Every fall, thousands of American teenagers leave
the comfort of home for the first time and enter a new world, a world full of excitement and learning. This new world is college, where students are often crammed into dormitories like sardines. In addition to the close social ties created by dorm life, many people believe this close habitation is
what spreads diseases, including meningococcal virus. Although no study has proven
how the disease spreads, we do know that college students, especially freshmen, are contracting the disease at an unusually
high rate. Fortunately, scientists have recently discovered a new meningococcal
vaccine, and they are encouraging universities to offer this vaccine to their students.
Meningococcal
disease, very similar to the more known meningitis, is a viral disease, caused by the bacteria Neisseria meningitides. The incidence rate in the United States is
relatively low, around 1 per 100,000 people, with a fatality rate of about 10%. In
a 1998 study conducted at several Maryland colleges, the incidence rate rose to 3.24 per 100,000. Meningococcal is a very resilient and versatile disease, having five different strains, each more common
in different aged people. One strain is of most concern to college students for
two reasons. First, 35% of meningococcal cases from 1992-1996 in the U.S. were
caused by serogroup C, the most out of any serogroup. Secondly, serogroup C cases
have a fatality rate of 14%, higher that the average death rate of meningococcal. This
fact is alarming since serogroup C is the most common on campuses.
Meningococcal disease is especially dangerous
because of the ease of transmission between a carrier and a non-carrier. Any
physical contact can spread the bacteria. The scariest thing, however, is that
some people can carry the disease and not become infected by the bacteria. Most
people’s immune systems are strong enough to defend against the meningococcal bacteria, but they are still carriers
of the disease. These carriers are the people who eventually spread the disease
to others, whose immune system is compromise. Sadly, college students often have
weakened immune systems because of their lifestyles, which include too much stress, a lack of sleep, and overuse of alcohol
and drugs.
Many
colleges can learn a lot from the military’s use of the meningococcal vaccine.
The living conditions of recruits are very similar to that of collegians living in dormitories. Both involve living extremely close to young adults coming from all over the country. The spreading of a viral disease is very easy in this type of environment.
In 1971 the military began using the meningococcal vaccine with its troops, which has reduced hospitalizations greatly. In the years before implementing the vaccine, the rate of hospitalization due to meningococcal
was 25.2 out of every 100,000 persons. This is 25 times the national average. Since the serogroup C vaccine has been employed, an 89.5% reduction has been seen
in meningococcal cases. Unfortunately, there is no evidence showing that a similar
reduction in cases would be seen in such a comparable environment as a college dormitory.
However, the fact that they are both similar environments predicts that any results in another study would be similar.
Because
of the recent rise in meningococcal deaths in the past decade, university administrations are being pressured, mostly by parents,
into educating their students about the disease, and more importantly, offering vaccinations.
The vaccine comes in the form of a shot, similar to the popular influenza vaccination.
Unpleasant reactions are very rare, and only have to do with pain and/or redness at the site of the injection. Serious reactions, such as seizures and anesthesias, are even rarer. The vaccine currently covers four of the five strains, including serogroup C. The only strain not covered by the vaccine is serogroup B, which scientists are now trying to incorporate
into an all-encompassing vaccine. Even without serogroup B, the vaccine has the
potential to prevent 65% of meningococcal deaths (Harrison).
The
fact that the simple act of getting vaccinated can help prevent a deadly disease is reason enough for college campuses all
over the country to supply vaccinations. Many universities pride themselves on
offering free flu shots, so why can’t they add the meningococcal vaccine to their vaccination programs? The evidence in favor of campus-wide vaccination is clearly positive, and any institution not in favor
of offering vaccines to its students doesn’t care about them.
References:
Rosenstein et al. The changing epidemiology of meningococcal disease in the United
States, 1992-1996. Journal of Infectious Diseases 1999; 180:1894-901.
Harrison, Lee H. Preventing Meningococcal Infection in College Students. JAMA. 1999; 281: 1906-1910.
Abramson et al.
Meningococcal Disease Prevention and Control Strategies for Practice-Based Physicians.
Committee on Infectious Diseases. <http://web12.epnet.com/citation.asp?tb=1&ug=dbs+13.html>