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Meningitis on Campus

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Meningococcal disease is a potentially life-threatening bacterial infection caused by a virus or bacteria. It can lead to meningococcal meningitis, (an inflammation of the membranes surrounding the brain and spinal cord) or meningococcal septicemia (an infection of the blood). Meningococcal disease, caused by bacteria called Neisseria meningitidis, is the leading cause of bacterial meningitis in young adults in the U.S. Viral meningitis is usually less serious and goes away on its own.

Meningococcal disease affects 1,400 to 3,000 Americans each year and is responsible for approximately 150 to 300 deaths. Adolescents and young adults account for nearly 30 percent of all cases of meningitis in the United States. Approximately 100 to 125 cases of meningococcal disease occur on college campuses each year, with 5 to 15 students dying as a result.

Five predominant strains of N. meningitidis account for most cases of meningococcal disease. These are A, B, C, Y, and W-135. The currently available vaccine protects against four of the five strains (A, C, Y, and W-135). Evidence shows approximately 70% to 80% of cases in the college age group are caused by strains C, Y, or W-135, which are potentially vaccine preventable. No vaccine is available for strain B.

Meningococcal disease is contagious and progresses very rapidly. The bacteria are spread person-to-person through the air by respiratory droplets (coughing, sneezing). The bacteria can also be transmitted through direct contact with an infected person (drinking after someone, kissing). The bacteria cannot live outside the body for very long, so the disease is not as easily transmitted as a cold virus. Meningitis occurs most often in late winter and early spring.

Meningococcal bacteria attach to the mucosal lining of the nose and throat, where they multiply. When the bacteria penetrate the mucosal lining and enter the bloodstream, they move swiftly through the body and can cause serious damage to various organs and prevents blood from circulating to limbs. Some people are carrier of meningococcal bacteria (up to 11%) in the nose and back of the throat. Nothing usually happens to these carriers other than acquiring natural antibodies.

Symptoms of meningococcal disease often resemble those of the flu. This can make it difficult to diagnose. The symptoms are extremely easy to overlook and dismiss as something minor. The only way to definitively diagnose meningococcal meningitis is through a spinal tap – something not routinely done on people who have flu-like symptoms. Symptoms may include high fever, severe headache, stiff neck, rash, nausea, vomiting, fatigue, and confusion. If you notice these symptoms in yourself or someone else, contact your college health center or local hospital – especially if your symptoms are sudden or severe. Symptoms can develop over several hours or they may take 1-2 days. Seek treatment as soon as you can. If not treated early, meningitis can lead to death or permanent disabilities. 20% of those that survive meningitis will suffer from long-term effects, such as brain damage, hearing loss, seizures, learning disabilities, or limb amputation.

Bacterial meningitis can be treated with antibiotics. It is essential however, that treatment start early in the course of the disease. Appropriate antibiotic treatment reduces the risk of dying from meningitis to below 15% for college age students. Antibiotics also should be given to those in close contact with a person who is diagnosed with meningitis.

Students living in residence halls are more likely to suffer from meningococcal disease than the general college population. Lifestyle factors, such as crowded living situations, patronizing bars, irregular sleep, and sharing personal items may contribute to this. To help prevent the spreading of the disease, follow good hygiene practices – wash your hands, don’t share drinks or other items that have been in one’s mouth, etc.

The American College Health Association (ACHA) recommends all first-year college students living in residence halls receive the meningococcal vaccine. Twenty states now require college students to either get the vaccination or sign a waiver that says they’ve read about the disease. Three states mandate the vaccination for college students, but allow exemptions for religious or medical reasons. Eleven states require information about the vaccine and the disease be provided on campus. A growing grassroots movement is pushing for more states to require the shot. The Centers for Disease Control and Prevention recommends the vaccination, Menactra, for kids ages 11-18. Only 12% of teenagers got the vaccine in 2006.

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