Meningitis an Issue

Are the words of this article fading into a mass of black smudges to the pounding rhythm of your aching head? Are you abnormally hot or feverish? Does your neck feel like you just took a lengthy test, the searing pain shattering your concentration with the slightest neck movement?

You might have meningitis.

According to several recent studies, the risk for meningococcal infection - a cause of the life-threatening disease meningitis - is significantly higher for college students residing in on-campus dormitory housing. Freshmen are at a particularly high risk of contraction.

In a recent study conducted by The Journal of the American Medical Association (JAMA) 96 cases of meningococcal disease were identified between Sept. 1, 1998 and Aug. 31, 1999 among college students in the United States. Rates were highest in the northern and southeastern regions of the country, which would include the state of Maryland. Of the 96 cases, 31 percent were freshman dormitory residents. In fact, freshman residing in a dormitory were threefold as likely to contract the disease, a finding that led researchers to compare the incidences to those of the military. Because of unusually close living quarters, both environments permit the spread of the disease.

According to a study conducted by the CDC and the American College Health Association (ACHA), on-campus resident freshmen had an annual meningococcal disease incidence of 4.6 per 100,000. This is by far the highest rate of all age groups, excepting children less than two years of age.

As for meningitis at the Johns Hopkins University, Dr. Alain Joffe, physician at the Health and Wellness Center, said, "My sense is that we get a case maybe once a year or maybe once every other year, so it's really difficult to spot trends since there's so few cases."

Despite the rarity of the disease in the United States, it can pose a true threat and is easily spread in a dormitory atmosphere. People can die of the infection, said Joffe, since it is a blood-born virus and thus can travel to the brain.

A study conducted in 1999 of meningococcal infection and college students in the state of Maryland indicated that the annual incidence among 4-year undergraduate on-campus residents was 3.24 per 100,000 as opposed to the general population of 18 - 22 year olds at 1.44. Yet, the same study concluded that the meningococcal vaccine could possibly have prevented more than 80% of the cases of college students.

"Every student in the state of Maryland must have proof of vaccination to live on-campus at a state college," said Joffe. "Nevertheless, the vaccine only treats the meningococcal strain, which is the most common among college students."

But how does one recognize the signs of meningitis?

"They're very cold-like symptoms: fever, headache, stiff neck and, in advanced cases, a skin rash," said Joffe. "But a lot of people carry the germ in their nose and have no symptoms. There's probably some genetic factor so that some people's immune systems are more robust. There's also a variability in the strains so that some are more virulent than others."

The 2001 study conducted by JAMA identified several risk factors for the meningococcal disease: immune deficiency, recent upper respiratory tract infection, being of white race and exposure to radiator heat. Previously identified risks include low socioeconomic status, household crowding, exposure to tobacco smoke and consistent bar and nightclub patronage. However, this current study indicates that tobacco smoke exposure, low socioeconomic status and crowing were not evident causes.

Although its imminence has declined today, large epidemics of the meningococcal infection swept the United States until 1944. Epidemics of great magnitude still scour developing countries where one percent of the population is often attacked with the virus.

"[According to studies], it looks like what happened is the number of meningococcal cases [among college students in the U.S.] increased from the early to mid-90s and then began to decline in the late-90s," said Joffe.