Study Shows Increased Risk of Meningitis for First-Years

A study published in Wednesday’s Journal of the American Medical Association (JAMA) indicates that first-year college students living in dormitories are at a much higher risk than the general college-aged population for contracting the potentially fatal disease bacterial meningitis.

While for all Americans aged 18 to 23 the overall incidence of meningitis during a one-year period was 1.4 cases per 100,000 individuals, for first-years living in dorms the rate was 5.1 cases per 100,000.

“Because of the close quarters in which they live, freshmen in dormitories may be exposed to N meningitides more frequently than other college students,” the study reported.

However, college students as a whole were less likely to contract the disease than the general college-aged population.

While the JAMA article said that more study was needed to understand why college students as a whole were less likely to be infected than their peers not in school, it did note that the drop in infections after the first year made sense.

“The exposed freshmen…would develop protective immunity leading to lower rates in subsequent years,” the study reports.

While rare, meningitis can be an extremely serious disease if contracted. Virtually all of those sickened by the disease require hospitalization and roughly one in ten die.

The study supports recent recommendations by the Center for Disease Control’s Advisory Committee on Immunization Practices and the American Academy of Pediatrics, both of which say doctors should inform incoming first-year students and their parents about an immunization that is available to protect against meningitis infection. However, the vaccine only works against two of three strains of the meningitis bacteria.

“Our study is important because it identified a relatively small group of college students at a higher risk for meningococcal disease who are easily accessible and could be targeted for immunization,” the study reported.

David S. Rosenthal ’59, director of Harvard’s University Health Services (UHS), said that for the past two years UHS has mailed notices encouraging incoming first-years to receive the meningitis immunization. He estimates that half of the incoming class receives the shot.

Rosenthal said he believed that the attention generation by this week’s study on menegitis will likely increase the numbers of incoming first-years who are vaccinated against the disease.

However, this week’s study and the previous recommendations stop short of suggesting that all incoming first-years should be vaccinated. They note that even with the increased rate of infection among first-years living in dorms, vaccination of the student population is not cost-effective given how few cases of meningitis actually occur.

According to this week’s study, out of the almost 600,000 college first-year students who lived in dorms nationwide during the 1998-1999 school year, only 30 contracted bacterial meningitis.

The vaccination has not been added to the list of those required of incoming college students by Massachusetts because the current vaccination does not prevent the vaccinated individual from being a carrier of meningitis and possibly infecting others according to Bela T. Matyas, medical director of the epidemiology program at the Mass. Department of Public Health.

Instead, the vaccine only works to prevent the particular individual from getting the symptoms of the disease.

“The vaccine doesn’t provide public health protection,” said Matyas.

Currently required vaccinations, such as those against measles and polio, do prevent the further spread of the disease. Testing is currently underway in Britain on a meningitis vaccination that would also prevent individuals from spreading the disease.

If the testing proves the vaccination effective, it could be available in the United States in two years.

While UHS will provide the vaccination to interested students, it is not included in the basic student health fee and must be paid for separately.

—Staff writer Daniel P. Mosteller can be reached at dmostell@fas.harvard.edu.