Dr. Michael Omidi on Second Hand Smoke and Meningitis

Even though the meningitis outbreak directly resulting from contaminated medications from New England Compounding Center has been the most widespread cause of meningitis in the US in recent months, there is still a risk of meningitis from another hazardous source: cigarette smoke.

Invasive Meningococcal Disease

According to a study in the journal BNC Public Health, secondhand smoke exposure can double the risk of invasive meningococcal disease, which can lead to bacterial meningitis in children and infants, resulting in death in 5 percent of patients and permanent neurological damage and behavioral disorders in one in six patients. The risk is especially high in infants under five years of age.

Pregnant mothers who either smoke or are in proximity to cigarette smoke are also at risk of delivering a child that is three times more likely to develop invasive meningococcal disease than mothers who live in nonsmoking environments.

Invasive meningococcal disease is communicable, and is spread via close contact and fluid exchange. Many people carry the meningococcal bacteria in their throats, but do not go on to become infected with meningitis; exposure to secondhand smoke appears to facilitate infection in children and toddlers, although researchers cannot yet find the cause. Bacterial meningitis is significantly more difficult to treat than viral meningitis, which can often clear itself from the system without medical intervention.

Meningitis Symptoms

Symptoms of meningitis are nausea, stiff neck, fever and headache. Long term disabilities stemming from the disease are deafness, brain damage and paralysis. Meningitis is an inflammation of the covering around the spinal cord and brain. While viral meningitis can clear itself without significant medical attention, bacterial meningitis must be treated immediately. If you experience symptoms, visit your physician right away. Bacterial meningitis is typically treated with antibiotics, and occasionally hospitalization, so that the medical team can monitor patients for seizures or signs of brain damage or hearing loss.

Children between the ages of 11 and 18 can be vaccinated against two of the three strains of meningitis. Teenagers that are college age and plan on living in a dormitory should receive a vaccination, since people living in close quarters with recycled air systems are at greater risk of becoming infected than those living alone.

Meningitis isn’t the only diseased caused by the meningococcal bacteria; septicemia, a severe infection of the bloodstream is also caused by meningococcal bacteria. Septicemia, or sepsis, is a serious, often fatal condition that typically occurs in children, people living with compromised immune systems and people ingesting immune-suppressing drugs. Symptoms include fatigue, decrease in urination, nausea, rapid pulse, rapid breathing and high fever.

Meningitis Symptoms and Treatments

500 Confirmed Cases and 40 Deaths Now Reported

Health officials are only just beginning to get an idea of the scope of meningitis outbreak. There have been more than 500 confirmed cases and close to 40 deaths, and that isn’t even counting the patients with meningitis symptoms who, while having been injected with medications from New England Compounding Pharmacy, haven’t been injected with the methylprednisolone acetate, which was the drug that was verified to have been contaminated.

Symptoms for fungal meningitis are the same as the symptoms for bacterial or viral meningitis, the more common forms of infection. Fungal meningitis occurs when one of several types of fungus gets into the bloodstream and attacks the spinal cord (the recipients of the tainted steroid were especially vulnerable, since the fungus was being injected next to their spinal cords). It cannot be transmitted from person to person, but ingesting fungus spores in the atmosphere, or working with infected soil can lead to fungal meningitis. People with compromised immune systems are susceptible to fungal meningitis.

What is Fungal Meningitis

Fungal meningitis is the inflammation of the spinal cord lining and the brain; the fungus travels up the spinal cord via the spinal fluid and settles in the brain, which has almost no defense mechanisms. Symptoms of fungal meningitis include headaches, stiff necks, fever, light sensitivity, weakness and nausea. Fungal meningitis can also cause blood clots and lead to stroke. Many of the patients who contracted fungal meningitis from the tainted drug supply died from stroke, making the diagnosis difficult, since doctors don’t often test for additional medical disorders when a patient succumbs to stroke.

Confirming Fungal Meningitis and Treatments

The only way of confirming that the infection is fungal meningitis with any degree of certainty is by spinal tap or lumbar puncture, where a sample of spinal fluid is extracted and tested for the presence of fungus. Because fungal meningitis is so rare, there aren’t as many efficient treatments for the disease as there are for bacterial and viral meningitis (viral meningitis often doesn’t even require medications). Treatments are administered intravenously, and can often take a month or longer to effectively kill the fungal infection. These treatments must also be given in a hospital setting so that a physician can monitor the patient. The drugs, voriconazole and amphotericin B, can cause damage to the liver and kidneys.

Unfortunately, the fungal meningitis symptoms start off so slowly that infected patients might not feel the need to seek medical attention until the infection has taken aggressive hold (some of the symptoms are similar to migraine headaches). It is important that anyone who has had injections of any kind from the New England Compounding Pharmacy (especially those who have even mild symptoms) get tested for the onset of fungal meningitis.