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College students at heightened risk for lethal meningitis B infections

(Reuters Health) – College students may be much more likely than others in their age group to develop a rare but potentially fatal type of bacterial infection that can be prevented with vaccination, a U.S. study suggests.

Among young adults ages 18 to 24, college students are more than three times as likely to be infected with meningococcal disease serogroup B, researchers found. These bacteria can enter the bloodstream and lead to severe swelling in the brain and spinal cord. Even though the relatively new MenB vaccine helps protect against this strain, it isn’t widely used or recommended for all teens or college students, the study team notes in Pediatrics.

“Our results demonstrate that while the incidence of disease is low in persons aged 18-24 years, college students are at increased risk for serogroup B meningococcal disease compared to non-college students,” said lead study author Dr. Sarah Mbaeyi of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta.

“College students, parents, and providers should be aware of the availability of MenB vaccines,” Mbaeyi said by email.

The disease kills about 10 to 15 percent of people who catch it, previous research has found. Many survivors have lasting impairments like neurological deficits, loss of limbs or digits and hearing loss.

The older MenACWY vaccine covers four other strains of meningococcal disease and is recommended as a routine childhood vaccination as well as for any unvaccinated or under-vaccinated college students living in residence halls, Mbaeyi and her colleagues note.

Due in part to more widespread vaccination, these strains are less common than strains covered by the MenB vaccine, they write.

For the study, the researchers examined national data on all meningococcal disease cases among young adults 18 to 24 years old, including both college students and those not enrolled in school, over a two-year period.

During this time, there were 166 cases of meningococcal disease among young adults, for an average annual rate of 0.17 cases for every 100,000 people in this age group.

Six serogroup B outbreaks were identified on college campuses, accounting for about one third of the cases of this strain developed by students during the study period. However, among all meningitis cases in college students during this period, 77 percent involved serogroup B. That compares to 38 percent of the meningococcal disease cases in peers who were not college students.

The study wasn’t designed to prove whether or how college students might be more likely to contract serogroup B strains of meningococcal disease. In addition, too few students were infected for researchers to identify trends over time in infection rates among college students.

Bacterial meningitis may be spread by coughing, sneezing or kissing. People can carry the bacteria and spread it to others even when they aren’t sick, according to the CDC.

“The infection is transmitted from person to person and requires close contact,” said Dr. Lucila Marquez of Baylor College of Medicine and Texas Children’s Hospital in Houston.

“Therefore, it seems logical that living in dorms or any activity that could put young adults in close proximity for extended periods of time could increase the risk of infection,” Marquez, coauthor of an accompanying editorial, said by email.

The higher risk faced by students in the study has the potential to prompt changes in national vaccine guidelines to recommend routine MenB vaccination for college attendees, Marquez said.

SOURCE: and Pediatrics, online December 31, 2018.

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