setting fights a Meningitis outbreak can be seen at University College of London. When a doctor comes into contact with a possible meningococcal disease. The Doctor attending a case of meningococcal disease or suspected case has the duty to report it immediately (Long, 2014). In London they are required to consult the Communicable Disease Control (CCDC) no matter what time of day (Long, 2014). Overall, I want to look at how the two main forms of meningitis compare; as well as, how viral meningitis effects children in education settings. Defining the Problem: Meningitis is a type of disease with many causes and forms. More specifically, meningitis is “a disease caused by the inflammation of the protective membranes covering the brain and spinal cord known as the meninges” (CDC, 2014). This usually occurs after an infection that caused fluid around the brain or spinal cord (CDC, 2014). There are two main forms of meningitis that are common in the United States are usually caused by bacteria or viruses. Those forms are Bacterial and Viral Meningitis. Bacterial Meningitis is a severe form of this disease with serious complications. While Viral Meningitis is common and most individuals recover without treatment or medications. Bacterial Meningitis is very severe and can have lasting effects or complications. Some of these serious complications include brain damage, hearing loss, and learning disabilities (CDC, 2014). This form of meningitis is contagious. While, Viral Meningitis is a less lethal form. It is not contagious and is usually contracted by close contact. Agent or Agents: Either form of meningitis bacterial or viral can be caused by a wide variety of diseases or illnesses. Several pathogens can cause bacterial meningitis. Some of these pathogens include Haemophilus influenza, Streptococcus pneumonia, Listeria monocytogenes, and Neisseria meningitides (CDC, 2014). Whereas, for Viral meningitis there is one virus that seems to cause the majority of the cases today. That virus is called the Non-polio enteroviruses (CDC, 2014). Describe the Condition or Conditions: Viral meningitis is the most common type of meningitis. It is usually caused by non-polio enteroviruses and has a higher likelihood of seeing cases of this type of meningitis pop up. “Enteroviruses usually enter the human most by the fecal-oral route or on rare occasions it can follow the respiratory route” (Wan & Roos, 2013). Most of the known cases are normally mild and most patients make an exceptional recovery. The only real way for transmission is that “if you come into close contact with someone who has viral meningitis you can get it” (CDC, 2014). It is normally not a life threatening disease. The incubation period for viral meningitis is approximately 1-2 weeks or more specifically 7-10 days (The Meningitis Centre). An example of some of these everlasting symptoms are that people “may have recurrent headaches, tiredness, problems concentrating, become irritable, or depressed” (The Meningitis Centre). Mortality and Morbidity: When it comes to Bacterial meningitis there are more pronounced cases. Between the years 2003-2007 there were 4,100 cases of bacterial meningitis reported annually and 500 of those cases resulted in death (CDC, 2014). There is rarely any deaths reported when it comes to viral meningitis. However, in the United States of America there is an estimated 75,000 cases reported annually (CDC, 2014). Death rates for viral meningitis are hard to find. However, the number of reported cases has decreased. The following picture highlights some facts that deal with mortality and morbidity: (MYBABA, Viral Meningitis Week) One fact that I believe it highlighted well is that viral meningitis does not have a high mortality rate. Summary of Data: Age Group: Newborns Host Characteristics – Age: Bacterial Meningitis (CDC, 2014) Possible Agents: Group B streptococcus, E. coli Infants and Children Adolescents and Young Adults: Older Adults: Streptococcus pneumonia, Neisseria meningitides Neisseria meningitides Streptococcus pneumonia, Neisseria meningitis Individuals at higher risk for contracting Viral Meningitis. Those affected by this form of meningitis are children younger than the age of 5 years old and “people who have weakened immune systems caused by diseases, medications (such as chemotherapy), and recent bone marrow transplants” (CDC, 2014). Environmental attributes - Social and Economic Factors: An increase in viral meningitis can be seen in the homeless population. Especially those individuals who are living in shelters. Shelters are home of many types of people especially those