Meningitis Outbreaks at 2 Colleges Unrelated, Says CDC

November 26, 2013

Meningitis outbreaks at Princeton University in New Jersey and the University of California, Santa Barbara (UCSB), are unrelated, even though 2 such outbreaks occurring at the same time is unusual, an official with the Centers for Disease Control and Prevention (CDC) said November 25.

Amanda Cohn, MD, a CDC medical officer and meningitis expert, also said at a news conference that her agency is close to approving a meningitis B vaccine for Princeton students that is not licensed by the US Food and Drug Administration (FDA).

Since March 2013, 7 confirmed cases of meningitis B involving 6 students and 1 visitor have been reported at Princeton University, with an eighth case of meningococcal disease coming to light last week. Public health authorities have yet to determine whether the last case, similar to the rest, was caused by the meningococcal bacteria called serogroup B.

At UCSB, 3 undergraduate students have come down with meningitis, all this month. Two of the cases have tested out to be meningitis B, and laboratory work in the third case is pending, according to the Santa Barbara County Public Health Department.

"Fortunately, there haven't been any fatalities from these 2 outbreaks, but there have been some very serious cases," said Dr. Cohn.

She noted that even though meningitis B struck both universities, they represent different strains of serogroup B, which argues against the outbreaks being connected.

There is an FDA-approved meningitis vaccine protecting against serogroups A, C, W, and Y, but the United States lacks one for serogroup B, which accounted for one third of the roughly 500 meningitis cases last year. The European Union and Australia have approved a stand-alone meningitis B vaccine manufactured by Novartis that the FDA has cleared for use at Princeton University on an investigational basis.

The CDC also believes that the situation at Princeton University warrants expanded access to the meningitis B vaccine, said Dr. Cohn. Final approval of this move rests with the agency's institutional review board, which will make sure the proposed vaccination program is conducted safely and effectively and that "the kids getting the vaccine fully understand that it's an investigational vaccine."

Dr. Cohn said she expects the agency's institutional review board to green-light the plan in time for vaccination at Princeton University to begin "shortly after the Thanksgiving holiday, hopefully."

For an individual to receive full protection, he or she must receive a second dose 1 to 6 months after the first dose, according to the CDC. Princeton University stated in a news release last week that it expects to make the first dose available in December and the second in February.

The CDC is tentatively recommending that all undergraduate Princeton students living in campus dorms or off-campus, as well as all graduate students in dorms, receive the vaccine. Other vaccine candidates are members of the university community with medical conditions such as sickle cell disease and so-called complement deficiencies that put them at a higher risk for contracting meningitis B. Vaccination would be voluntary.

Residents of Princeton, New Jersey, would not be eligible for the vaccine. Past meningitis outbreaks at universities have not spread to surrounding communities, Dr. Cohn noted.

The CDC is not recommending that Princeton University students cancel travel plans over the Thanksgiving holiday or otherwise curtail social activities. "There is no evidence that family members and the community are at increased risk of getting meningococcal disease from casual contact with Princeton University students," the agency said on its Web site.

On a similar note, the executive director of student health at UCSB said in a campus-wide email last week that public health authorities have not advised the university to cancel campus activities and events in light of its meningitis outbreak. That UCSB administrator, Mary Ferris, MD, added that the university has conferred with the CDC and other agencies about making the meningitis B vaccine available to its student body. UCSB plans to monitor the proposed vaccination program at Princeton University.

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