March 24, 2008

Cornell Addresses Meningitis Threat

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Along with the mid-semester grind of prelims, problem sets, presentations and papers, this semester some Cornell students faced an unprecedented stress — the threat of bacterial meningitis. In the week prior to spring break, two students were hospitalized with the rare, yet potentially fatal disease that kills approximately 100 to 125 college students per year.
A little over two weeks after the initial scare, the two students, a 21-year-old female and a 20-year-old male, have been released from their respective hospitals and are doing well, according to Dr. Janet Corson-Rikert, executive director of Gannett Health Services. But the two cases caused students, faculty and health officials to examine the dangers of the contagious disease.
The Cornell community took a number of precautionary steps to ensure that the disease was contained after the first student was diagnosed on March 8. On March 14, one day after the second student was hospitalized, the University sent an e-mail to all students specifying three locations where individuals may have had contact with the infected students and recommending that members of the community be on alert for symptoms of the disease.
According to Daniel Sherman ’10, a fraternity brother of one of the infected students, all members of the fraternity were advised to take 500 mg of Ciprofloxacin, or Cipro, a broad-spectrum antibiotic that blocks bacterial DNA replication.
“We contacted a number of people outside of our fraternity who we believed may be at risk [including] our cook and any other staff and recommended that they take Cipro,” Sherman said.
Since the two diagnoses, health officials have been investigating the two cases, attempting to determine if they are linked.[img_assist|nid=28960|title=|desc=|link=node|align=left|width=|height=0]
“It’s been confirmed that both cases were caused by type B neisseria meningitidis,” said Simeon Moss ’73, director of Cornell University Press Relations.
Neisseria meningitidis, better known as meningococcus, is one of the leading causes of meningococcal disease, or bacterial meningitis. In an infected person, the membranes that surround the brain and spinal cord become inflamed. The inflammation is caused by each of five strains of the meningococcus bacteria. A vaccination protects against four of the five strains.
“Currently two different meningococcal vaccines are available in the U.S., both of which provide protection against four of the five serogroups of the bacteria; A, C, Y and W-135,” Corson-Rikert stated in an e-mail.
The vaccine fails to protect against the B serogroup, which was confirmed to have caused the disease in the two Cornell students.
While vaccinated students could not have been protected against the strain that hit Cornell, the American College Health Association cites that 70 to 80 percent of all cases of bacterial meningitis reported by college-age individuals are caused by the four potentially vaccine-preventable strains.
In 2003, George Pataki, former New York State governor, signed legislation requiring institutions, including all colleges and universities in the state, to distribute information about bacterial meningitis to all enrolled students. The law requires that all students either provide proof of immunization or sign a waiver acknowledging the risks posed by the refusal to be vaccinated.
The ACHA estimates that young adults and adolescents between the ages of 15 and 24, the demographic most closely associated with college students, account for 30 percent of reported cases of bacterial meningitis in the U.S. Additionally, the fatality rate of the disease within this demographic is approximately 25 percent, which is significantly higher than the overall fatality rate of 10 and 15 percent.
Among college students, freshmen living in dormitories run a significantly higher risk of contracting the disease. A study conducted by the Center for Disease Control in 1999 concluded that of the 90 cases of meningococcal disease reported by college students, an alarming 44 percent of the infected were freshmen living in dorms.
Experts point to a number of explanations for the skewed statistics. It is suspected that freshmen are more susceptible to the disease because they have not yet built up the immunity to bacteria that are widespread in communal living conditions, such as dormitories. Additionally, college freshmen face lifestyle factors such as irregular sleeping patterns, exposure to smoking and excessive alcohol consumption that may increase the risk of infection.
The disease can be spread person-to-person via respiratory droplets in the air released by coughing or sneezing. Additionally, the disease can be transmitted directly through oral contact with items such as cigarettes and drinking glasses, or by kissing.
According to Corson-Rikert, Cornell employs multiple strategies to reduce the likelihood of infectious diseases in the community. Gannett provides information about vaccinations, promotes general public health strategies and works with the Tompkins County Health Department to “conduct ‘contact tracing’ and make treatment recommendations on a case-by-case basis when individuals become ill with an infection that has significant public health import,” Corson-Rikert stated in the e-mail.
However, most health insurance plans, including Cornell’s Student Health Insurance Plan, do not cover the cost of the meningococcal vaccine, which is available at Gannett for $105.
“Ultimately, an individual’s best defense is in behavioral choices,” Corson-Rikert stated. “To boost the immune system through adequate sleep, regular exercise, and proper nutrition; to wash hands regularly; and to avoid high risk activities such as beer pong, shared drinks, cigarettes, joints and bongs, which can rapidly spread both bacteria and viruses even among people who believe they are healthy, but who are capable of transmitting incubating disease.”
Though the most recent cases of bacterial meningitis were contained, in the past century the University has seen widespread infectious diseases plague the community. In 1903, a typhoid epidemic broke out as a result of an intestinal bacteria found in the Fall Creek water supply, killing 85 Ithaca residents, including 19 students. Fifteen years later, in 1918, approximately 900 students contracted the worldwide influenza pandemic that ultimately killed 37 students.
Corson-Rikert acknowledged that the U.S. is overdue for an influenza pandemic, which she said, “has the potential to wreak havoc around the world.” She assured that the University is actively working to prepare a coordinated response, should such an outbreak occur.