Recently, students were alerted of two cases of meningitis B on campus. All information in this post is from the CDC and Columbia Health (through their health advisory notice and FAQ, linked previously) and with an interview with Dr. Melanie J. Bernitz, Associate Vice President and Medical Director of Columbia Health.
What is meningitis, and what does the B mean? Meningitis is inflammation of the meninges (membranes of the brain and spinal cord). It can be caused by multiple things, but meningococcal bacteria are the most well-known cause. There are multiple types of meningococcal bacteria – types A, B, C, W, and Y are the most common culprits of meningitis outbreaks. The B strain caused the current outbreak.
What are the symptoms? According to Columbia Health: “Signs and symptoms of bacterial meningitis could include high fever, headache, stiff neck, mental confusion, vomiting, feeling very tired, and a skin rash. The incubation period can vary from two to ten days, but on average is four days.”
How is it spread? Meningococcal bacteria can spread through close contact via respiratory secretions – coughing, kissing, etc. This is especially relevant on college campuses, where all of the above are common in a relatively contained space. However, it’s important to keep in mind that Meningitis B is far less contagious than the flu or the common cold. Meningococcal bacteria are also not spread through touching – if someone who has it touches a doorknob, and then you touch the same doorknob, you won’t contract the disease. Transmission relies on asymptomatic carriers. Dr. Bernitz explains:
“About anywhere from 5-25% of a young adult population – usually adolescents and young adults – are what we call asymptomatic carriers. That means they carry the bacteria around, usually in their oropharynx, and it doesn’t do them any harm. [Few asymptomatic carriers go on to develop the disease.] They carry it, as we carry many bacteria in our body… they don’t get sick, and within weeks or months they’ll clear that. They may transmit it to another person who could become an asymptomatic carrier, or another person who could become an asymptomatic carrier, and the bacteria bounces around the population until it finds what we call a susceptible host, and that’s a person who for whatever reason will go on to develop the disease… That’s why it can hang around in a population without people knowing that it’s there.”
Has Columbia had any issues with meningitis B before? Per Dr. Bernitz, “No… meningitis B in general, you just see single sporadic cases, and that’s not only true at Columbia, but that’s true in most communities…. So usually a single case occurs and passes.” Cases that fit this profile amount to 98% of cases of meningococcal disease reported in the United States.
Should I get vaccinated for meningitis B? Columbia Health is not encouraging mass vaccination for meningitis B at this time. If you are concerned and are considering getting vaccinated, they urge you to talk to your healthcare provider. Vaccination against meningitis B is not required by New York State law, and no undergraduate or graduate schools of Columbia require vaccination. The vaccine was licensed relatively recently (the two available vaccines were licensed in around 2014-2015, according to Dr. Bernitz), so the information on whether mass vaccination stymies an outbreak simply isn’t available yet.
What should I know about the vaccine? Immunity is conferred through either 2-3 rounds of shots with either Bexsero or Trumenba. The amount of dosages needed varies depending on which vaccine is given – Bexsero is a 2-dose series, and Trumenba is given either as a 2 or 3-dose series. Columbia Health encourages you with your medical care provider about which vaccine is available. The amount of dosages needed varies by person, and you should ask your medical care provider how many dosages you will need. (Check the CDC page, linked above, for more information. However, discussion with your healthcare provider is strongly recommended before you get the vaccine.)
I can’t get vaccinated. How should I protect myself? According to Dr. Bernitz, the best way is through personal hygiene and common sense. This means thorough hand washing, not sharing silverware, and thinking about how you interact with others – “Really, the same things you would think about with the cold and common flu.” There is no reason to hole up and isolate yourself. Students are still encouraged to go to class, leave campus, and go about their daily routine. Importantly, Dr. Bernitz stressed that “…there’s nothing this community did to make this happen, and there’s nothing this community could have done to prevent this happening. It’s one of those things – it’s an infection that lives in our environment and sometimes just rears its ugly head. And that’s when we come in and we were able to put in place whatever measures were appropriate to protect our community.”
Edit February 8, 2019, at 6:07 pm: A previous version of this post left out that the number of dosages needed depends on which vaccine is given. Bwog regrets the error.
Image via Bwog Archives