College Freshmen at Risk for Meningitis

A new report published in the Journal of the American Medical Association shows an increase in risk of meningitis for college-age students and recommends vaccination. Dr. Nancy Rosenstein of the Centers for Disease Control and Prevention [the CDC] is a meningitis expert and contributed to the report in JAMA. She spoke with the Early Show about the study's findings.

According to the CDC, meningitis is an infection of the fluid in a person's spinal cord and the fluid that surrounds the brain. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection.

There are approximately 2,400 cases of invasive meningococcal disease each year in the US with a 10 to 15% fatality rate. Since 1990, outbreaks have increased--notably, among children and young adults.

During the 1990s, the number of meningococcal outbreaks increased in the community and on college campuses. Several recent studies identified subgroups of college students that were at increased risk of meningoccocal infection, such as freshmen living on campus. This finding led to recent national recommendations about the use of meningococcal vaccine among college students.

The study also found that the majority of the deaths of 15- to 24-year-olds in the study were vaccine preventable.

What's most important about what your study found?

The bottom line is that we found that overall, college students didn't have a higher risk compared to others in same age group, but college freshmen in dorms did have an increased risk.

We don't know why? Our study was able to identify that it wasn't smoking or other outside factors. The risk factor exists all on its own. It's frustrating, but what's important is we identified that it can be targeted for vaccination.

Didn't the CDC already recommend vaccinating against meningitis?

I hope people listened, but this is another opportunity to get the message out. It's August and students are just about to go to school, so it seems like a good time to reiterate the message. Our underlying message is geared especially towards those who are freshmen in dorms. They and their parents should be educated about meningitis and the vaccine.

Isn't the cost of the vaccine prohibitive?

It is a relatively expensive vaccine. Some college students have been reluctant to get vaccinated because one dose costs about $75, which is not always covered by insurance.

Who else needs the vaccine?

The group at highest risk is younger children under 2 years old. The problem with that age group is the vaccine that's available doesn't work well on young children.

Are there other alternatives to the current vaccine?

New vaccines are on the horizon and should be incorporated into small children's vaccination schedule in the next 3 to 5 years. The current vaccine is very safe: It's impossible to get meningococca disease from the vaccine. It has been widely used in the US military since the early 70s. The vaccine in the 15- to 24-year age group is very effective against two out of three strains of bacteria: There are three main groups that cause meningococcal disease.

Why is meningococcal disease such a threat?

One of the problems with the diagnosis is early on it's hard to distinguish from other diseases like the flu.

According to the CDC, high fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the diseasprogresses, patients of any age may have seizures.
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