Meningitis Threat for College Freshmen

Aug. 8, 2001 -- Here's one more reason besides home cooking and clean laundry for college students to consider staying home during their freshman year.

A study published in today's The Journal of the American Medical Association reports that college freshmen living in dormitories were more than seven times as likely to acquire the infection leading to meningitis than college students in general and three and a half times as likely as the population of 18- to 23-year-old nonstudents.

The study, conducted by the Centers for Disease Control and Prevention, also suggests that the use of the currently available vaccine for the infection could substantially reduce risk of the disease in these students.

Close, Not Casual, Contact

Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain, caused by bacteria called meningococcal.

Meningococcal infection is a major cause of bacterial meningitis, the more severe from of meningitis that can result in permanent brain damage, hearing loss, learning disability or loss of a limb.

The meningococcal bacteria are spread from person to person through close contact, not by casual contact or by touching contaminated objects. Common symptoms of meningitis include high fever, headache, and stiff neck and can develop anytime from several hours to 1 to 2 days after infection.

Freshmen at Particular Risk

The infection is said to have risen in incidence over the past 10 years among adolescents and young adults as outbreaks of meningococcal disease, rare in the 1980s, have become more frequent since 1991. Though the CDC altered its recommendations last year to support vaccination of college-aged students for the disease, the risk of the disease is still considered relatively small for this age group, at 1.4 individuals per 100,000 and a total of 2,400 yearly cases for the entire U.S. population.

The CDC study, conducted over a one-year period from September of 1998 to August of 1999, surveyed the health departments in the 50 states along with 231 college health centers.

All cases of meningococcal disease in college students reported to the health departments and student health centers were reviewed, with risk factors such as living arrangements, race, smoking and drinking habits examined.

The study found that, of the 96 cases of meningococcal disease in college students, nearly a third were cases of college freshmen living in dormitory-style housing, even though that population only represented four percent of the total population studied.

But Why?

As clear as the risk to campus-living freshmen may be, the reasons for their increased vulnerability is not as well understood.

Crowded living arrangements, stress and indulging in behavior such as smoking and drinking were among the risk factors previously suggested in studies.

The current CDC study did not find a clear relationship between such factors and meningococcal infection, but suggests that perhaps college dorm-residing freshman may be at increased risk of infection because they are simply exposed to the bacteria more often.

Of particular importance was the study's finding that, of the 9 percent of the college students who died from the infection, nearly 70 percent were infected with a strain of the disease that is preventable with current vaccine, suggesting that a vaccine could have saved these lives.

Vaccine, Education Recommended

Currently, the CDC and the American College Health Association recommend that college freshmen dormitory residents and their parents should be educated about meningococcal disease and the benefits of vaccination. As people of any age can carry the germs for days, weeks or months without becoming ill, the bacteria may be carried by around 10 to 25 percent of the population at any time.

Only rarely, however, do the bacteria overcome the body's defenses and cause meningitis. For this reason, vaccination is an important step in preventing meningitis, particularly if there are known cases in a geographic area.

Though the vaccine has been criticized by some as being ineffective against all strains of the meningococcal bacteria, the ACHA recommends that colleges and universities make efforts to provide access to the vaccine for those who wish to reduce their risk of disease.

Dr. James Turner, chair of the ACHA's Vaccine-Preventable Diseases Task Force, estimates that over a million and a half college students have used the vaccine since the ACHA first made its recommendations in 1997.

The cost of vaccination (from $65 to $85) is traditionally incurred by the student or their family and often covered by insurance. The vaccine is usually good for four years.

"It's not that different than getting a flu vaccine," says Turner, "And when you think of the context of a college education, the cost is not more that a good pair of athletic shoes."

Turner estimates that as many as 100 cases of meningocccal infection and 10 to 20 lives have been saved by these vaccinations alone.