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Q: I was becoming increasingly concerned about the number of meningitis cases reported in the newspaper, and then my son brought home a notice that a girl in their school had been found to be a carrier of the bacteria though she was not yet ill. She was removed from school and treated, but I need to know: why the increased incidence? How is the disease passed? Just how worried should we be?
Overall, there really is not an increased incidence of bacterial meningitis. Technically, bacterial meningitis is an infection of the coverings of the brain. In fact, the bacteria germ that used to most commonly cause meningitis (Hib) has been prevented through vaccinations. The incidence of disease by this germ has dropped dramatically over the last decade.
We all worry about our children, particularly when we're talking about such a potentially serious infection. Meningitis can be caused by a number of different germs. Meningitis cases caused by bacteria are treated with antibiotics. These germs may be carried in people's nasal passages and that's how the exposure occurs. The disease is passed from person to person in close contact with mouth and nasal secretions. Why, after exposure, a normally healthy individual goes on to develop such a serious infection is not clear.
Once meningitis is diagnosed, depending on which germ is the culprit, the decision may be made to use an antibiotic preventively. This may help eliminate that germ in people who might have had close contact with someone who was sick with meningitis. Don't be overly worried. I would carefully observe your child and follow the recommendations of his doctor about whether the need for the preventive medicine is indicated. If your son is acting ill with fever after this type of exposure, you should contact his doctor promptly.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.