Bacterial Meningitis Infection Hospitalizes NJ College Student

A student at the New Brunswick campus of Rutgers University (RU) in New Jersey has been hospitalized due to an infection with Neisseria meningitidis, which causes meningococcal meningitis. As a result, RU Health Services contacted all students who had been in recent contact with the student to advise them to begin preventive antibiotic treatment.

There are three serogroups of N. meningitidis most common to the continental US: B, C, and Y. According to a New Jersey Department of Health (NJDOH) statement regarding the Rutgers case, testing is still underway to determine the specific serogroup type that the student is infected with.

Risks Associated with Bacterial Meningitis

According to the Centers for Disease Control and Prevention (CDC), N. meningitidis affects individuals of all age groups, however, infants are at the highest risk for infection, as well as those living in close proximity to infected individuals, particularly in college dormitories. Individuals diagnosed with bacterial meningitis often recover, although the disease can cause serious complications, including brain damage, hearing loss, and learning disabilities, as the bacteria causes swelling in the meninges (the protective membranes covering the brain and spinal cord).

Transmission and Symptoms of Bacterial Meningitis

Bacterial meningitis can be spread through exposure to the saliva or mucus of an infected individual during close or lengthy contact. N. meningitidis is not spread through casual contact. Those infected with bacterial meningitis typically start to show signs between 3-7 days after coming in close contact with the bacteria.

Symptoms often manifest as:

• Fever
• Headache
• Stiff neck
• Nausea
• Vomiting
• Increased sensitivity to light (photophobia)
• Altered mental status (confusion)

The CDC recommends that anyone who comes in contact with an infected individual be tested for the contagion if they start to show symptoms. N. meningitidis can be detected in the blood or cerebrospinal fluid. The severity and treatment of the illness vary depending on the bacterial agent which caused infection.

Prevention of Bacterial Meningitis

Several vaccines are now available to prevent infection with the three meningococcal serogroups B, C, and Y:

• Meningococcal conjugate vaccines (MCV 4) [C,Y] Recommended for people who are 55 years of age and younger
• Meningococcal polysaccharide vaccines (MPSV4) [C,Y] Recommended for people over 55 years of age
• Serogroup B meningococcal vaccines (MenB) [B]

MenB vaccines provide short-term protection to those between 16 and 23 years of age, and are most effective when used between the ages of 16 years and 18 years. MenB vaccines are recommended for anyone 10 years of age or older who is at an increased risk of contracting a serogroup B meningococcal infection, such as:

• Those individuals amidst an outbreak
• Individuals with a damaged or removed spleen
• Anyone with persistent complement component deficiency
• Anyone receiving treatment with eculizumab
• Microbiologists who work with N. meningitidis isolates

MCV4 and MPSV4 vaccines are not recommended for those who are moderately or severely ill or have a life-threatening allergy to any of the vaccine components. Since there is not much information regarding the risks MenB vaccines pose in pregnant or breastfeeding women, the CDC recommends these vaccines be administered in these populations only if clearly needed.

Since these vaccines do not provide 100% protection against meningococcal infection, the CDC advises that all individuals, including those who have already received vaccination, stay away from those who are known to be infected. There are a number of antibiotics that can help treat meningococcal disease. Prophylaxis is recommended to help prevent infection. Early diagnosis and treatment are advised.

The Rutgers Case

The Rutgers University student is currently being treated for meningococcus and is said to be recovering. The University will not be cancelling any scheduled events or activities on the New Brunswick campus. The NJDOH recommends that all students monitor themselves for symptoms or signs of bacterial meningitis and make an appointment with a healthcare provider if they suspect they are infected. Those who are ill should avoid school or work to prevent the spread of infection. The sharing of eating utensils, drinks, and cigarettes between students or faculty should be avoided. All personnel and students are advised to keep up to date on all vaccinations.

“At this time, there is one confirmed case of bacterial meningitis caused by Neisseria meningitidis. Although there is great concern from the public, there are no recommendations for the surrounding community to avoid contact with Rutgers University or Rutgers University students,” said State Epidemiologist, Christina Tan, MD, MPH. “We encourage individuals to continue to practice healthy habits—wash your hands frequently, cover your coughs and sneezes, and avoid sharing food and drinks with others. Students are being advised to seek medical attention immediately for symptoms compatible with meningococcal disease.”