Why Is Meningitis Still Causing Deaths on U.S. College Campuses?

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Last year the Centers for Disease Control and Prevention (CDC), approved a vaccine for meningococcal disease, or meningitis, yet many of this year’s 20.5 million college students are not vaccinated, leaving them vulnerable to contracting the disease.

According to the CDC, meningococcal disease refers to any illness that is caused by the type of bacteria called Neisseria meningitides and there are several serogroups, including A, B, C, Y and W-135. The illness they cause are often severe and include infections of the lining of the brain and spinal cord. They may also cause bloodstream infections. Up to 15% of people who contract it die, usually within 24 hours.

I know about this disease first-hand. I contracted it during my first few weeks of college and I nearly lost my life. I spent two weeks in coma and lost my hearing. I had to put off medical school for a year while I recovered.

How does one typically contract the disease? Meningococcus bacteria are spread through the exchange of respiratory and throat secretions like spit, particularly wherever large groups of people gather together or live in close quarters. This makes college students one of the groups most at risk, as was the case for me.

A few months ago, two Rutgers University students contracted meningitis B, and thankfully, both students recovered. Earlier this year, three othercollege campuses had cases, leading to the death of one person. Additionally, outbreaks occurred on five campuses between March 2013 and February 2016, resulting in two deaths, along with a limb amputation in one victim and neurological issues in others. Scores of other cases occurred on many campuses across the country during that time period which did not rise to the level of an outbreak.

While many states have mandates of vaccination for all incoming college and university freshman, at least 12 states do not require the vaccination, including my own state of Michigan. This needs to change.

Most college students physically interact with other students from out-of-state. As such we cannot afford to a situation where divergent vaccination policies further limit the effectiveness of vaccines in states they are required. To optimize herd immunity against meningitis among college students in the U.S, we need to mandate vaccination in all schools in all states.

While meningitis can be treated with antibiotics, quick medical attention is extremely important to save lives. Keeping up with the recommended vaccines is the most comprehensive and best defense against it.

The first vaccine for the prevention of meningococcal disease was developed in 1912. By the 1970s, specific vaccines were available for four of the five serogroups which commonly cause the infection. But serogroup B remained elusive until 2013 when Bexsero, a Meningitis B vaccine produced by Novartis, was approved for use in Europe. In October 2014,Trumenba, a serogroup B vaccine produced by Pfizer, was approved by the Food and Drug Administration. Bexsero was subsequently approved for use in the United States in February 2015.

Thus, vaccines are available, but the problem is the policies that govern vaccination practices in the different states.

The Advisory Committee on Immunization Practices (ACIP) recommends that clinicians administer a vaccine that offers protection against serogroups A, C, Y and W-135 to adolescents at 11 or 12 with an initial dose and again at 16 years of age for a booster dose. As of this month, New York students in grades 7 and 12 must be vaccinated against meningococcal disease, for instance, and already 27 states include the vaccine as part of the regular slew of immunizations.

But ACIP only states that clinicians may choose to administer serogroup B meningococcal vaccine to patients 16 through 23 years of age. In part, this is because important data for making policy recommendations are not yet available because these vaccines were recently licensed for use in the United States under an accelerated approval process. Hopefully, in the near future, with more research the vaccine may be mandated for this age group, too.

But since not all states have actively mandated the vaccine for adolescents and teens and college-age students are at a heightened risk, the CDC should do more than just recommend meningitis vaccination for college-age students.

Others agree. Several universities in states like Arizona, Michigan,Pennsylvania and Texas are strongly recommending or requiring that students receive the vaccination this fall.

Emily Stillman was a sophomore at Michigan’s Kalamazoo College when she tragically contracted meningitis. On February 2nd 2013, after just 36 hours in the hospital, Emily died from complications of the disease. The Meningitis B vaccine was not available before Emily’s illness, but now that it is, her mother Alicia Stillman is fighting to avoid this from happening to other families in the future. She created the Emily Stillman Foundation to raise awareness of the dangerous risks of Meningitis B and wants the vaccine to be a requirement for all college students.

Meningitis is preventable through vaccines, let’s make sure no college student is ever hospitalized or dies from it again.

Utibe Effiong MD,MPH, is a meningitis survivor who told his story in a TED Talk in Berlin, Germany. He is a U.S physician and public health scientist and an alumnus of the Aspen Institute New Voices Fellowship.

This article was first published by Scientific American.

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