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Los Angeles County Director of Public Health Dr. Jonathan Fielding
A case of contagious, bacterial meningitis that killed 33-year-old Brett Shaad of West Hollywood does not appear to be linked to a wider outbreak, says Dr. Jonathan Fielding, director of public health for Los Angeles County.
“Our investigation is ongoing, we continue to carefully monitor the situation and we are prepared to recommend routine immunization if there is any indication of a local outbreak,” Fielding told reporters Wednesday.
Nevertheless, Fielding says, “we remain vigilant and on alert.”
Fielding said that in the past five-and-a-half months, there have been 13 cases of meningitis reported in Los Angeles County. The annual average is 25.
Of those cases, there were four deaths — including Shaad — but public health officials have found no links among them. A spokesman said the county is still conducting tests to determine whether the cases involved the same strain of bacteria.
Meanwhile, here are answers to common questions about the infection.
What is Meningococcal meningitis?
It’s a bacterial form of meningitis, which is an infection that inflames the lining surrounding the brain and the spinal cord. It’s a serious medical condition that can cause brain damage, hearing loss and death.
Viral and fungal forms of meningitis also exist, says Dr. Otto Yang, associate chief of infectious diseases and professor at the David Geffen School of Medicine at UCLA.
Is it contagious?
Yes. The strain that infected and killed Shaad is contagious, but it’s not easily spread, says Yang, who is also director of scientific research at the AIDS Healthcare Foundation.
How do you catch it?
The infection is transmitted through exposure to respiratory secretions — specifically from the saliva or nose mucus — of an infected person. You could catch it if a sick person sneezes directly on you, if you’re exposed to their infected saliva through a kiss, or if you share eating utensils or drinks.
If your contact is limited to, say, a casual conversation with someone who may be infected, or you stood in line next to the infected person, you’re not likely to become infected, Yang says.
The incubation period is typically two to 10 days.
Who is at risk?
If you live in crowded quarters with many others — such as in a college dormitory or military housing — you could be at greater risk of catching it from an infected person in your midst.
Also at greater risk are travelers to “the meningitis belt of sub-Saharan Africa, stretching from Senegal in the west to Ethiopia in the east,” says the World Health Organization.
Otherwise, the risk is generally low, unless you are “in close quarters or really intimately in contact with the person,” Yang says. He adds that that even doctors who examine infected patients aren’t considered to be at risk unless there’s direct exposure to the patient’s saliva or mucus.
Am I at greater risk if I'm a gay man?
Several fatal cases of the infection among gay men in New York and the Shaad case in Los Angeles — which reportedly occurred after Shaad attended a large gathering of gay men in Palm Springs — caused some to worry that homosexuals are at greater risk of contracting meningococcal meningitis. They are not.
“This is not a gay disease at all,” says LA County Director of Public Health Jonathan Fielding. “It’s the behaviors that predispose the individuals of either gender to the disease.”
The L.A. Department of Public Health says of the 13 meningitis cases reported to L.A. County since November 2012, four involved gay men.
What are the symptoms?
The main symptoms to watch out for are:
- High fever
- Severe headache with associated sensitivity to light
- Stiffness of the neck
- Generalized muscle ache
- Low blood pressure
- Confusion and/or altered mental state.
Yang says another symptom specific to the strain of meningitis that killed Shaad is a rash defined by “small spots of hemorrhage in the skin.”
What if I've been in contact with someone who is now sick?
If you’ve shared close quarters with a known infected person and you think you may have been exposed, antibiotics will “markedly reduce the risk of getting it yourself,” Yang says.
If I think I have become infected, what should I do?
You should seek immediate medical attention. This particular strain, Yang says, is especially aggressive and progresses rapidly.
Should I get vaccinated?
The L.A. County Department of Public Health says you should first ask your health provider if a vaccine is necessary.
Yang says it may be a good idea to do so if you live in or work under crowded conditions; if you have a compromised immune system; or if you plan to travel in those regions of sub-Saharan Africa where the infection is common.
Other than that, unless you believe you’ve been exposed, there’s “no urgency, no rush” to seek a vaccine, Yang says. “Fewer than one person in 100,000 will get it.”
Where can I get vaccinated against Meningococcal meningitis?
Free vaccinations for uninsured L.A. County residents are available at these locations.