Meningococcal Disease in College Students

Meningococcal Disease in College Students 

Introduction: The rates of meningococcal disease among adolescents and yuong adults are known to have increased over the past 10 years. However, data on meningococcal disease in college students in the United States were not collected until 1998, when nationwide surveillance was undertaken by the Centers for Disease Control and Prevention in conjunction with the Council of State and Territorial Epidemiologists and the American College Health Association.

Methods: Fifty state health departments and 231 college health centers participated in a prospective surveillance study with a nested case control study. Each case patient (or a surrogate) and control was interviewed and data collected on basic demographics, medical history, and exposure to large groups of people. Findings were analyzed to determine rates of meningococcal disease and to identify risk factors for the disease in the college student population.

Results: During the study period (September 1, 1998 to August 31, 1999), 96 cases of meningococcal disease were identified. The median age of the patients was 19; 52% were men, and 90% were white. Forty four cases (46%) occurred from December through March. Only 2 cases were outbreak related. In 54 cases (68%), illness was was caused by vaccine preventable serogroups. The incidence rate for undergraduates was 0.7 per 100,000 individuals versus 1.4 per 100,000 for the general population of 18 to 23 year old nonstudents. The highest incidence rate was reported for freshman living in dormitories (5.1 per 100,000). Other risk factors for meningococcal disease identified in multivariable analysis were white race, radiator heat, and a recent history of upper respiratory tract infection.

Conclusion: As a group, college students in the United States do not differ overall from nonstudents of similar age in risk for meningococcal disease. Among college students, the risk is greatest for freshmen who live in dormitories. Currently available quadrivalent polysaccharide vaccine could substantially reduce the risk of meningococcal disease for college freshmen.