Meningitis is a scary word around college campuses. Because students live and learn in close quarters, they are at a higher risk of being affected by a meningitis outbreak than the general population. So far in 2016, three meningitis cases have appeared at campuses on the East Coast: a Rutgers University student was hospitalized for a case of bacterial meningitis March 18; on February 14, a Yale University freshman was also hospitalized; and a 19-year-old female was hospitalized for meningococcal disease at Penn State University March 29. All three cases were confirmed by officials at each university.
April 24 is recognized as World Meningitis Day— a day dedicated to raising awareness of the dangers of the disease and emphasizing the importance of vaccination. The last time Drexel University’s student body dealt with meningitis it was accompanied by loss and grief, as the disease took the life of late student and Phi Mu sister Stephanie Ross March 10, 2014. Ross was affected by serogroup B: the same type of bacterial meningitis involved in the infamous Princeton University meningitis outbreak that spanned from 2013 to 2014.
“The most common [types of] meningitis on college campuses [are] covered by the approved meningitis vaccine,” Dr. Marla Gold, professor and dean emerita of the Dornsife School of Public Health explained in a phone interview. The bacteria which can cause bacterial meningitis include Neisseria meningitidis and Streptococcus pneumoniae. These bacteria can present different antigens on their cell surfaces, so the best meningitis vaccination protects against as many serogroups, or types, as possible. Five of the six serogroups—serogroups A, C, W-135, Y— are commonly known and preventable. The sixth type, which as of now lacks a vaccine, is X.
Drexel’s meningitis vaccination policy currently requires all full-time undergraduate students 21 years or younger and all students living in University housing to receive the Meningococcal Quadrivalent vaccine. This vaccine protects against four serogroups (A, C, W and Y). The university’s current requirements do not require vaccinations against serogroup B, which Ross passed away from, although there are two vaccines pharmaceutically available.
“Currently we do not require the [meningococcal] B vaccine since the ACHA (American College Health Association), our guiding body, has not yet endorsed that vaccine as ‘required’ for university students,” Annette Molyneux, Associate Dean of Students for Counseling & Health, explained in an email.
“We do recommend that all students speak with their family physicians about the advisability of getting that vaccine as well and [we] will assist students in finding locations where that vaccine is available,” Molyneux continued.
Gold explained that the CDC only recommends vaccination against serogroup B for those considered to be at an increased risk of infection. This increased risk arises when an outbreak occurs on a campus or within a residential community, as it did at Princeton.
Drexel’s policy follows Pennsylvania state guidelines, but not all states employ the same protective policies. In 2009, Texas adopted its first act concerning meningitis vaccinations, largely thanks to GlaxoSmithKline (GSK) spokeswoman and meningitis survivor Jamie Schanbaum and The J.A.M.I.E. Group. The act, dubbed the Jamie Schanbaum Act, requires college students to be vaccinated against the A, C, W and Y serogroups, which was previously not required.
“My mission is now to make sure that every parent and child talks to their healthcare provider about how to help protect against the five vaccine-preventable groups of meningitis,” Schanbaum said in an email interview.
Schanbaum’s story demonstrates the devastating effects meningitis can have on unsuspecting victims. She was a college sophomore attending the University of Texas when she suddenly fell ill.
“I thought I might have the flu or perhaps an asthma attack. I was wrong,” she recalled. Schanbaum went to the hospital immediately, and was lucky enough to survive.
However, in the seven months she spent recovering, she was subjected to necessary amputations.
“At the hospital, the doctors said they had no choice but to amputate to save my life. So they amputated both legs below the knee and fingers on both my hands. It was their only choice,” Schanbaum said.
The CDC states that meningitis can potentially arise from a variety of sources including bacteria, viruses and fungi. When the protective membranes around the central nervous system become infected, especially those surrounding the spinal cord and brain, inflammation may occur. This is how meningitis starts.
However, patients can be infected with the bacteria or viruses which commonly cause meningitis without ever suffering the worst symptoms. The infection itself is termed meningococcal disease, but the inflammation is the defining, and most damaging aspect of meningitis. The inflammation can cause severe and permanent nerve damage leading to several potential outcomes, one of which Schanbaum suffered.
“I saw my limbs go from red to purple to black to literally rotting,” Schanbaum remembered.
The disease did not slow Schanbaum down. Since recovery she has discovered cycling, and has since taken a gold medal in the USA Cycling Paralympic Road National Championships, and has also competed in Guadalajara at the Pan American Games. For work, she drives for the services Uber and Lyft in her hometown of Austin, TX.
Shanbaum has now made it her mission to spread awareness about meningitis and prevention of the disease. She urges college-aged students to have conversations with their parents and their healthcare providers about how to protect themselves from all five preventable types of meningitis.
“[I]t’s important to talk to your peers. We must raise awareness of meningitis,” she stated.
“I look forward to continuing my work with GSK to reach young people and parents around the country and raise awareness, so we can prevent meningitis,” she continued.
But why are health officials so focused on protecting college-aged students specifically? Due to the close living conditions and general social habits of students who live on campus in residential dorms, apartments or greek housing, the disease is more easily transmissible in common collegiate settings. Infectious bacteria from a patient with bacterial meningitis are found in respiratory droplets from breath, or in secretions from the throat, which are likely to be spread when sharing drinks or kissing, according to the CDC.
“In the nation when there have been outbreaks on college campuses … the population that you worry about the most are residential students because of close quarters. So that’s why that recommendation is for students,” Gold explained. She also explained that these measures are not as necessary for faculty and professional staff, since they do not come in such close contact as students living in residential quarters.
College students are one of the most susceptible groups when it comes to meningitis, and yet there seems to be a lack of awareness for college-aged students about all the facts. When Schanbaum was first told why she was so sick, she had never even heard of meningitis.
“I thought: what is meningitis? At that time, I didn’t know the alarming statistics,” Schanbaum recollected.
Between the years 2003 and 2007, the CDC reported an average of about 4,100 cases of bacterial meningitis, and about 500 related deaths per year. This equates to about 1.2 deaths in every 10 cases, just over a 10 percent mortality rate for the bacterial disease.
GSK also presents some scary figures from the CDC: in 2013, invasive meningococcal disease caused 65,700 deaths worldwide, equating to a death every eight minutes. Even though nearly 90 percent of those who get the disease survive, the CDC reports that 1 in 5 survivors suffer a life-long disability.
These numbers have prompted GSK to partner with Schanbaum and fellow paralympian Aaron Phipps in their first ever global disease awareness campaign for meningitis, called “Win for Meningitis.” The campaign was formally launched April 14. As part of the awareness campaign, GSK will host an event on World Meningitis Day, called the “Hour of Power Rowing and Cycling Challenge,” where Schanbaum will speak to share her story. The event will take place at Lloyd Hall at Boathouse Row from 12:00 – 2:30pm on Sunday, April 24.
“After seven months in the hospital and an extensive recovery process, I went from wondering ‘why me?’ to wondering ‘why anybody?’” Schanbaum explained.
As for Drexel’s campus, the university has several safeguards in place in case a student falls ill with meningitis or if an outbreak occurs.
“We have what a lot of campuses don’t, which is a university-wide public health advisory group which meets proactively,” Gold explained.
“We meet routinely several times a year and we go over the statistics for what’s happening on campus and make sure that all pieces of the operation are aware of what to do,” she continued.
This involves making sure that security officers, professors, and other campus officials remain educated about the warning signs of meningitis, and how to take action in situations which might involve the disease. The goal is to make sure that those in charge can quickly recognize, or at least consider, a possible case of meningitis.