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A Portrait of Meningococcal Disease in Young Adults
Neisseria meningitides causes a complicated disease picture in the U.S. Only about 2500 cases of invasive disease are reported yearly, but the case fatality rate is high (10 percent to 15 percent). Available polysaccharide vaccines provide short-term protection against many, but not all, strains. Meanwhile, recent data that suggest a rising risk for disease on college campuses has increased public anxiety levels considerably. In 2 studies, investigators provide new data on meningococcal disease in young adults.
In a population-based, active surveillance study, researchers charted disease rates in Maryland residents from 1990 through 1999. In total, 71 of 295 cases (24 percent) occurred in 15- to 24-year-olds, with an incidence in this age group that peaked and fell again during the decade. In 15- to 24-year-olds, disease was considerably more likely to be fatal than it was in those younger than 15 (22 percent vs. 4.6 percent). Most cases were caused by vaccine serotypes.
In another study, researchers compared 50 college students from around the country who were diagnosed with invasive meningococcal disease (from September 1998 through August 1999) with 148 age-matched controls. Being a freshman, living in a dormitory, and having radiator heat all were associated with increased risk for disease. Overall, freshmen living in dorms had roughly 3-fold higher risk for disease than did the general population, but, as a group, college students had no greater risk than did others of their age.
Comment: Should new freshmen, bound for a year of dormitory life, be vaccinated against meningococcal disease? Advisory committees now leave this tricky decision to the discretion of parents and doctors. An editorialist looks forward to the day when an improved vaccine, administered in infancy, will provide long-lasting immunity and simplify the situation considerably.
— A Zuger
Published in Journal Watch General Medicine August 17, 2001
Citation(s):
Bruce MG et al. Risk factors for meningococcal disease in college students. JAMA 2001 Aug 8 286 688-693.
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Harrison LH et al. Invasive meningococcal disease in adolescents and young adults. JAMA 2001 Aug 8 286 694-699.
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Wenger J. Toward control of meningococcal disease: Reducing risk in college students. JAMA 2001 Aug 8 286 720-721.
- Original article (Subscription may be required)
- Medline abstract (Free)