TB and Meningitis Campaigns March and April 2009

Charlotte Carneiro, RN MS COHN-S CIC

Springtime, a season of renewal is appropriate for OHNs to review their knowledge of two complex diseases, Tuberculosis and Meningitis. Both diseases have preventive interventions and both have campaigns world- wide this spring.

March 25, 2009 is World TB Day celebrated annually on the day that Robert Koch discovered the bacillus, Mycobacterium tuberculosis. Tuberculosis is alive and well in Washington though the number of cases reported 20 March 2009 have decreased 2007 to 2008. Racial and ethnic disparities continue to persist.

OHN nurses can avail themselves of the information on the CDC web site and share pamphlets with workers. Google World TB Day and download a poster to engage at least one person in the dialogue that TB remains one of the curable as well as preventable diseases on the earth.

April 25, 2009 is World Meningitis Day. Worldwide coalitions are promoting the preventive measures against meningitis. Meningitis in the bacterial form carries a U.S. case fatality rate of 10-14% and morbidity for neurological sequelae following recovery of 11-19% (1)

Three age-associated forms of bacterial meningitis have vaccines effective against them:

1. Haemophilus influenzae type B (HIB) primarily is for children under 5 years. In some case adults may receive this also.

2. Meningococcal vaccines (MCV or MPSV) are targeted at ages11-19 years old, first year college students, military recruits and travelers to endemic countries. Adults with specific asplenia or complement deficiencies may also receive these.

3. Pneumococcal polysaccharide against (Streptococcal pneumoniae) is for adults >65 years.

Over the last 20 years, I have had personal association with these diseases, developed respect for them and continue to support the campaigns against them. Our daughter was in a clinical trial of the HIB vaccine that is used today. Our five year old nephew died within hours from meningococcal meningitis. I investigated a hospitalized teen on a senior bus trip and several contact students with positive blood cultures. I investigated several cases of deaths due to “Strep pneumo”.

My takeaway message for clients in the prevention of meningitis is to get the vaccines at the appropriate age. Seek treatment early for any sudden acute onset of headache and high fever. The message for TB prevention is also to seek care for any unexplained cough of two weeks or more. Encourage any worker with any travel history and possible TB exposure to be educated and screened as appropriate.

References:

http://www.cdc.gov/meningitis/bacterial/faqs.htm

MMWR Prevention and Control of Meningococcal Disease October 2006 55 (41) 1120,1124

MMWR Quick Guide Recommended Adult Immunization Schedule January 9.2009 vol .57 no .53

www.StopTB.org global plan video