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Team physician Dr. Chad Roghair discusses health risk posed by bacterial meningitis

Editor's note: On January 21, health officials received test results confirming that the cause of Alisa Lewis's death was bacterial meningitis.

– Following the Jan. 19 death of Cal women's basketball player Alisa Lewis from what is believed to be bacterial meningitis, Assistant Vice Chancellor for Public Affairs George Strait sat down to discuss the health risk posed by the disease with Dr. Chad Roghair. Roghair is the women's basketball team physician and head physician for the Urgent Care Unit at UC Berkeley's University Health Services. Additional information about Lewis and about bacterial meningitis is online.

George Strait: What happened to Alisa?

Chad Roghair: The probable cause of Alisa's death is bacterial meningitis. Additional tests are being done, but we believe this is the cause of her death.

GS: How common is bacterial meningitis?

CR: Very uncommon. In fact, here at Berkeley prior to this, I don't believe we have had a proven case in more than than five years. The overall rate of bacterial meningitis is 0.7 cases of meningococcal meningitis per 100,000 undergraduate students.

GS: Who is at risk from being in contact with Alisa?

CR: Bacterial meningitis is spread through large respiratory droplets, so it needs to be people who have close, intimate contact. At greatest risk would be individuals who had kissed or shared close intimate space with her within the prior week of the development of the illness. Those who had casual contact, such as hand-shaking or were in proximity within the classroom or in the environment, are not considered to be at high risk.

GS: What about her teammates?

CR: Teammates are individuals probably at higher risk because of the amount of time in contact that they spend together, grouped together in team meetings, in huddles, in close proximity during drills and playing, and often they live together, eat together and socialize together. They would be more in a close contact group. However, it is still felt that people with intact and normal-functioning immune systems are not at an extreme high risk. Bacteria meningitis does not spread the way a flu/viral infection can spread.

GS: What about her classmates?

CR: Classmates are considered more of a casual contact and the risk of them developing this infection is minimal. It is not felt by most infectious disease experts that preventative treatment for these individuals outweighs the risk incurred by the preventative treatment, which is the taking of an antibiotic medication. Their risk is very minimal. It approaches that of people at large who have no known close contact with somebody with meningitis.

GS: So as a result of Alisa's tragic death, what's the public health plan?

CR: The plan is to continue to track the exact cause of her illness – the bacteria that ultimately caused her condition – and when you can isolate that, you can definitively know the treatments required. At this point our suspicion of bacterial meningitis is high enough that we feel close, intimate contacts – teammates, housemates – warrant a single dose of antibiotic treatment of a medicine called Ciprofloxacin (Cipro). That has proven to be a very effective prophylactic treatment for meningitis.

GS: So what are you doing for the women's basketball team, the men's basketball team, trainers, and coaches?

CR: We have interviewed close friends, teammates, coaching staff, to determine individuals who, in the past week, have had close physical contact. Those individuals who have had prolonged close physical contact we are recommending treatment with Cipro, a one-time dose. So again, it is felt strongly that casual contact is not a risk factor to warrant treatment.

GS: Have you notified Stanford and other teams that the women's basketball team has played recently?

CR: We have identified other universities and teams that may have had contact with her and have communicated with their medical staff the steps that we are taking here, and they are taking the appropriate steps for their campuses.

GS: Suppose Alisa signed an autograph for someone, should that person be concerned?

CR: It is felt that brief, casual contacts, such as a handshake or an autograph, are not intimate contact and do not warrant prophylactic contact treatment. However, if there are questions from fans or people in the community who have had contact wsith the women's basketball team, we feel they should direct their questions to their personal physicians.

GS: Isn't there a vaccine against this kind of meningitis?

CR: There is an available vaccine for meningitis but is effective for only 30 percent of the types of meningitis. Because the risk of meningitis to the community is low, it is not a required immunization. Currently, for University of California students, it is a recommended vaccination but not on the list of vaccinations required for students attending a UC school. (Additional information about the efficacy of the vaccine is online.)

GS: How concerned should someone be who did not have close contact or intimate contact with Alisa, and how concerned should the general population of Berkeley be?

CR: Meningitis is a serious condition so education about the disease is very important for parents. However, the risk for people who have not had close contact is extremely low. It is not a highly prevalent disease and should not be cause for panic, but it should just be something that people take the time to educate themselves on the signs and symptoms of meningitis and then make the individual decision on whether immunization is something that they wish to pursue. We have additional information about bacterial meningitis on the University Health Service website, and people can make decisions from there, or again, decide to consult with their own physician.

GS: And what are the symptoms?

CR: The most significant symptoms would be severe headache and stiff neck, both of which can be associated with fever, and a diffuse rash on the body, especially if it is associated with fever and stiff neck.