Nov. 2, 1999 LOS ANGELES (Oct. 25, 1999) – An advisory committee for the Center for Disease Control and Prevention (CDC) last week urged college freshmen to consider being vaccinated against meningococcal meningitis.
Moshe Arditi, M.D., the Director of Pediatric Infectious Diseases at Cedars-Sinai Medical Center, and an authority on the prevention, diagnosis and treatment of bacterial infections, says meningococcal infection is a very dangerous situation that can kill within just a few hours.
"The bacteria travel through the bloodstream, frequently reaching the meninges, the lining of the brain and spinal cord, and causing the inflammation called meningitis. In other instances, the bacteria don't even have time to go that far, instead causing a fulminant blood infection, bringing about septic shock and shutting down the body's organs. This can occur very rapidly," says Dr. Arditi.
Although the bacterium that causes meningococcal infections -- Neisseria meningitidis - is easily passed through direct contact activities such as coughing, sneezing or kissing , many people carry it for days or weeks in the secretions of the nose and throat without getting sick. Even so, meningococcal meningitis appears to be an opportunistic disease, infecting people who live in close proximity.
In fact, the military began fighting the bacteria years ago, introducing the first vaccine in 1971 to prevent outbreaks among new recruits housed in crowded barracks. Today, the battle field is moving to the college campus.
"It appears that the overall incidence of this problem in high school and college kids aged 17 and older has doubled in the last few years," says Dr. Arditi. "College students do not have an increased incidence of meningococcal disease compared to the general population, but students living on campus have a three-fold increased risk compared to those who live off campus."
While crowding may play a role in these statistics, it probably is not the only factor. "In some ways, entering college freshmen may be analogous with military recruits, but on-campus residence halls typically are not as crowded as military barracks," says Dr. Arditi. "There may be other risk factors involved with living on campus, such as alcohol-related behavior, exposure to tobacco smoke and other activites that may weaken the immune system's response. It may be that many dorm students are exposed to the bacteria for the first time and therefore have not had an opportunity to develop immunity."
Dr. Arditi says the vaccine costs about $65, a bargain compared to the cost of higher education. "In my opinion, it is reasonable for physicians to provide college students, especially those living on campuses, with the option of receiving the vaccine if they want to reduce their risk."
The vaccine is not, however, a guarantee of immunity. There are five serogroups or strains of the bacterium: A, B, C, Y, and W. The vaccine protects against four of the five.
"The college campus outbreaks have mostly been caused by group C and the vaccine is reasonably effective against A, C, Y and W. But currently there is no effective vaccine approved in the United States for serotype B, which causes about one-third of the cases," Dr. Arditi says.
Tell-tale symptoms of meningitis include high fever and severe, sudden headache. These often are accompanied by such complaints as stiff neck, nausea, vomiting, mental changes and a rash. According to Dr. Arditi, 3,000 new cases of meningococcal infection cause about 300 deaths per year in the United States.
The Director of Cedars-Sinai Medical Center's Division of Pediatric Infectious Diseases, Dr. Arditi is available to provide additional information on this subject.
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