Meningitis fears lead some to drop CPR classes

NASHUA – The executive director of the local chapter of the American Red Cross says people are canceling registrations for CPR classes in the wake of a cluster of bacterial meningitis cases across the state – even though there has been no link anywhere between CPR classes and the disease.

“Training is not a way to get meningitis,” said Vaughn Maurice, the Red Cross executive. “You can’t get it practicing on a manikin.”

But people are frightened: One of five New Hampshire teenagers hospitalized last week with symptoms of bacterial meningitis died Saturday. On Monday, state health officials alerted hospitals to heighten vigilance against the disease that infects the membranes surrounding the spinal cord and brain and is fatal in up to 15 percent of cases, according to the Centers for Disease Control.

Still, the odds of contracting the disease are low: The CDC says four out of 1,000 people exposed to the disease through a household contact will develop it, while four out of 500,000 from the general public who are exposed will become ill.

The disease is spread by intimate contact such as kissing and sharing eating utensils or water bottles. It could also be transmitted through real-life CPR.

“A person practicing CPR (on a dummy) is not at an increased risk. There has to be person-to-person contact,” said Dr. Alex Granok, infectious disease specialist at Southern New Hampshire Medical Center.

Not only is the manikin disinfected after each use, Granok said, but participants in CPR classes also wear disposable masks that are designed with a one-way valve: the person breathes into the dummy, but cannot suck air out.

State epidemiologist Dr. Jesse Greenblatt said the state Department of Health and Human Services is not recommending the cancellation of CPR classes.

“There has not been a CPR class outbreak nationwide,” he said, emphasizing the absence of a link between the disease and CPR training.

Meningitis is caused by viruses or bacteria. Viral meningitis is relatively mild and is the most common form of the disease in the U.S. – about 75,000 cases of it occur annually. Bacterial meningitis is serious and requires immediate medical attention: There are about 5,800 cases in the U.S every year.

“It’s a type of illness we have all the time – sporadically,” said Dr. James Martin, medical director for the emergency department at St. Joseph Hospital. “Now we have a little cluster.”

Martin stressed that the disease is transmitted through intimate contact and that “being in the public shouldn’t increase risk,” although reports of bacterial meningitis have raised anxiety levels.

“It gets people very nervous. It’s an aggressive bacteria,” he said, adding that the emergency department is following state guidelines and has heightened its lookout for the disease.

“As emergency physicians, we’re always on the lookout,” he said, ticking off a list of symptoms that includes fever, headache, stiff neck, light sensitivity and mental confusion.

Granok, of the medical center, said most patients with those symptoms don’t have bacterial meningitis. But like hospitals across the state, the medical center is stepping up its vigilance in response to the increase in cases statewide.

He said treatment for those who are exposed is a regimen of antibiotics: Doctors generally prescribe ciprofloxacin for adults and rifampin for children.

In addition, he said there is vaccine that protects against several strains, although a current strain, identified as serogroup B, is not covered by currently available vaccines.

Granok said those at greatest risk for contracting bacterial meningitis are college freshmen starting school, travelers to Africa and the Middle East, and others with particular health conditions.

“We see a number of cases every year, not usually linked like this, usually sporadic,” he said.

Hattie Bernstein can be reached at 594-6439 or bernsteinh@telegraph-nh.com.