Meningitis is an inflammation of the meninges -- a set of three protective membranes covering the brain and spinal cord -- that follows a bacterial infection. According to FIRSTConsult.com, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae cause 75 to 80 percent of bacterial meningitis cases worldwide.
Of these, Neisseria meningitidis is the most common cause of meningitis in children and young adults. There are an estimated 2,200 to 3,000 cases of meningococcal infection every year in the United States, according to a study conducted by Dr. Nancy Rosenstein and her colleagues published in the New England Journal of Medicine. Of these cases, five to 40 percent are fatal.
According to the American College Health Association (ACHA), 100 to 125 cases of meningococcal disease occur annually on college campuses since people who live in close quarters, such as military housing or college dormitories, have a higher chance of contracting meningococcal bacteria.
The ACHA also indicates that social behaviors such as smoking or exposure to smoking, excessive alcohol consumption or drink-sharing increase college students' risk of contracting bacterial meningitis.
There are five serotypes of Neisseria meningitidis (A, B, C, Y and W-135). Menomune and Menactra, the two meningitis vaccines that have been approved by the Food and Drug Administration (FDA), offer protection against all serotypes except serotype B. Researchers are currently investigating methods for developing a vaccine that will be effective against serotype B infection, which accounts for approximately 30 percent of all cases of bacterial meningitis infection, according to data from the Centers for Disease Control and Prevention.
Maryland state law requires that all students attending college in Maryland be vaccinated for meningitis prior to enrollment. Students may choose to waive this requirement, and according to Alain Joffe, MD, MPH, the director of the Johns Hopkins University Student Health and Wellness Center, approximately ten to 15 percent of entering freshman decline the meningococcal vaccine for various reasons.
"People don't update their vaccinations, tetanus shots, etc. It's easy to let those concerns slide. It is, however, very important to think about preventative measures and we do send out a pamphlet to all incoming freshman encouraging them to get the meningococcal vaccine," said Joffe.
Joffe said that the new vaccine, Menactra, is more potent and offers more long lasting protection (ten to 15 years) against meningococcal infection, which has raised concerns among some upperclassmen about the need to get revaccination, since many of them received the Menomune vaccine. "The vaccine is very effective. Menomune offers protection for about two to three years, but the risk of meningococcal infection significantly declines once students move out of University housing and into more apartment-style living," said Joffe.
If students wish to be vaccinated, the Student Health and Wellness Center offers the Menomune vaccine for $70 and at a discounted rate of $8 for students who are covered by the Johns Hopkins University Health Insurance Plan.
Joffe emphasized that the major factor that puts students at risk for contracting meningococcal infection is "the tendency to forget about the possibility of disease contraction in certain social settings." He added, "People may share drinks or a cigarette, and not realize [the possibility of contracting meningitis]."
Early diagnosis of meningitis can help prevent progression of the disease by treatment with antimicrobial agents to help rid the body of the bacteria. According to First Consult, there are many clinical features of bacterial meningitis, including: fever, headache, stiff neck, altered mental state, seizures, rash, nausea, vomiting and sensitivity to bright light. If an individual may have come in contact with a person affected by meningitis, antibiotic treatment is recommended. First Consult emphasizes that "speed of intervention to prevent neurological injury is the key to successful management."
According to the ACHA, meningococcal bacteria are transmitted through droplets of respiratory secretions and direct contact with a person affected by the disease. Many factors put a person at risk for contracting bacterial meningitis, including immune deficiency, alcoholism, diabetes and head trauma. A higher incidence of meningococcal infection is usually found in late winter and early spring, but rapid treatment upon detection of symptoms can alleviate the disease and prevent death.
According to Joffe, it is very important to take preventative measures, especially for students still living in dormitory-type housing. "There is good evidence that the vaccine is effective. We tend to focus on cases where the vaccine failed, but we forgot the numerous instances where the vaccine actually averted the disease."
