Most of the meningococcal cases that occur in the US are not linked to outbreaks. But when outbreaks do occur, they are usually in dense populations, such as nursing homes, military barracks, prisons, and college campuses.
Even one meningitis case on a college campus causes concern and requires a public health response due to its ability to cause death or permanent disability so quickly. College and local public health officials investigate every case, identify close contacts, and administer preventive antibiotics. With each new case, this work load increases, and often with it, campus anxiety.
Meningococcal serogroup B bacteria have been responsible for several outbreaks and isolated cases on US college campuses in the last five years. The vaccines given to adolescents routinely at 11-12 years and again at age 16 years do not protect against serogroup B.
Two newer vaccines that offer protection against serogroup B, are recommended for permissive use in adolescents and young adults age 16-23 years, with a preferred vaccination age of 16-18 years. Individuals in this age group are encouraged to speak with their healthcare professional about vaccination.
Serogroup B vaccines are also used in efforts to contain outbreaks. All of the cases in the following outbreaks were caused by serogroup B meningococcal disease and serogroup B vaccines were used to protect students:
- University of Wisconsin-Madison: Three cases of meningococcal disease were reported during the fall semester of 2016.
- Santa Clara University: Three cases occurred in the spring semester of 2016.
- Rutgers University: Two students were diagnosed with serogroup B meningococcal disease. CDC testing found that the bacteria from the two students were genetically indistinguishable even though no link could be found between the students. This suggests some carriage among other members of the Rutgers population.
- Providence College: Two cases occurred at this Rhode Island college during one week in February 2015.
- University of Oregon: Seven cases have been reported since the beginning of 2015. One student has died from the disease.
- Princeton University: An outbreak at this New Jersey campus spanned one full year (March 2013 to March 2014) and included nine cases and one death. This lengthy outbreak was punctuated by some long gaps between cases—which is not the usual pattern. Several cases also occurred off of the Princeton campus, including a student at a nearby college, but were confirmed through molecular typing of bacteria isolated from the sick adolescents to be part of this outbreak.
- University of California, Santa Barbara: Four cases occurred within a few weeks in November 2013. Further investigation linked these four cases to one that occurred on the campus seven months earlier. One student suffered bilateral foot amputations.
- CDC reported three additional meningococcal serogroup B disease outbreaks on college campuses between 2008 and 2011: University of Pennsylvania had four cases from February to March of 2009, Lehigh University had two cases in November 2011, and in the longest outbreak of all, Ohio University had 13 cases from January 2008 to November 2010.
- In addition to these outbreaks, single meningococcal B cases were reported at Georgetown University in Washington, DC (September 2014) and San Diego State University (October 2014). In both cases, the students died. Another case was reported at Yale University (February 2015).
The different patterns of cases on US college campuses demonstrate the challenges public health officials face in trying to predict how outbreaks will progress or when they will end. While there have been many other isolated cases of meningococcal disease that may have been serogroup B, for many of the reports of individual cases, there was no follow-up reporting to confirm what the serogroup the student contracted.