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MENINGOCOCCAL B DISEASE

Posted on: 08/10/2015

To our patients heading off to college and their parents,

Serogroup B meningococcal outbreaks at four U.S. universities have made headlines in the past 18 months. The FDA has licensed two MenB vaccines in the last year. MenB accounts for approximately 30% of all meningococcal meningitis in the U.S. In June the CDC Advisory Committee on Immunizations Practices voted that parents may want to consider giving a MenB vaccine to their children at risk. Please read the following for more in-depth information.

Meningococcal Disease: What You Need to Know

1. The risk of meningococcal disease is higher in young adults and those living in group settings such as residence halls.

2. There have been recent outbreaks of serogroup B meningococcal disease at universities and colleges across the country, which have resulted in several deaths. There have been sporadic cases of the disease in the local Cincinnati community. It is estimated that serogroup B causes approximately 30% of meningococcal meningitis in the U.S.

3. Meningococcal disease is typically spread by exchange of respiratory and throat secretions. This is most commonly done by kissing or sharing eating utensils and drinking glasses.

4. Meningococcal meningitis causes a sudden onset of fever, headache and stiff neck. You also might have nausea, vomiting, an increased sensitivity to light, and altered mental state or confusion.

5. There are two FDA vaccines newly available to help protect against serogroup B meningococcal disease, Bexsero and Trumenba.

6. The MenB vaccine is not the same meningitis vaccine you may have received previously. (Menactra at AHP). That one protects against other strains of meningococcal disease, but not serogroup B.

Serogroup B Meningococcal Disease and Vaccines

There are several types of meningococcal disease caused by different serogroups (“strains”) of the Neisseria meningitidis bacteria. One type is serogroup B meningococcal disease. www.cdc.gov/meningococcal/index.html

Vaccines Are Now Available to Help Prevent Serogroup B Meningococcal Disease

Two new serogroup B meningococcal (MenB) vaccines (Bexsero® and Trumenba®) were recently licensed. They are different from the meningococcal vaccine you may have already received. That prior vaccine does not offer protection against serogroup B meningococcal disease.

In June 2015, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices recommended that a MenB vaccine may be administered to adolescents and young adults 16 through 23 years old to help protect against most serogroup B meningococcal disease, as well as patients 10 years of age and older with persistent complement deficiencies and anatomic or functional asplenia.

Outbreaks of Serogroup B Meningococcal Disease Occur on College Campuses

Several recent outbreaks of serogroup B meningococcal disease have occurred on college campuses across the United States. In 2013, outbreaks at two universities in New Jersey and California had a combined 13 cases and one associated death. In 2015, outbreaks at two universities in Oregon and Rhode Island saw a combined nine cases and one death. Those schools now all recommended MenB vaccination for their students. There have also been 4 cases in Hamilton and Butler counties in the last 6 months and two deaths.

Following are frequently asked questions about the new MenB vaccine:

1. Why do I need the MenB vaccine?

Meningococcal disease is a very serious, potentially fatal, illness. The bacteria that cause meningococcal disease require lengthy or very close, person-to-person contact in order to spread. You must be in close contact (e.g., by living in close quarters, kissing) with the person’s saliva (spit) or other respiratory secretions in order for the bacteria to spread. Vaccination can help keep you safe and healthy.

2. What could happen if I get meningococcal disease?

Meningococcal disease can cause meningitis or bacteremia/septicemia (infection of the bloodstream). Common symptoms of meningococcal meningitis include sudden onset of fever, headache and stiff neck. Symptoms of meningococcal septicemia may include fever, fatigue, vomiting, cold hands and feet, cold chills, severe aches or pains, rapid breathing, diarrhea and a dark purple rash.

Symptoms can develop quickly or over several days. Even with antibiotic treatment, meningococcal disease can be fatal in about 10 to 15 percent of cases. Of those who survive, about 11 to 19 percent have long-term complications such as permanent hearing loss, loss of limb or brain damage.

3. Is the MenB vaccine the same as the general meningitis vaccine?

No. The MenB vaccine can only help prevent serogroup B meningococcal disease. The other meningococcal vaccine, known as meningococcal conjugate vaccine (Menactra given at AHP), covers serogroups A, C, W and Y. These are different strains than serogroup B. The serogroup B (MenB) vaccine is new and recently approved.

4. Where can I get the MenB vaccine?

AHP offers Bexsero® vaccine at both locations. To be fully immunized you will need 2 shots given 1 month apart. If you are a college student going away and unable to return to our office in 1 month, please check with your university's health center to see if they are offering 1 of the 2 FDA approved vaccines. These are not interchangeable. If your school offers Trumenba®, you may wish to start your series there.

5. Will insurance cover this vaccine?

Most insurances cover MenB vaccine. However, with new vaccines you need to check with your plan as it will vary. Prior to scheduling an appointment, please call your insurance to see if CPT code 90620 for Bexsero® is covered. Two doses are required to complete the series.

6. Are there potential side effects from the vaccine?

As with all vaccines, there could be some side effects. The most common include pain at the injection site, painful muscles and joints, nausea, a general feeling of being unwell and a headache. Among young adults, there is also a risk of fainting after getting this vaccine. We will ask you to stay for 15 minutes after getting the vaccine to ensure that a severe reaction or fainting does not occur.

7. What else can I do to avoid getting sick?

For meningococcal disease, we recommend that you:

· Know the symptoms of meningococcal disease.

· Avoid activities – like smoking or sharing respiratory secretions (such as by saliva, kissing or close coughing) that may increase your risk of illness.

· Seek medical attention immediately if you have any symptoms of meningitis or a bloodstream infection.

With flu season around the corner, remember to cover your mouth with your elbow or tissue when you cough or sneeze. Wash your hands frequently with soap and water or use an alcohol-based hand sanitizer.

For additional information on meningococcal disease and the MenB vaccine, please visit:

Centers for Disease Control and Prevention

http://www.cdc.gov/meningococcal/index.html

http://www.cdc.gov/meningococcal/vaccine-info.html

National Meningitis Association

http://www.nmaus.org/disease-prevention-information/serogroup-b-meningococcal-disease/

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