Communicable Diseases - Bacterial Meningitis Protocol
Key goals related to the handling of a bacterial meningitis case:
- Identify the “index case” (initial case of meningitis) and arrange for rapid hospitalization.
- Identify other individuals who may be at risk for developing infection (potential secondary cases) and arrange for treatment.
- Educate the campus community about the risk factors related to contracting meningitis and the treatment process.
- Reassure those individuals who are not at risk.
- Prepare for second and/or further cases.
- Collaborate closely with the Saratoga County Health Department to determine if mass vaccination or any other community-wide actions are necessary.
I. Bacterial meningitis case identified
Health Services would most probably become aware that a Skidmore student (or students) has (have) contracted bacterial meningitis in one of three ways:
- An outside/off-campus agent provides notification that a student has been diagnosed.
- Another office or individual in the Skidmore College community learns of a case and notifies Health Services.
- A Skidmore College Health Services practitioner makes the diagnosis.
Once a case has been reported, the Director of Health Services will quickly gather as many details as possible regarding the case and potential contacts that may be of concern, as prompt action is of essence in effectively treating the affected individual and any others who may have been exposed to the illness. In the event that another office or individual in the Skidmore College community first learns of a case, it is imperative that Health Services be notified immediately.
II. Emergency Management Team
- The Director of Health Services will notify the Dean of Student Affairs of the situation and request that the Emergency Management Team be alerted to prepare for coordination of the College’s response.
- Appropriate members of the campus Emergency Management Team (Response Group) will collaborate to determine target individuals who may be at risk for meningitis as a result of contact with the index case.
- The Director of Health Services will collaborate with, provide on-going situational updates and serve as the primary medical/health resource to the Dean of Student Affairs and EMT.
III. Initial Priority Actions/Decisions
A. Health Services
- The Director of Health Services (or Health Services’ designee) will be responsible for coordinating the efforts of Health Services and for preparation of the clinic office, facilities and staff to respond to meningitis inquiries and administer preventive treatment.
- As part of a coordinated response, Health Services will collaborate closely with the office of Health Promotions in the preparation of meningitis-related educational materials for distribution to patients as they arrive at Health Services. These materials will also be distributed on campus to educate specific groups of people (or the community in general) about bacterial meningitis.
- The Director of Health Services will contact the Saratoga County Health Department to notify them of the meningitis case, and to initiate a collaboration of Public/Community Health and campus efforts.
- The Director of Health Services will also contact the Saratoga Hospital Emergency Room director and staff so they can prepare for possible patients. Other colleges and universities in the Capital District should also be advised.
B. Identification and treatment of possible at-risk individuals/groups
Individuals/groups who may be “at-risk” for exposure to the index case include:
- All household or household-like contacts (i.e.: roommate(s) and residence hall floor-mates, but not residents living on other floors in the hall).
- Anyone who has had intimate contact with the index case and may have had such contact within (and including) 14 days of the onset of symptoms of the case.
- Anyone who has been exposed to the index case's respiratory or oral secretions (i.e.: kissing, sharing a drink, sharing food or eating utensils, sharing a cigarette) within (and including) 14 days of the onset of symptoms of the case.
**All individuals meeting the above criteria for possible exposure or are otherwise determined to be “at-risk” need to be seen by Health Services or by another licensed health care professional within 24 hours of the identification of the index case**
- Health Services personnel will begin offering chemoprophylaxis (preventive medication) to all close contacts and “at-risk” individuals (including students, faculty and staff), as deemed appropriate, as soon as possible (within 24 hours) after diagnosis of the index case. Treatment will be provided based on the individual’s level of risk, exposure, and medical history. Most will be offered Cipro 500 mg in a single dose. For those less than 18 years of age, Rifampin 300 mg – two capsules every 12 hours for a total of 4 doses – will be prescribed.
C. Reassurance of those NOT at risk
Individuals not meeting any of the criteria for possible exposure listed above do not need medical treatment, just reassurance. --Bacterial meningitis is not spread through casual contact. Examples of individuals who would "not be at risk" include:
- Someone who shared a class with the index case.
- Someone who sat next to the index case in the library.
D. Cleaning/disinfection Procedures
For any cases of bacterial meningitis identified amongst residential students, arrangements should be made for thorough cleaning and disinfection of their residence hall room(s). All potentially contaminated materials should be removed from their room(s) and the room itself thoroughly cleaned and disinfected. Housekeeping personnel responsible for the cleaning and disinfection process should utilize appropriate personal protective equipment (PPE) provided by the College. If the student was seen in Health Services, the same procedures should be followed for the examination room.
E. Notification of “at-risk” individuals/groups
Once target individuals / groups have been identified, it will be necessary to have a specific briefing with representatives from the groups that would be responsible for contacting students who may have been exposed to the index case; for example the coach of a sports team, an RA or other Residential Life staff member, or representatives for a student club or organization. A designated member of Health Services (or of Student Affairs) will be responsible for speaking with these group representatives. They should be provided with a summary of what has occurred, what needs to be done, and the need to contact students who may be potential secondary cases. These representatives may be asked to contact individuals and direct them to report to Health Services.
The Director of Communications, the Chief Technology Officer and/or representative of the Office of the President will be the primary contacts for on and off-campus communication of important information related to an incident of bacterial meningitis in the Skidmore College community. Communications developed by their offices will be used throughout the crisis to educate the community about bacterial meningitis and what steps are being taken. The Director of Communications is the college's representative designated to coordinate information to the media.
Depending on the situation, other student groups, campus departments, or faculty/staff will be briefed about the meningitis incident and related procedures. For example, a special briefing could be held in the residence hall of the index case. Information shared would be helpful in providing correct information, alleviating rumors, and dispelling potentially needless worry.
IV. Collaboration with Saratoga County and NYS Public Health Departments
Saratoga County and New York State Health Public Health Department staff with collaborate with Skidmore College in determining whether campus-wide/community mass meningitis immunization is indicated, and in decisions regarding other possible community-based considerations such as: quarantine, cancellation of classes and/or community/athletic events, restriction of public/visitor access to campus, campus “closure”, etc.