By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
I have a running list in my head of diseases and conditions that I wouldn’t wish on my worst enemy. Very high on that list is Invasive Meningococcal Disease (IMD). The reason goes back to college, years before I became a nurse.
I was a Resident Advisor my sophomore year at Texas A&M (yes, I am an Aggie). One of the girls on my floor one morning wasn’t feeling well and didn’t go to class. Her roommate came back to their room that afternoon and found her unconscious. The roommate came running for me and together we called 911. The next morning, the girl died from Meningococcal Meningitis, a form of IMD.
The health department came up and looked for everyone she may have exposed, and we all had to take antibiotics prophylactically. I still remember how stunned I was at the time. I couldn’t wrap my head around a disease where someone was perfectly fine one day, and dead the next. Even now, with all the experience I have in healthcare, IMD, and the possibility it can become fatal so quickly is hard to fathom. That is why a recent health alert issued by the Texas Department of State Health Services (TX DSHS) about an increase in cases really caught my attention.
IMD is a group of illnesses caused by the bacteria Neisseria meningitidis. The bacteria can live in the upper respiratory tract of people and cause no symptoms. But, if it spreads to other systems, it can cause very serious illnesses including sepsis (an infection that affects the entire body because bacteria are in the blood stream), septic arthritis (infection in joints), and meningitis (an infection of the tissues that surround the brain and spinal cord, causing them to swell—that swelling can damage the brain and/or spinal cord).
In the U.S., rates of IMD have been low since the 1990s, when vaccines for this illness became available. However, rates outside the U.S. are much higher. About 1.2 million people around the world get IMD each year and 135,000 of those cases are fatal. Statistically the fatality rate for IMD is about 15%, and of those who survive, 20% have permanent disabilities. IMD can occur at any age, but it is most prevalent in children under age one and young people aged 16-23. IMD primarily follows a seasonal pattern with most cases in the U.S. falling in January, February, and March.
IMD is spread by sharing respiratory and throat secretions. It takes close contact with the secretions of an infected person (coughing or kissing, for example) or prolonged contact (people in the same household, for example) to spread IMD. If someone is diagnosed with IMD, those are the people who will also receive prophylactic (preventative) treatment for IMD.
Symptoms of IMD need to be acted upon quickly because two forms of this disease can become extremely serious and even deadly in just a few hours. For Meningococcal Meningitis, the most common symptoms are fever, headache, and a stiff neck. Other symptoms can include nausea and/or vomiting, light sensitivity (photophobia), and confusion or other alterations in mental status. Babies with Meningococcal Meningitis may be slow or inactive, irritable, feeding poorly and have a bulging anterior fontanelle (the soft spot on the top of the head). For Meningococcal Sepsis, symptoms include fever and chills, fatigue, vomiting, cold hands and feet, severe aches and pain in muscles, joints, chest, or belly, rapid breathing, diarrhea, and in late stages, a dark purple rash. If you or someone you love is showing symptoms of these conditions, it is crucial you seek medical care immediately.
There aren’t many better examples of the conventional wisdom saying, “an ounce of prevention is worth a pound of cure,” than IMD and the vaccine to prevent it. Since the vaccination came out in the 1990’s we have fewer than 1,000 cases a year in the U.S. With it’s 15% death rate, that calculates out to 150 people at most. Still far too many, but much improved over the years before the vaccine.
I am extremely concerned as a health care professional, that the increase we are seeing in cases is tied back to the vaccine reluctance that has been building over the last several years, especially since the pandemic. I am a very firm believer in choice when it comes to healthcare, but I also cannot stress this enough, healthcare choices need to be made using credible sources, not social media.
IMD alone is awful, but that it most commonly attacks babies and young people makes it even worse. Please speak to your primary health care provider about vaccination if your child has not been vaccinated. This is not a disease I would wish on anyone, least of all a child. It is a disease that can be prevented, and that prevention is far, far better than any cure when it comes to a disease that can kill in hours.
