Meningitis at Princeton University

On Monday, the seventh student with bacterial meningitis at Princeton University in New Jersey was reported by the CDC.

Princeton University has been hit with its seventh case of meningitis since an outbreak that began last spring, a university spokesman said Monday.

The latest case was reported over the weekend, when a male student became acutely ill and underwent treatment at the campus health center, spokesman Martin A. Mbugua said.

The student was later taken to a local hospital, where meningitis was diagnosed early Sunday, Mbugua said. The student remained in the hospital Monday.

Health officials are conducting tests to determine whether the student has type B meningococcal bacteria, the type contracted by six other Princeton students this year.

Students living in dormitories are required to receive the meningitis vaccine, which protects against most strains of meningitis but not type B. The CDC has now decided to import a vaccine that has yet to be approved in the US to halt the breakout. The vaccine, Bexsero (pdf), is available in Europe and Australia.

“This is a bad disease and we know how devastating it is,” Dr. Thomas Clark, acting head of the Centers for Disease Control’s meningitis and vaccine preventable diseases branch, told NBC News. “A lot of us had a gut feeling that there would be more cases and we should get the ball rolling.”

The unprecedented move could aim to inoculate the nearly 8,000 undergraduate and graduate students at the Ivy League school in hopes of stopping the spread of an illness that kills 10 percent or more of teens and young adults who get it.

“If you’re a student at Princeton University right now, your risk is quite high,” Clark said.

Officials at the New Jersey university were mum on the arrangement, providing no details about how or when a vaccination effort would be launched.

The Princeton cases were all caused by the B strain of the bacterium Neisseria meningitidis which is uncommon in the US.

What you need to know about meningitis from the Center for Disease Control

Transmission

The germs that cause bacterial meningitis can be contagious. Some bacteria can spread through the exchange of respiratory and throat secretions (e.g., kissing). Fortunately, most of the bacteria that cause meningitis are not as contagious as diseases like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been. Other meningitis-causing bacteria are not spread person-to-person, but can cause disease because the person has certain risk factors (such as a weak immune system or head trauma). Unlike other bacterial causes of meningitis, you can get Listeria monocytogenes by eating contaminated food.

Sometimes the bacteria that cause meningitis spread to other people. This usually happens when there is close or long contact with a sick person in the same household or daycare center, or if they had direct contact with a patient’s oral secretions (such as a boyfriend or girlfriend). People who qualify as close contacts of a person with meningococcal or Haemophilus influenzae type b (Hib) meningitis are at higher risk of getting disease and may need antibiotics (see Prevention). Close contacts of a person with meningitis caused by other bacteria, such as Streptococcus pneumoniae, do not need antibiotics. Tell your doctor if you think you have been exposed to someone with meningitis.

Healthy people can carry the bacteria in their nose or throat without getting sick. Rarely, these bacteria can invade the body and cause disease. Most people who ‘carry’ the bacteria never become sick.

Signs & Symptoms

Meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck. It will often have other symptoms, such as

   Nausea

   Vomiting

   Increased sensitivity to light (photophobia)

   Altered mental status (confusion)

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure.

Babies younger than one month old are at a higher risk for severe infections, like meningitis, than older children. In newborns and infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear to be slow or inactive (lack of alertness), irritable, vomiting or feeding poorly. In young infants, doctors may look for a bulging fontanelle (soft spot on infant’s head) or abnormal reflexes, which can also be signs of meningitis. If you think your infant has any of these symptoms, call the doctor or clinic right away.

Later symptoms of bacterial meningitis can be very severe (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

While the Bexsero vaccine will only be made available to the Princeton community, it is important that all students, whether they live on or off campus, even at home, receive the meningitis vaccine.