Neisseria_meningitidis

Rare meningococcal outbreak at University of California and Princeton University sparks debate on vaccination!

By: Rohini Manaktala.

The news of recent meningitis cases at University of California and Princeton University has sparked a debate as to whether a vaccination for a rare strain of meningococcal disease should be offered for college bound students.

Meningococcal disease is a bacterial infection that causes meningitis, which is an inflammation of the membrane layers covering the brain and spinal cord. It can also cause bloodstream infections leading to sepsis. The symptoms of meningitis include: fever, vomiting, skin rash, headache, stiff neck, photosensitivity and altered mental status. If treatment is not received in a timely manner it can lead to brain damage, limb amputation, hearing disturbances and even death.

College-aged students are at a higher risk of meningococcal disease. In particular, students who live in dormitories can easily acquire the disease by saliva and respiratory secretions. It can spread to other individuals who are in close contact with an infected person. These individuals are often given antibiotics prophylactically. Meningitis is diagnosed through laboratory testing performed on blood or cerebrospinal fluid samples. If bacteria are present, the sample can be cultured in order to determine the exact pathogen and it’s sensitivities to antibiotics. In terms of treatment, early antibiotic therapy is critical.

The recent cases of meningitis at University of California and Princeton University were caused by the meningococcal bacteria type-B strain, while the Center for Disease Control (CDC) recommended vaccine is quadravalent in nature and only targets strains A, C, W-135 and Y.

In light of its eighth student case of meningitis, Princeton University proposed providing Novartis Company’s Bexsero vaccine for meningitis type-B. However, it is currently only licensed in Europe and Australia. Therefore, the university is awaiting CDC’s final approval. If it is approved, then the vaccine will be highly recommended to all undergraduate and graduate students living in dormitories as well as the employees of the university with immunocompromised conditions. Yet again, it would be up to the students as to whether they would like to receive the vaccination or not.

According to the CDC, the current guidelines for meningitis vaccine are as follows:

  • All 11-12 year old children should receive the meningococcal conjugate vaccine followed by a booster dose at 16 years of age.
  • Adolescents who receive their first dose at age 13-15 years should receive a booster dose between 16-18 years of age.
  • Adolescents who receive their first dose at or after age of 16 years will not need a booster dose.

The booster dose is given because protection from the disease diminishes within 5 years and a single dose given in the early teenage years will not provide sufficient coverage during the at-risk late teenage years.

Overall, each year several thousands of incoming freshmen students enroll in college campuses nationwide. And each year in the U.S. there are approximately 700-1,000 cases of meningococcal disease. Given this information, numerous students are put at risk for the disease while cohabiting in residency halls. So, the question remains, “Would a vaccination against a rare strain of meningococcal disease be worthwhile especially in the light of the recent outbreaks on two college campuses?”

References:

1) http://www.cdc.gov/meningitis/bacterial.html

2) http://www.cdc.gov/vaccines/vpd-vac/mening/who-vaccinate.htm

3) http://www.cdc.gov/features/meningococcal/

4) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001700/

5) http://dailyprincetonian.com/news/2013/11/breaking-eighth-case-of-meningitis-at-princeton-reported/

6) http://www.cnn.com/2013/11/22/health/princeton-meningitis/index.html?hpt=he_c2

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