Overview
Meningococcal disease is a potentially life-threatening bacterial
infection that can lead to meningococcal meningitis, an inflammation of
the membranes surrounding the brain and spinal cord, or meningococcal
septicemia, an infection of the blood.
Meningococcal disease, caused by bacteria called Neisseria
meningitidis, is the leading cause of bacterial meningitis in older
children and young adults in the United States. It strikes 1,400 to
3,000 Americans each year and is responsible for approximately 150 to
300 deaths.
Adolescents and young adults account for nearly 30 percent of all
cases of meningitis in the United States. In addition, approximately
100 to 125 cases of meningococcal disease occur on college campuses
each year, and five to 15 students will die as a result. Evidence shows
approximately 70 to 80 percent of cases in the college age group are
caused by serogroup C, Y, or W-135, which are potentially
vaccine-preventable.
Vaccination Recommendations for College Students
On February 10, 2005, the Advisory Committee on Immunization
Practices (ACIP) for the Centers for Disease Control and Prevention
(CDC) voted to recommend that all incoming college freshmen living in
dormitories be vaccinated against meningococcal disease. The ACIP also
recommended vaccination for all adolescents at high school entry and
during pre-adolescent health care visits (11 to 12 years old).
The American College Health Association (ACHA) issued similar
immunization recommendations for all first-year students living in
residence halls. The ACIP and ACHA recommendations further state that
other college students under 25 years of age may choose to receive
meningococcal vaccination to reduce their risk for the disease.
ACHA and ACIP recommendations, coupled with the availability of a
new vaccine that may provide longer duration of protection, will help
increase rates of immunization against meningococcal disease and will
give college health professionals the guidance needed to help protect
college students against meningococcal disease.
Meningococcal Disease Caused by Five Strains/Serogroups
Five predominant strains or serogroups of N. meningitidis account
for most cases of meningococcal disease. These are A, B, C, Y, and
W-135. The currently available vaccine protects against four of the
five strains (A, C, Y, and W-135), and evidence shows approximately 70
to 80 percent of cases in the college age group are caused by serogroup
C, Y or W-135, which are potentially vaccine-preventable. No vaccine is
available for widespread vaccination against serogroup B.
Transmission and Symptoms of the Disease
Meningococcal disease is contagious and progresses very rapidly. The
bacteria are spread person-to-person through the air by respiratory
droplets (e.g., coughing, sneezing). The bacteria also can be
transmitted through direct contact with an infected person, such as
oral contact with shared items like cigarettes or drinking glasses, and
through kissing.
Meningococcal bacteria attach to the mucosal lining of the nose and
throat, where they can multiply. When the bacteria penetrate the
mucosal lining and enter the bloodstream, they move quickly throughout
the body and can cause damage to various organs.
Many people in a population can be a carrier of meningococcal
bacteria (up to 11 percent) in the nose and back of the throat, and
usually nothing happens to a person other than acquiring natural
antibodies.
Symptoms of meningococcal disease often resemble those of the flu or
other minor febrile illness, making it sometimes difficult to diagnose,
and may include high fever, severe headache, stiff neck, rash, nausea,
vomiting, fatigue, and confusion. Students who notice these symptoms -
in themselves, friends, or others - especially if the symptoms are
unusually sudden or severe, should contact their college health center
or local hospital.
If not treated early, meningitis can lead to death or permanent
disabilities. One in five of those who survive will suffer from
long-term side effects, such as brain damage, hearing loss, seizures,
or limb amputation.
Persons at Risk for the Disease, Including College Students
Meningococcal disease can affect people at any age. Infants are at
the highest risk for getting the disease. Disease rates fall through
later childhood but begin to rise again in early adolescence, peaking
between the ages of 15 and 20 years.
Due to lifestyle factors, such as crowded living situations, bar
patronage, active or passive smoking, irregular sleep patterns, and
sharing of personal items, college students living in residence halls
are more likely to acquire meningococcal disease than the general
college population.
Prior to 1971, military recruits experienced high rates of
meningococcal disease, particularly serotype C disease. The United
States military now routinely vaccinates new recruits. Since the
initiation of routine vaccination of recruits, there has been an 87
percent reduction in sporadic cases and a virtual elimination of
outbreaks of invasive meningococcal disease in the military.
In addition to increased risk because of crowded living situations,
proximity to a person diagnosed with disease (e.g., being a household
contact) also increases one's risk of disease. Other factors also
increase risk, such as a compromised immune system (which might be
caused by HIV/AIDS or taking certain chemotherapy or
immuno-suppressants) or having no spleen. Even something as simple as a
respiratory tract infection may increase the risk of getting the
disease. Certain genetic risk factors also may increase susceptibility
to infection.
Vaccination to Prevent Meningococcal Disease
Meningococcal vaccination is recommended for all first-year students
living in residence halls to protect against four of the five most
common strains (or types) of N. meningitidis (A, C, Y, and W-135). In
persons 15 to 24 years of age, 70 to 80 percent of cases are caused by
potentially vaccine-preventable strains. All other college students
younger than 25 who wish to reduce their risk of infection may choose
to be vaccinated.
Because disease rates begin to climb earlier in adolescence and peak
between the ages of 15 and 20 years, the vaccine also is recommended
for adolescents at high school entry and young adolescents at the
pre-adolescent health care visit (11 and 12 year-olds).
Vaccine Availability from the SU Student Health Center
There is no longer a nation wide shortage of the vaccine for
meningitis however some clinics do not carry the vaccine. The SU
Student Health Center has adequate doses of the vaccine and will offer
it to students at cost.