SDSU meningitis case concerns colleges
Two unrelated recent cases of meningococcal meningitis at San Diego State University and Palomar College in San Marcos have health officials concerned, especially with the upcoming holiday of Halloween. The infected SDSU freshman, Sara Stelzer, was admitted to the hospital with flu-like symptoms on Oct. 14, and died 48 hours later. The Palomar College student is still recovering.
Stelzer was a member of the Kappa Delta sorority at SDSU. She had recently attended fraternity parties on Oct. 8 and Oct. 9 at the Alpha Epsilon Pi and Delta Sigma Phi houses, where she could have exposed other students to the disease.
The deadly bacterial meningitis case has University of San Diego students concerned as they try to protect themselves from the meningococcal disease until the Center for Disease Control takes action. On the eve of Halloween, USD students looking to attend a large party are considering the recent case of meningitis at SDSU before making holiday plans.
Meningitis is the infection of the meninges, membranes surrounding the brain and spinal cord, which is caused by the meningococcal disease. It is a very serious infection that can cause brain damage, loss of hearing, kidney disease, loss of limb and death. Symptoms include fever, intense headache, and a stiff neck.
Meningitis is spread through the exchange of respiratory secretions, and can be transmitted through coughing, sneezing, kissing, sharing cups or utensils, or any other direct contact with infected saliva or mucus. The World Health Organization warns that 5 to 10 percent of the population carries meningococcal disease but is asymptomatic and these carriers can unknowingly infect others.
There are vaccines in the United States that are effective in preventing four of the five strains of meningococcal disease. The SDSU student was infected with serogroup B invasive meningococcal disease, which is not protected by domestic vaccinations. This lack of protection makes an outbreak more likely.
USD sophomore Dante Enriquez felt his concerns about meningitis would lead to him taking extra caution this Halloween.
“I think that the meningitis case is definitely going to affect my Halloween plans,” Enriquez said. “I’m not scared, but I am definitely going to be cautious.”
USD senior Katie Anschuetz is also concerned about the meningitis case at SDSU. Anschuetz and her family have a personal connection to meningitis.
“My mom was hospitalized for over a month with meningitis when she was 17, so my family knows how serious it can be,” Anschuetz said. “My parents are very interested in knowing the status of the outbreak in San Diego now.”
Although there is a vaccination against serogroup B meningitis that is distributed in Europe, Australia and Canada, it is not available in the United States.
The meningococcal meningitis cases at SDSU and Palomar College did not fit the standards for the use of the vaccine by the Centers for Disease Control, CDC. The standard requires that two or more cases occur in the same location within a six month period. The cases, which were only about 30 miles apart, were not considered to be in the same location
However, the USD Health Center can prescribe an antibiotic prophylaxis that prevents the meningococcal disease from causing a meningitis infection to students who suspect contact with an infected person. While an antibiotic can be used to control meningococcal disease, only a vaccination prevents the contraction of it.
Some USD students are frustrated that the CDC has not made the vaccine for serogroup B meningitis available to students in San Diego yet, despite the recent case at SDSU.
Sophomore Shalin Shah is worried that the CDC is waiting for the worst to happen before providing a vaccination for serogroup B meningitis.
“What surprises me is that the CDC hasn’t brought in the vaccine yet like they have in the past and they’re waiting for more people to get infected or die before they act on it,” Shah said.
Until use of the vaccine is approved, students are encouraged to watch for symptoms of meningitis. Dr. Julianne North from the USD Health Center described the unique symptoms of meningitis that set it apart from common illnesses like the flu.
“The flu can have an abrupt onset with fever but usually is more respiratory: more sore throat, cough and congestion,” North said. “Meningitis presents very quickly with a high fever and usually also with vomiting, headache and neck pain.”
North stressed that anyone with these symptoms should seek medical attention and be evaluated right away.
The strain of meningitis that Stelzer had is not as rare as students might hope. Last year, meningococcal serogroup B outbreaks occurred at Princeton University and the University of California at Santa Barbara. These outbreaks resulted in the death of one student and the permanent disablement of another student.
The National Foundation for Infectious Diseases published a report in May 2014 examining these two campus outbreaks and the challenges of managing them. In the UCSB case, four students were infected within a period of two weeks, seven months after the index case. At Princeton, nine students were infected over the course of a year. The ninth case, a student from Drexel University, died from the Princeton strain a week after exposure to Princeton students.
At Princeton, the long intervals between meningitis cases led to a false sense of security on campus. Though the time from infection to development of meningitis symptoms is two to 10 days, there could be carriers in the community with no symptoms passing it along well after that time period.
In contrast to the Princeton cases, the UCSB outbreak occurred rapidly. Four students, who had little in common, were all infected shortly after the widely attended Halloween festivities in Isla Vista.
USD sophomore Jessi Pettenuzzo expressed her concern that Halloween might play a role in spreading the disease in San Diego.
“There will probably be a lot of mixing between college campuses on Halloween,” Pettenuzzo said. “USD is a small community and once one person gets sick here, it seems like everyone does. Thats manageable when you’re dealing with a common cold or flu, but not with meningitis.”
The CDC worked with Princeton and UCSB to get the Federal Drug Administration to approve the use of the experimental vaccinations for the campus community. If another SDSU student is infected, the CDC is expected to make the vaccination available there as well. If a USD student is infected, it is unknown if it will meet the criteria for use of the vaccination.