Serogroup B Meningococcal Disease Outbreaks

The following information on serogroup B meningococcal disease outbreaks is provided by ACHA’s Vaccine-Preventable Disease Advisory Committee after consultation with the Centers for Disease Control and Prevention (CDC).

The ongoing serogroup B meningococcal disease outbreak at Princeton University brings national attention to an issue of longstanding importance to the college health community. The dramatic decline in cases of meningococcal disease since the late 1990s coincides with the widespread use of the quadrivalent meningococcal vaccine in adolescents and students entering college.

Outbreaks of serogroup B meningococcal disease are rare. Since the first case last spring, Princeton officials have collaborated diligently with local and state public health officials and the CDC. After the third case (which defines an outbreak), CDC initiated discussions with the Food and Drug Administration (FDA) for permission to acquire Bexsero, the serogroup B meningococcal vaccine that is licensed in Europe and Australia, to be made available for this specific outbreak. Cases of meningococcal disease are reportable in every state, and no spread beyond the Princeton campus has occurred or is expected.

It is well known that the close quarters of campus residence hall living puts students at increased risk for meningococcal disease.


What is meningococcal disease?

Meningococcal disease can refer to any illness that is caused by the type of bacteria called Neisseria meningitidis, also known as meningococcus. Fewer than 1,000 cases of meningococcal disease occur each year in the United States. These bacteria can cause serious infections like meningococcal meningitis (infection of the protective membranes of the brain and spinal cord) and meningococcal septicemia (bloodstream infection causing bleeding into the skin and organs).

There are five main serogroups ("strains") of meningococcal bacteria: A, B, C, Y, and W. The most common ones that cause disease in the United States are B, C, and Y. In 2012 there were about 500 total cases of meningococcal disease, and 160 of those cases were caused by serogroup B.

A Note Regarding Viral Meningitis: Viral meningitis is generally less severe and resolves without specific treatment. Viral meningitis can affect anyone. People who are around someone with viral meningitis have a chance of becoming infected with the virus that made that person sick, but they are not likely to develop meningitis as a complication of the illness. Common symptoms in adults include: high fever, severe headache, stiff neck, sensitivity to bright light, sleepiness or trouble waking up, nausea, vomiting and lack of appetite. The symptoms of viral meningitis usually last from 7 to 10 days, and people with normal immune systems usually recover completely. There is no specific treatment for viral meningitis. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Most patients completely recover on their own within 7 to 10 days. A hospital stay may be necessary in more severe cases or for people with weak immune systems. There are no vaccines for the most common causes of viral meningitis.  


Signs & Symptoms

Symptoms of meningococcal disease occur within 3-7 days after the person has been exposed to the meningococcal bacteria.

Early signs of meningitis disease:

Usually begins with flu-like symptoms, which begin suddenly, and progress to 

  • high fever
  • nausea
  • vomiting
  • photophobia (increased sensitivity to light)
  • altered mental status (confusion)
  • severe headache
  • stiffness and pains in the neck, shoulders, and back
  • a skin rash of tiny bright red spots often appears.

IF YOU HAVE THESE SYMPTOMS GET MEDICAL CARE IMMEDIATELY.

Prompt treatment and notification of local public health officials for a suspected case, allow for prompt post-exposure antibiotic prophylaxis.


Diagnosis and Treatment

Early diagnosis and treatment are very important. If meningococcal disease is suspected, samples of blood or cerebrospinal fluid (near the spinal cord; see image below) are collected and sent to the laboratory for testing. It is important to know if it is meningococcal disease because the severity of illness and the treatment will change depending on the cause. In the case of meningococcal disease, antibiotics can help prevent severe illness and reduce the chances a close contact will also develop disease.

Meningococcal disease can be treated with a number of effective antibiotics. It is important that treatment be started as soon as possible. If meningococcal disease is suspected, antibiotics are given right away.

 


 

Prevention

Students are advised to receive a quadrivalent meningococcal vaccine or a booster dose for students entering college, if the first dose was given prior to age 16.

The vaccine for meningococcal meningitis is an injectable, inactivated-bacteria vaccine. It protects against 4 types of the disease (known as A, C, Y, and W-135) It is about 85-90% effective against these types. The vaccine does not protect against meningococcal disease type B. Most meningococcal disease in the United States and other industrialized countries is caused by type B or type C.

Meningococcal vaccines are available at the University Health Center.

Call (301) 314-8184 to schedule an appointment.

Practice Good hygiene measures such as:

  • Not smoking, and avoiding secondhand smoke
  • Not sharing drinking and eating utensils and other items that have contacted saliva will help prevent the spread of meningitis
  • Good basic personal hygiene
  • Covering your cough or sneeze with tissue or your elbow and
  • Frequent hand washing are critical to help prevent the spread of illness and disease.  If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands.

If your (roommates, boyfriends, and girlfriends) have had close contact with the person with meningococcal meningitis, see a practitioner at the Health Center or your personal physician for preventive treatment immediately.

If you or your family have any questions, you may contact the University Health Center at (301) 314-8180 or the Prince George’s County Health Department at (301) 583-3750.


Meningococcal disease information

 

Content Sources: Centers for Disease Control and Prevention, American College Health Association, National Meningitis Association