who live in condensed spaces (Triant). These individuals do not necessarily have the greatest hygiene techniques (Triant). Temporal Variation – Seasonal: When it comes to viral meningitis increased temperatures cause a larger number of outbreaks (Triant). In the fall and summer seasons, individuals are at a higher risk for contracting viral meningitis (Triant). Temporal Variation – Epidemic and Environmental attributes – Education: There have been a few small outbreaks of viral meningitis in the media lately. One case was reported at Negley Elementary School in Kyle, Texas (KUVE ABC, 2015). While other cases report slightly larger outbreaks around the state of Texas. This consisted of 3 cases in the town of La Porte, Texas (ABC 13 Eyewitness News, 2015). Two of the cases were reported at Jennie Reid Elementary School (ABC 13 Eyewitness News, 2015). While, the other case was at La Porte High School (ABC 13 Eyewitness News, 2015). All of these patients attended the same event that was not school related. Unfortunately, because of their ages and close contact to other students, more were at risk of becoming affected. Prevention: Individuals who have viral meningitis can see a reduction in symptoms within a few weeks. A great way to prevent the spread of viral meningitis is by increasing your hygiene. Some ways you can lower your chances of getting infected are: Wash your hands with soap and water (CDC, 2014). Avoid touching your face with unwashed hands (CDC, 2014). Avoid close contact such as kissing, hugging, or sharing cups or eating utensils with people who are sick (CDC, 2014). Cover up cough and sneezes with anything but hands (CDC, 2014). Clean and disinfect frequently touched surfaces (CDC, 2014). STAY HOME when you are sick (CDC, 2014). There is a very unique distribution for Viral Meningitis. Researchers stated that this form of meningitis is most common in children under the age of 5 and those with a weakened immune system. It was interesting to see that in the media most outbreaks of viral meningitis came to younger individuals who were at events where there was a crowded population in a condensed area. At these events it is probably not the most sanitary which can cause the spread of germs. Most events also do not have a policy on sick individuals. They are usually open to the public which can also increase the risk of becoming ill. The other way many documents talked about transmission was that through homeless shelters. In these shelters, individuals are living in a condensed space and probably cannot afford to practice proper hygiene that would keep them free of many illnesses. I believe practice proper hygiene properly would help reduce the spread of Viral Meningitis. I believe further areas of research could be in educational settings to see public health and school official’s reaction times in learning of a possible infectious disease case. I think official’s reaction times are extremely important in preventing the spread of diseases. I do not think every disease is the same. As I do think it’s a great idea to have universal protocols in some instances it is important to have protocols dependent on the infectious disease. I believe further research should be done in the field of reaction times. I think decreasing this time frame could help reduce many infectious disease outbreaks from spreading. References: ABC 13 Eyewitness News. (2015, 05 28). Three la porte isd students contract viral meningitis. Retrieved from http://abc13.com/health/three-la-porte-isd-students-contract-viralmeningitis/746680/ CDC. (2014, 11 26). Meningitis - home. Retrieved from http://www.cdc.gov/meningitis/index.html CDC. (2014, 04 1). Bacterial meningitis. Retrieved from http://www.cdc.gov/meningitis/bacterial.html CDC. (2014, 11 26). Viral meningitis. Retrieved from http://www.cdc.gov/meningitis/viral.html KUVE ABC. (2015, 05 28). Hays elementary school reports viral meningitis case. Retrieved from http://www.kvue.com/story/news/local/hays-county/2015/05/28/hays-elementaryschool-reports-viral-meningitis-case/28086021/ MYBABA. (Photographer). (2014, 05 06). Viral Meningitis Week [Web Photo]. Retrieved from http://mybaba.com/viral-meningitis-week/ The Meningitis Centre. (n.d.). Viral meningitis. Retrieved from http://www.meningitis.com.au/about_meningitis/viral_meningitis.phtml Triant , V. (n.d.). Viral meningitis. The Health Care of Homeless Persons, 175-180. Retrieved from http://www.bhchp.org/BHCHP Manual/pdf_files/Part1_PDF/ViralMeningitis.pdf Wan, C., & Roos, K. (2013, 09 19). Viral meningitis. Retrieved from http://emedicine.medscape.com/article/1168529-overview