Risk of Meningitis Upped for College Freshman

From the WebMD Archives

Aug. 21, 2000 -- Is your child off to college this fall? If you've made a checklist of items to pack and things to take care of before he or she goes, you may want to add just one more item -- a meningitis vaccination. Growing research has found that some groups of college students may be at a higher risk of contracting bacterial meningitis, and that risk can be minimized by means of quick injection.

Meningitis causes an inflammation of the membranes surrounding the brain and spinal cord, and it can be life threatening. Some forms of bacterial meningitis are contagious and are spread through the air in much the same way as a cold or the flu. It also can be transmitted by direct contact with an infected person, such as sharing drinking glasses or cigarettes, or through intimate contact such as kissing. Also, people may carry the infection without actually being sick.

So how high is the risk for a college student? That information isn't clear and varies among different populations.

One of the largest and most recently published studies took a look at the infection rate among 2,500 students at the University of Nottingham in the U.K. The researchers examined the students and found that the number carrying the infection increased dramatically over a four-day period at the start of their fall term. By December, one third of the students tested were found to be carrying the bacteria.

"The study suggests that during the first month of the term, the carriage increases among incoming students," Nancy Rosenstein, MD, tells WebMD. But students in this country should not get overly alarmed, as there are differences between the U.K. and the U.S.

Unlike the U.K., American college students are not at a higher risk for meningitis when compared to other people in the same age group. In fact, the infection rates are overall lower for college students than for their counterparts who are not in school. But there is one exception: college freshmen living in dormitories.

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"This group has a higher rate of infection than others in a similar age group who are not in college, or who are in college but not residing in a dormitory," she says. Rosenstein is with the meningitis branch of the CDC.

Randy Rock, MD, points out that the increased risk among freshmen living in dorms may be six times as higher than other groups. "Other studies have suggested that risk is also higher among those who smoke or consume alcohol or spend a moderate to significant amount of time in bars," says Rock, who is the chief of staff of student health services at the University of Kansas in Lawrence.

Luckily, meningitis is relatively rare in the U.S., with about 3,000 individuals becoming infected each year. Estimates show that 100 to 125 cases occur each year on college campuses, causing between five to 15 deaths.

A number of different bacteria can cause meningitis with one in particular being the culprit for most cases in the U.S. The available vaccine is for meningitis caused by this microorganism but it is not effective against the disease when it's caused by other bacteria.

However, the vaccine offers protection against 70% of the cases among college students making it an option worth considering, according to the CDC. In October of 1999, the CDC's Advisory Committee on Immunization Practices (ACIP) modified their vaccine guidelines to address the situation.

"Our current recommendations are that college freshman, and especially those who are going to live in dormitories, and their parents, be educated about [meningitis] and told about the availability of a safe and effective vaccine," Rosenstein says, "So they can make an informed decision about whether or not they want to be vaccinated."

The ACIP recommends that vaccination should be provided or made easily available to students who want to reduce their risk of contracting this illness. They also advise that colleges and universities provide information about the disease to students and their families.

Easier said than done, Rock says. Access to the vaccine can be a problem, as many health departments, as well as physicians' offices, do not stock the vaccine. "The protocols are very new," he says, "So many of the health departments are not on par with them. And if a physician's office does not see very many college age patients, they also would not have a reason to carry it."

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Not all student health services are universally equipped to take care of the demand for the vaccine. Availability varies across the country, and Rock feels that this is something that needs to be addressed. "We're informing parents and students in orientations and mailings from the universities about the vaccine, but maybe we haven't gone the next step and let them know where to get it," he says.

The American College Health Association, whose membership includes more than 900 schools, has agreed to adopt the ACIP guidelines, and offer their suggestions as to who may benefit most from the meningitis vaccine:

  • Entering college students, particularly those living in dormitories or resident halls, who wish to decrease their risk factors,
  • Undergraduate students 25 years of age or under who want to lower their risk of contracting meningitis, and who are not pregnant,
  • Students who have medical conditions, such as HIV, that weaken their immune systems, and
  • Students traveling to areas of the world with widespread meningitis.

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