What every parent needs to know about meningitis

Q. What do I do if a student at my child's school is diagnosed with meningitis?
A. You can continue to send your child to school because he is not at risk with just casual contact with classmates. Sitting next to someone who contracted the disease does not put him at increased risk, nor does breathing the same air in a classroom or playing soccer in the gym. However, if he shared a water bottle after gym class with someone who has been diagnosed, then he will probably be identified as a "close contact." Close contacts include family members, roommates, child-care and nursery-school contacts, and anyone else possibly contaminated by the patient's oral or nasal secretions.

Q. What about day-care centres?
A. Day-care centres may be somewhat riskier. A study done in 1999 in the United States revealed that children aged 13 to 23 months in a day-care setting for four hours or more a week with two or more children developed pneumococcal disease or another invasive bacterial disease twice as often as those not in day care. For those aged 24 months to about five years, the risk increased threefold.

However, while those ratios seem high, the numbers are still low. Only an estimated 65 Canadian children under age five develop pneumococcal disease each year –- inside day-care centres or out, according to Tam.

On the rare occasion when a child is diagnosed, all children in the same day care or nursery school are given antibiotics.

Q. Does my child need treatment if she turns out to be a "close contact"?
A. When meningitis is identified by a doctor, the cases are reported to the local public-health unit. With the help of schools and day-care centres, the public-health unit will get in touch with anyone who was in close contact with the affected person and may have contracted meningitis from him. Your child is identified as a close contact if she was with the patient any time in the seven days before symptoms appeared and up to 24 hours afterward, and if she shared mucosal fluids with this patient. If this is the case, she needs antibiotics within 24 hours. Doctors stress that antibiotics do not take the place of vaccinations.

Q. Will I be alerted if someone has been diagnosed with meningitis at my child's school or day-care centre?
A. You and your neighbours will be alerted if experts identify two or more people with meningococcal disease in the same geographical area who likely got the disease from the same infected person. Health Canada calls this a cluster.

You'll also be told if an outbreak is declared in your area. An outbreak is defined as more than the usual number of cases for that specific community that are not linked to one source.

Because multiple sources mean the germ may spread rapidly, immunization programs paid for by the province or territory may be set up in your community to target at-risk groups. In this case, antibiotics are also given to identified people, and schools send information packages home with your children.

Q. Will I know if a single case is diagnosed in my community or at my child's school?
A. Maybe, but maybe not. Each province has procedures in place to quickly alert local medical officers of health when a case is identified. The case is then reported to provincial and, eventually, national authorities.
There is usually no general public announcement for a single "sporadic" case, even if the patient dies.

Few public-school boards have policies in place regarding the reporting of a case of meningitis to parents. Most school authorities say they would follow procedures outlined by their community's health unit.

Q. What else can I do to protect my child from meningitis?
A. Teach your children to avoid any saliva-sharing activities, such as kissing or sharing objects with fresh saliva on them such as straws, cups, glasses, bottles, team water bottles, forks, spoons, toothbrushes, sports mouth guards, musical-instrument mouthpieces, lip gloss, lipstick, cigarettes, food and drinks. Encourage them to practise the No. 1 hygiene rule: wash hands regularly.

Don't forget your older kids, especially college-bound freshmen who may easily dismiss something very serious as "just the flu." Recent studies in the U.S. show that college freshmen living in residence have a slightly higher risk of contracting meningitis than those of the same age group living in other settings (i.e., at home or in off-campus housing).

Another important tip is to familiarize yourself with the signs and symptoms of the disease, and to know how and when to get help.

The final piece of advice comes from Lisa: "Do more than trust your instinct: act on it."

Get more tips on children's health in our forums.

Page 3 of 3