What is meningococcal meningitis?
Meningococcal disease is a rare but potentially fatal bacterial
infection. The disease is expressed as either meningococcal
meningitis, an inflammation of the membranes surrounding
the brain and spinal cord or meningococcemia, the
presence of bacteria in the blood.
What
causes meningococcal meningitis?
Meningococcal disease is caused by the bacterium Neisseria meningitidis,
a leading cause of meningitis and septicemia (or
blood poisoning) in the United States. Meningitis is one
of the most common manifestations of the disease,
although it has been known to cause septic arthritis,
pneumonia, brain inflammation and other syndromes.
How
many people die from meningococcal meningitis each
year?
Meningococcal disease strikes about 3,000 Americans each year and
is responsible for approximately 300 deaths annually.
It is estimated that 100 to 125 cases of meningococcal
disease occur annually on college campuses and five
to 15 students die as a result.
How
is meningococcal meningitis spread?
Meningococcal disease is transmitted through the air via droplets
of respiratory secretions and direct contact with
an infected person. Direct contact, for these purposes,
is defined as oral contact with shared items such
as cigarettes or drinking glasses or through intimate
contact such as kissing.
What
are the symptoms?
The
early symptoms usually associated with meningococcal
disease include fever, severe headache, stiff neck,
rash, nausea, vomiting, and lethargy, and may resemble
the flu. Because the disease progresses rapidly,
often in as little as 12 hours, students are urged
to seek medical care immediately if they experience
two or more of these symptoms concurrently.
Who
is at risk?
Recent evidence found students residing on campus in dormitories
appear to be at higher risk for meningococcal disease
than college students overall. Further research recently
released by the CDC shows freshmen living in dormitories
have a six times higher risk of meningococcal disease
than college students overall.
Although anyone can come in contact with the bacterium that causes
meningococcal disease, data also indicates certain
social behaviors, such as exposure to passive and active smoking, bar
patronage, and excessive alcohol
consumption, may put students at increased risk for
the disease. Patients with respiratory infections,
compromised immunity, those in close contact to a
known case, and travelers to endemic areas of the
world are also at increased risk. Cases and outbreaks
usually occur in the late winter and early spring
when school is in session.
How
often do outbreaks occur in on college campuses?
From 1980 to 1993, there were 21 outbreaks, three of which occurred
in colleges. From 1994 to 1996, there have been 26
outbreaks, four of which occurred in colleges. Between
1986 and 1993, an outbreak was defined as five cases
of the same serotype in 100,000 people with at least
three occurring within three months. From 1994 to
present, 10 cases of the same serotype in 100,000
people with at least three occurring within three
months constitute an outbreak.
Is
one type of serogroup of meningococcal meningitis
more common in college students?
Recent evidence shows the epidemiology of meningococcal disease
is changing with a majority of cases (65 percent)
in the college age group caused by either serotype
C, Y, or W-135, which are all vaccine-preventable.
Does
the CDC recommend vaccination for college students?
As of October 20, 1999, the Advisory Committee on Immunization Practices
(ACIP) of the U.S. Centers for Disease Control and
Prevention (CDC) recommends that individuals who
provide medical care to college freshmen, particularly
those who live in or plan to live in dormitories
or residence halls, should provide information about
meningococcal disease and the benefits of vaccination
with these students and their parents. ACIP further
recommends that immunization should be provided or
made easily available to those who wish to reduce
their risk for meningococcal disease. Other undergraduate
students wishing to reduce their risk for meningococcal
disease can also choose to be vaccinated.
Additionally, the ACIP recommends that colleges and universities
provide information about meningococcal disease and
the vaccine to freshman, particularly those who plan
to live in dormitories and resident halls, and encourages
public health agencies to serve as a resource for
information about meningococcal disease and vaccination,
including how to obtain the vaccine.
Why
should college students consider vaccination with
the meningococcal vaccine?
Data from the U.S. Centers for Disease Control and Prevention (CDC)
demonstrate increasing incidence of outbreaks on
college campuses. Data further suggests that sub-populations
of college students are at increased risk for meningococcal
disease. Pre-exposure vaccination enhances immunity
to four strains of meningococcus that cause 65 to
70 percent of invasive disease and therefore reduces
a student’s risk for disease. Development of immunity
post-vaccination requires 7-10 days.
Who
should be vaccinated pre-exposure?
- Entering college students,
particularly those living in dormitories or resident
halls, who elect to decrease their risk for meningococcal
disease.
- Undergraduate students 25 years
of age or under who request vaccination in order
to decrease their risk for disease and are not
pregnant.
- Students with medical conditions
that compromise immunity (e.g., HIV, absent spleen,
antibody deficiency).
- Students traveling to areas
of the world with endemic meningococcal disease.
Are
colleges and universities following ACHA's recommendation?
Since the release ACHA's recommendation in 1997, it is estimated
that as many as 200 colleges and universities have
included the ACHA recommendation on their college
entrance health forms and/or are conducting awareness
campaigns to educate parents and college students
about this disease.
How
effective is the vaccine?
The meningococcal vaccine has been shown to provide protection against
the most common strains of the disease, including
serogroups A, C, Y and W-135. The vaccine has shown
to be 85 to 100 percent effective in serogroups A
and C in older children and adults.
Is
the vaccine safe? Are there adverse side effects
to the vaccine?
The vaccine is very safe and adverse reactions are mild and infrequent,
consisting primarily of redness and pain at the site
of injection lasting up to two days.
What
is the duration of protection?
The duration of the meningococcal vaccine’s efficacy is approximately
three to five years.
Because meningococcal meningitis is one of the most feared diagnoses
in the United States, sporadic cases and
outbreaks almost invariably spread panic through
college communities. In order to proactively guard
against an outbreak (or endemic disease), ACIP recommends
that undergraduate college students,
particularly freshmen who live in or plan to live
in dormitories or resident halls, should consider
getting the vaccine. 
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