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Article of Interest - College & Health

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Bridges4Kids LogoCollege Freshmen and the Meningitis Threat
by Kathleen Doheny, HealthDayNews, August 26, 2004
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Candie Benn was entertaining guests for Christmas Eve dinner. But her older daughter Melanie, then 18 and a college freshman home for the holidays, wasn't feeling well.

So Melanie headed up to her room to rest and recover from her flu-like symptoms.

For Christmas morning, Candie Benn recalled, "We were planning a big gathering at our house." But Melanie began to feel worse, so her mother drove her to a hospital emergency room near their home in San Diego.

It was then that Melanie and her mother learned why the young woman had developed a fast-spreading rash and why her symptoms -- fatigue, achiness, vomiting -- had worsened so suddenly.

She had meningococcal disease, a bacterial infection that can move swiftly and be fatal. These infections can strike the blood -- called meningococcemia -- or they can attack the fluid of the spinal cord or the brain, a condition called meningitis.

Melanie had the blood infection. To save her life, she was placed on a ventilator. She also had to have most of her arms and legs amputated.

"We did not know about bacterial meningitis," said Candie Benn, recalling that devastating holiday nearly nine years ago.

They also didn't know about the vaccine that can go a long way toward preventing such infections.

Every year, about 3,000 cases of meningococcal disease occur in the United States, according to the U.S. Centers for Disease Control and Prevention. The overall fatality rate is about 10 percent, but it's sometimes higher in young people.

Currently, the CDC's Advisory Committee on Immunization Practices recommends that college freshmen -- particularly those who plan to live in dormitories and residence halls -- be told about the vaccine for meningococcal disease.

Certain lifestyle factors, including crowded living conditions, a move to a new residence, and attendance at a new school with students from geographically diverse areas, are thought to heighten the risk for the disease.

As of July, 31 states had passed laws spelling out the requirements for immunization or informing college students and their parents about the disease, according to the National Meningitis Association. In some states, students must be told about the disease and the availability of the vaccine. In others, students in dorms must be vaccinated or sign a waiver saying they've been informed of the risks but choose not to get vaccinated. If they are under 18, a parent or legal guardian must sign the waiver, too.

Melanie made a remarkable comeback, returning to school and finishing not only her undergraduate work but getting a master's degree in social work from the University of California, Los Angeles. Today, she is a social worker at a San Diego hospital.

And, before her younger sister, Jessica, now 25, went off to college, she got the vaccine.

Candie Benn now volunteers with Moms Against Meningitis, part of the National Meningitis Association, heightening awareness of the disease and lobbying to make the vaccine mandatory for college students.

The vaccine is given in a single injection, said Dr. Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia and a professor of pediatrics at the University of Pennsylvania School of Medicine.

"The current vaccine protects against four of the five meningococcal strains," he said.

Those most vulnerable to the disease are infants, students living in dormitories, and military recruits. The vaccine prevents about 70 percent of meningococcal infections in teens and young adults, Offit said.

Death from infection with meningitis can occur within hours after onset of the illness, Offit explained in an article last year in the New England Journal of Medicine that discussed the meningococcal vaccine.

The disease is spread by coughing, sneezing, kissing or sharing drinking glasses. College freshmen living in dorms often skimp on sleep, further lowering their immunity to germs, experts say.

Symptoms of meningitis include a fever of 101 degrees or higher, a stiff neck, a purple rash, vomiting and headache. If these symptoms occur, immediate medical attention is crucial, including antibiotics.

A new vaccine is due out soon, said Offit, who predicts it could be licensed by the end of this year or early next year. The new vaccine is expected to be more powerful and have longer-lasting immune responses.

A bill in Congress, the Meningococcal Vaccination Act of 2004, would require that all new students who will live in on-campus housing at postsecondary schools get a vaccination. Those who want to be exempt must present a signed, written wavier.

"It's a horrible disease," said Candie Benn. "The best protection you have to not get it is to get the vaccine."

    

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