College students ages 18-24 are more than three times at risk for the potentially deadly serogroup B meningococcal disease (meningitis B) when compared with non-college students, according to a study published in the January 2019 issue of Pediatrics.
Although the incidence of meningococcal disease has steadily declined in the United States since the 1990s, adolescents and young adults remain at an increased risk for meningococcal disease. College freshmen living in residence halls, though not college students overall, have previously been identified as being at an increased risk for meningococcal disease compared with young adults of the same age who are not in college.
Meningococcal disease — a bacterial disease also known as meningitis — has many strains, with each one being called a specific serogroup; the five major strains are serogroups A, B, C, W and Y. According to the National Meningitis Association, of those who contract meningococcal disease, 10 to 15 percent die from it. Among those who survive the illness, 20 percent will have permanent disabilities, such as brain damage, hearing loss, loss of kidney function or limb amputations. The disease is spread through the exchange of respiratory secretions during close contact such as kissing or coughing on someone. The meningococcal bacteria cannot live outside the body for very long, so it does not spread as easily as a cold virus. The National Meningitis Association states that roughly one in 10 people carry meningococcal bacteria in their nose or throat without showing any signs or symptoms of the disease and can unknowingly transmit the bacteria to others.
The study, “Meningococcal Disease Among College-aged Young Adults: 2014-2016” (published online by the American Academy of Pediatrics this week), analyzed data from 2014-2016. During that time, 166 cases of various strains of meningococcal disease were reported in people ages 18-24, including 83 who were college students. Within the group of college students, fully three-quarters — 76.9 percent — of the cases were due to serogroup B; that strain of meningococcal disease only accounted for 38.4 percent of all meningococcal disease cases involving 18-24 year olds not enrolled in college. There is a vaccine for serogroup B (MenB), but it has only been “recommended permissively” by the CDC since 2015; this type of CDC recommendation means that decisions on whether to administer the vaccine should be made on a case-by-case basis that looks at the risk and benefit to the patient, rather than a blanket recommendation for all members of a particular group.
Students entering college and planning to live in dorms have also historically been at a higher risk than other people of the same age for two different strains of meningitis: meningococcal serogroup C and Y infections. Healthcare providers routinely recommended that this college-bound population receive the vaccine that prevents the strains C and Y: the quadrivalent meningococcal conjugate (MenACWY) vaccine that also treats strains A and W. With this newly released study showing that college students are more than three times at risk of contacting serogroup B meningococcal disease than those of the same age not attending college, researchers want to stress the awareness among parents and providers about the availability of MenB vaccine in addition to the MenACWY vaccine.