MENINGOCOCCAL DISEASE FACT SHEET

USC Fact Sheet  |   ACHA Fact Sheet  |   Related Site |   FAQs

Background: Meningococcal

Meningitis on Campus

Overview of Meningococcal Meningitis

Meningococcal disease is a potentially life-threatening bacterial infection. The disease most commonly is expressed as either meningococcal meningitis, an inflammation of the membranes surrounding the brain and spinal cord, or meningococcemia, a presence of bacteria in the blood.

Meningococcal disease is caused by Neisseria meningitidis, which has become the leading cause of bacterial meningitis in older children and young adults in the United States.

Meningococcal disease strikes about 3,000 Americans each year, leading to death in approximately 10 to 15 percent of cases, which translates into 300 deaths annually. It is estimated that 100 to 125 cases of meningococcal disease occur annually on college campuses and 5 to 15 students die as a result. The disease can result in permanent brain damage, hearing loss, learning disability, limb amputation, kidney failure or death.

The incidence of meningitis outbreaks of serogroup C has risen in the past 10 years, including cases at U.S. colleges and universities. Data suggest that certain social behaviors, such as exposure to passive and active smoking, bar patronage and excessive alcohol consumption, may increase students' risk for contracting the disease. Recent data also show students living in dormitories, particularly freshmen, have a sixfold increased risk for the disease.

Vaccination Recommendations for College Students

In April, 2005 CDC announced revised recommendations concerning meningitis disease vaccination for college students. The revised recommendation states that college freshmen living in residence halls are at increased risk of getting meningococcal disease and should be vaccinated. The CDC continues to recommend prophylactic vaccination for all persons, including college students who: (1) are routinely exposed to meningococcal bacteria; (2) travel or live in a port of the world where meningococcal disease is common; or, (3) have a compromised immune system or disorder.

Meningococcal Disease Caused by Five Strains/Serogroups

There are five predominant strains or serogroups of N. meningitidis that account for most cases of meningococcal disease. These are A, B, C, Y and W-135. Among the serogroups responsible for invasive meningococcal disease in the United States in 1997, serogroup B accounted for 30 percent of cases, serogroup C caused 28 percent, serogroup Y about 37 percent and serogroups A and W-135 were rare. Serogroup A is predominantly a cause of meningococcal disease in Africa and Asia. In general, serogroups C, Y and W-135 have higher rates of death and complications compared to serogroup B.

Transmission and Symptoms of the Disease

Meningococcal bacteria are transmitted through the air via droplets of respiratory secretions and direct contact with persons infected with the disease. Oral contact with shared items, such as cigarettes or drinking glasses, or through intimate contact such as kissing could put a person at risk for acquiring the infection. People identified as close contacts of a patient are at an increased risk for disease and should receive antibiotics to prevent meningitis.

Many normal healthy people become carriers of these bacteria and usually nothing happens to the person other than developing natural antibodies. Very rarely, for reasons such as suppressed immunity or concurrent respiratory illness, the bacteria invades the body, causing disease.

Meningococcal disease usually peaks in late winter and early spring. The disease can easily be misdiagnosed as something less serious, because symptoms are similar to the flu. The most common symptoms include high fever, headaches, stiff neck, confusion, nausea, vomiting, lethargy and/or rashes. Anyone with similar symptoms should contact a physician immediately. If untreated, often within hours of the onset of symptoms, the disease can progress rapidly and can lead to shock and death.

Incidence of Meningococcal Meningitis

In the United States, outbreaks of serogroup C meningococcal disease have been occurring more frequently since the early 1990s, especially among young adults in school and community settings. There were 26 outbreaks between 1994 and 1996; four of these outbreaks were at a college or university, compared with only 15 outbreaks occurring between 1989 and 1993, including two outbreaks at a college or university.

Persons at Risk for the Disease, Including College Students

Meningococcal disease can affect people at any age. Certain groups are at increased risk for contracting the disease including those in close contact with a known case, individuals with compromised immune systems and persons traveling to endemic areas of the world. Since 1991, cases of meningococcal disease among 15- to 24-year olds have more than doubled.

Recent evidence found that students residing in dormitories on campus appear to be at higher risk for meningococcal disease than college students overall. Data released by the CDC shows freshmen living in dormitories have a six times higher risk for meningococcal disease than college students overall.

Prior to 1971, the military had experienced high rates of meningococcal disease, particularly serotype C disease. The U.S. military now routinely vaccinates new recruits. Similar to many college students, military recruits live in confined areas. 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.

Vaccination to Prevent Meningococcal Meningitis

A quadrivalent polysaccharide meningococcal vaccine (“Menomune”) and a newly released quadrivalent conjugate vaccine (“Menactra”) are available against four of the most common strains of N. meningitidis in the United States (A, C, Y, W-135). The “Menomune” vaccine can be used in adults and children older than two years of age and is 85 to 100 percent effective in preventing serogroups A and C of meningitis in older children and adults. “Menomune” is effective for 3 to 5 years. “Menactra” is approved for use with persons 11 to 55 years of age, and is reported to be effective from 8 to 10 years.

In April, 2005 CDC announced revised recommendations concerning meningitis disease vaccination for college students. The revised recommendation states that college freshmen living in residence halls are at increased risk of getting meningococcal disease and should be vaccinated. The CDC continues to recommend prophylactic vaccination for all persons, including college students who: (1) are routinely exposed to meningococcal bacteria; (2) travel or live in a port of the world where meningococcal disease is common; or, (3) have a compromised immune system or disorder.

Cases/Outbreaks of the Disease

From 1994 to present, 10 cases of the same serotype in 100,000 people with at least three occurring within three months constitute an outbreak. The vast majority of disease occurs as sporadic and isolated cases, referred to as endemic disease.

For more information on meningococcal meningitis and the vaccine visit the websites of the Centers for Disease Control and Prevention (CDC), and the American College Health Association.

The American College Health Association

The American College Health Association (ACHA), founded in 1920, is a national nonprofit organization serving and representing the interests of professionals and students in health and higher education. Its mission is to be the principal advocate and leadership organization for college and university health. The association provides advocacy, education and services for its members to enhance their ability to improve the health of all students and the campus community.

Thomson Student Health Center thanks the ACHA for contributing to this information.

updated 06/02/05