Outbreak of Meningitis Causing Health Officials to Look Overseas for Help

By Thomas Clark, MD, MPH

This time last year public health officials were grappling with a meningitis outbreak linked to fungus found in tainted medication.  Now officials are trying to rein in a different outbreak of meningitis, more specifically meningococcal disease, popping up on a college campus, including Princeton University.

Most college freshmen are instructed to get a series of vaccinations before starting school in the fall, including one for meningococcal disease which can spread quickly in close quarters, such as dorms. The meningococcal vaccine routinely given to rising freshman protects against four different serogroups, or types, of meningococcal bacteria – A, C, Y, and W-135. Unfortunately, the cases of meningococcal disease that have been appearing at Princeton University are from a different strain of these bacteria not covered by the vaccine.

Taking Action

Because meningococcal disease can be deadly or lead to long-term disabilities [LINK], affecting the linings of the brain and spinal cord or the bloodstream, and can spread more easily on college campuses, it’s important that school and health officials take immediate action to stem the spread of disease. Princeton University and the New Jersey Department of Health have launched an aggressive awareness campaign to educate students and the University community about the disease and how to help prevent spreading it.  Individuals who were in close contact with patients diagnosed with meningococcal disease have also been recommended antibiotic treatment as a precautionary measure. But because giving antibiotics to everyone isn’t an effective strategy, CDC has recommended that a vaccine approved in Europe and Australia be imported to try and halt the spread of this outbreak. FDA has given the OK for use of the vaccine at Princeton University under an Investigational New Drug application. This is a term FDA uses to describe a vaccine that’s not licensed (approved) in the US, but which is made available in certain situations. FDA has concluded that the benefits of using the vaccine to prevent meningococcal disease at Princeton University outweigh the risks of possible adverse events. Clinical trials in other countries have shown the vaccine to meet safety and efficacy standards to allow licensure in the European Union and Australia in January and August 2013, respectively.  This is the first time CDC has had the chance to consider using this newly licensed vaccine in response to a serogroup B meningococcal disease outbreak.

Why Vaccinate?

Since students have become ill over the course of two school years, officials believe there will be more cases. And because predicting who meningococcal bacteria will strike next isn’t possible – many people carry the bacteria in their throats without actually get sick – vaccination is the most effective way of controlling future spread of the disease. Unlike antibiotics, a vaccine would protect people for a longer period of time, and could help decrease or stop the spread of the bacteria, which would help protect the University community as a whole. It also avoids some of the complications of antibiotics, such as antibiotic resistance and side effects. The vaccine is recommended for all Princeton University undergraduate (regardless of where they live) and graduate students living in dormitories. Certain other individuals associated with the University may be evaluated for vaccination if they have specific medical conditions. Getting vaccinated would be voluntary and funded by the University. You can get more information on the vaccine at http://www.cdc.gov/meningococcal/vaccine-serogroupB.html

Staying Safe at School

Meningococcal disease can spread from person to person, through saliva (think coughing or kissing) or through lengthy contact (think living in the same dorm room or apartment). Symptoms of meningococcal disease include rapid onset of fever, headache, body aches, and feeling very tired. Individuals may also experience a stiff neck, increased sensitivity to light, feel nauseated or confused, and have a rash. Students should be aware of how they are feeling and look for possible signs or symptoms. If you feel you might be getting sick, seek medical attention immediately and avoid contact with others (don’t go to class or work until you’ve talked to a doctor about how you’re feeling). The same basic health practices that you should normally follow for preventing infection from the flu or colds are also recommended. They include:

• Covering your mouth and nose when you cough or sneeze,
• Washing your hands often with soap and warm water, and
• Practicing good health habits like not sharing utensils, water bottles, or other items that might be contaminated with someone else’s saliva (this means beer pong too!)

***Stay Tuned!  Dr. Clark, Branch Chief of CDC’s Meningitis and Vaccine Preventable Diseases Branch is currently in New Jersey working with Princeton University on their vaccination campaign.***