Health Advisory: Meningitis B at Princeton & University of California-Santa Barbara
December 4, 2013
To: Students, Families, Faculty and Staff
From: Lisa Marx, CRNP, Director Health Services
As we approach the holiday break when students will return home to their families, I want to share with you information from the federal Centers for Disease Control that relates to the prolonged meningococcal (serogroup B) disease outbreak at Princeton University and the recent outbreak at University of California, Santa Barbara. We have seen no cases of meningococcal symptoms in Washington College students, faculty or staff, but want to share this advisory to answer any questions you may have about how the disease spreads and who is at risk.
The advisory states: “CDC does not recommend a change in normal activity to avoid contact with the affected universities or their students. Good hygiene practices such as hand washing, and coughing or sneezing into the arm are recommended. The licensed quadrivalent meningococcal vaccines are recommended for all adolescents 11 through 18 years old and first-year college students living in residence halls, but these vaccines do not protect against serogroup B, the serogroup that is causing the Princeton University and UCSB cases. A serogroup B meningococcal vaccine, which is only licensed for use in Europe and Australia, will be offered at Princeton University. FDA has allowed the use of the vaccine at Princeton University under an Investigational New Drug application.”
There is no recommendation to avoid contact with Princeton or UC-Santa Barbara students. Sporadic cases of meningococcal disease are not unusual on residential campuses. Although anyone can get meningococcal disease, adolescents and college students who live in dormitories are at an increased risk. The bacteria that cause meningococcal disease are less infectious than the viruses that cause the flu. To prevent the spread of any respiratory disease, it is always recommended that you practice good hygiene habits: Cover your cough to prevent the spread of infection to others, disinfect hands often with soap and water or hand sanitizer (especially before eating), and avoid sharing items like utensils and water bottles that are contaminated with saliva.
There is no recommendation to take antibiotics before attending events or activities at Princeton University or UC-Santa Barbara. Only people who have been in close contact with a suspected or confirmed case of meningococcal need to be considered for preventive treatment. The infectious period for meningococcal disease is considered to be from 10 days before the person becomes ill to 1 day after he or she starts on antibiotics. This means that people who were in close contact with the sick person during this time are at higher than average risk to get meningococcal disease. Close contact includes activities such as:
- living in the same household or sleeping in the same dwelling
- sharing eating utensils or food
- sharing drinks
- sharing cigarettes
- uncovered face-to-face sneezing or coughing
The bacteria are not spread by casual contact activities like being in the same work or schoolroom as the sick person, or handling books or other items that the sick person has touched. Likewise, being around a person who was in contact with the sick person does not put you at risk for catching meningococcal disease. The bacteria cannot live outside the body for very long, so the disease is not as easily transmitted.
Symptoms of Meningococcal Meningitis can include sudden onset of fever, headache, and stiff neck, often accompanied by nausea, vomiting, increased sensitivity to light, and mental confusion. These symptoms can appear quickly or over several days. Typically they develop within 3 to 7 days after exposure. Meningococcal meningitis is very serious and can be fatal, with death occurring in as little as a few hours. In non-fatal cases, permanent disabilities can include hearing loss and brain damage.
Meningococcal Septicemia (aka Meningococcemia)
Another severe outcome of meningococcal infection can be bloodstream infection, either septicemia or bacteremia. The more serious of the two is septicemia. In a victim of meningococcal septicemia, the Neisseria meningitidis bacteria enter the bloodstream and multiply, damaging the walls of the blood vessels and causing bleeding into the skin and organs. Symptoms may include fatigue, vomiting, cold hands and feet, cold chills, severe aches or pain in the muscles, joints, chest or abdomen, rapid breathing, diarrhea and, in the later stages, a dark purple rash.
If you think you or your infant or child has any of these symptoms, call the doctor right away. Meningococcal septicemia is very serious. In fatal cases, deaths can occur in as little as a few hours. In non-fatal cases, permanent disabilities can include amputation of toes, fingers, or limbs or severe scarring as a result of skin grafts.
Please refer to the CDC website for the most up to date information regarding meningitis including who is at risk, causes and symptoms, treatment, and surveillance.