A CDC official discussed the cases of meningococcal disease that have sprung up at universities on separate coasts in recent months.
Eight students at Princeton University in New Jersey and four at the University of California, Santa Barbara, have been diagnosed with serogroup B meningococcal disease. Unlike with serogroups C and Y, no vaccine is licensed in the U.S. to treat this strain.
Amanda Cohn, MD, a medical epidemiologist at the CDC, noted fewer than 1,000 cases of meningococcal disease occur each year in the U.S., down from almost 3,000 annually in the late 1990s and early 2000s. In its most serious form, meningococcal disease can become meningitis or septicemia. About 10% to 15% of people with meningococcal disease die, even with antibiotic treatment, and 15% of survivors have long-term disabilities such as loss of limbs, deafness, nervous system problems or brain damage.
Early recognition and early treatment of meningococcal disease is key to reduce the long-term sequelae, Cohn said on a conference call. However, its often difficult to diagnose meningococcal disease because often the first signs and symptoms are similar to the flu.
Vaccination is the best way to prevent meningococcal disease when its a vaccine-preventable strain. Hand-washing and covering your coughs or sneezes are also good practices to follow. Its critical that everybody be aware of the signs and symptoms of meningococcal disease and seek treatment immediately.
Signs and symptoms include rapid onset of high fever, headache, stiff neck, nausea, vomiting, increased sensitivity to light, confusion, exhaustion and sometimes a rash, Cohn said. And when we say headache, we mean its among the worst headaches that somebodys had in their life. And with the stiff neck, they really cant move their neck, or they cant, for example, touch their chin to their chest.
Regarding prevention, Cohn said health officials should follow up with patients to determine whether they have come into close contact with anyone, and then recommend preventive antibiotics to close contacts. Fortunately, meningococcal bacteria are harder to spread than viruses that cause things like the flu or respiratory viruses, and they dont live long outside the body. Theyre spread through the exchange of respiratory secretions. These bacteria are not spread by casual contact like being in the same room with somebody who is sick or carrying the bacteria or handling items that they touched.
A vaccine for serogroup B meningococcal disease has been licensed in Europe and Australia, but not the U.S. The CDC and the Food and Drug Administration have determined that the unique pattern of disease in this Princeton outbreak, the high rate of cases that have occurred and over the long period of time theyve occurred warrants access to this serogroup B vaccine for that high-risk population, Cohn said.
Such a determination has not been made for the UCSB outbreak. Each outbreak is unique and requires a rigorous assessment before use of this vaccine can be considered, Cohn added.
Cohn said the CDC is not concerned about the outbreak’s risk of spreading from the universities to the outside communities.
We dont have a great understanding of the organism and how it spreads, she said. But what we do understand is that outbreaks really havent spread from universities into communities in the past. There have been community outbreaks of meningococcal disease. But we havent seen cases occurring in universities [and] expanding into those communities.
More on preventing meningococcal disease: www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm