人妻少妇专区

Alumni Gazette

Bacterial meningitis鈥攁 disease that strikes without warning and can kill within hours鈥攔anks among the most feared of the infectious diseases that can strike humans. Its risk factors include some of the most mundane circumstances and activities鈥攍iving in a college dormitory or attending summer camp鈥攁nd some of the most exalted, such as undertaking the Hajj, the pilgrimage to Mecca made by more than 2 million Muslims each year.

Andrew Artenstein 鈥�81, an infectious diseases specialist and chair of the department of medicine at the Tufts University鈥揳ffiliated Baystate Health, has long had an interest in the disease. He鈥檚 the son of the late Malcolm Artenstein, an infectious diseases expert who helped develop the vaccine for one form of bacterial meningitis, meningococcal meningitis, at the Walter Reed Army Institute of Research in the 1960s.

鈥淚t was a very exciting time,鈥� Artenstein recalls. 鈥淚 was young, but I remember it vividly. It seemed that everything was out there to be discovered and to be solved.鈥�

In a book released last fall, Artenstein tells the story of the disease and efforts to control it, from the very first descriptions of the malady in the early 19th century to the present. Steven Opal, an infectious diseases specialist at Brown University, where Artenstein served for 10 years before joining Baystate Health, praises the scope of the book, which places the work of scientists against bacterial meningitis within the broader context of the development of microbiology and immunology. 鈥淚t鈥檚 a 鈥榤ust-read鈥� for medical history buffs,鈥� he says.

Though bacterial meningitis has always been uncommon, the stakes for preventing it are enormous given how often, and how quickly, it turns deadly. Artenstein begins the book鈥攁ptly titled In the Blink of an Eye: The Deadly Story of Epidemic Meningitis (Springer)鈥攚ith the story of Michael Gomes, a high school sophomore in New Bedford, Mass., who awoke one spring morning with a severe headache and neck pain.

What followed is a textbook example of the progression of bacterial meningitis. Gomes took Advil and went out for a game of pick-up basketball. But the Advil did little to alleviate his pain. During the game, he began to feel cold. On the walk home, he developed nausea, and vomited on the sidewalk. At home, he closed his shades (meningitis can make victims highly sensitive to light) and went to sleep.

When Gomes鈥檚 mother came home late in the afternoon, she found him difficult to rouse. When he arrived at the emergency room, he was losing consciousness.

Doctors performed a spinal tap and found the fluid surrounding Gomes鈥檚 spine鈥攚hich would normally be clear鈥攖o be a cloudy white. 鈥淢ichael had pyogenic meningitis, a bacterial infection that affects the tissues鈥攖he meninges鈥攖hat cover the brain and spinal cord in the central nervous system,鈥� Artenstein writes. 鈥淒espite the best efforts of modern medicine and powerful treatments that were brought to bear in the case of Michael Gomes, he died within 24 hours. A healthy, 16-year-old boy playing basketball with friends one day, gone the next鈥攊n the blink of an eye.鈥�

Why does bacterial meningitis strike one healthy young adult and not another? The reason lies in characteristics of both the bacterial organism and the human host. 鈥淢ost of the time,鈥� Artenstein writes, 鈥渨hether the human host or the bacteria gain the upper hand in their struggle for dominance is a matter of luck and timing.鈥�

The tragic story of Michael Gomes shows bacterial meningitis in its episodic form, which kills many thousands of individuals every year around the globe. But the disease also has an epidemic form, in which it can spread rapidly, having the potential to kill in much higher numbers.

From the early 19th century onward, outbreaks have occurred often among troops housed in barracks. It鈥檚 no accident that the first successful meningitis vaccine was developed at a military medical facility.

鈥淭he military is a microcosm for addressing infectious diseases,鈥� Artenstein says. 鈥淚t puts people in new habitats. It crowds people together. And the whole mission of military medicine is preserving the force, so prevention, the key to attacking infectious diseases, has always been huge.鈥�

After graduating from medical school at Tufts, Artenstein followed his father鈥檚 path and became an Army doctor and researcher at Walter Reed. He spent 10 years there, treating military personnel and their families around the world.

Artenstein says that while the vaccine developed by his father鈥檚 team in the 1960s made huge strides in preventing outbreaks of meningitis, it was not effective in preventing all strains of the disease.

鈥淪cience is a stuttering process,鈥� he says. 鈥淵ou make incremental advances, you go back a few steps, then finally there鈥檚 some big breakthrough and the whole field moves in a certain direction.鈥�

Since the breakthrough of the late 1960s, the quest to eradicate bacterial meningitis has continued to make incremental advances, especially in the so-called 鈥渕eningitis belt鈥� in sub-Saharan Africa.

Forty-plus years may seem like a long time, but Artenstein takes a long view. 鈥淚鈥檓 a student of history as well as a practitioner in the present,鈥� he says. The battle against bacterial meningitis has taken place 鈥渙nly over a couple hundred years. In the scheme of things, that鈥檚 a really short time frame.鈥