Thursday, April 24, 2014
By Janet Lorin, Randolph Brown And Michelle Fay Cortez
Princeton students are taking precautions after a seventh meningitis case on campus this year is prompting efforts to offer them a vaccine unavailable in the United States.
Since the outbreak in March, the Princeton, N.J.- based Ivy League school has reached out to students and parents through posters and e-mails on ways to protect themselves, including not sharing cups. In September, Princeton distributed almost 5,000 plastic 16-ounce tumblers with the message “Mine. Not Yours.”
All seven cases developed infections with meningococcus B. That strain of the bacteria isn’t covered by vaccines available in the U.S., prompting federal health officials to approve import of an immunization. Princeton trustees were considering over the weekend whether to use the vaccine, made by Novartis AG., which said the shots could be available in the next month or two.
The outbreak is the first of the meningitis B strain in a specific group in which health officials have had the option to vaccinate, according to Barbara Reynolds, a spokeswoman for the Centers for Disease Control and Prevention in Atlanta.
The CDC requested and received permission last week from the FDA to import the vaccine, a necessary protocol since the treatment hasn’t been approved in the U.S.
The treatment “could be used in a campuswide vaccination campaign if it were decided that that was the best course of action,” Reynolds said Nov. 16 in a telephone interview. Vaccination would be voluntary, she said.
“It probably takes one to two months until vaccination could start” at Princeton, said Andrin Oswald, head of Novartis vaccines and diagnostics, in a telephone interview from Basel, Switzerland. The immunization is manufactured in Europe and would have to be administered under a special program since it’s not approved in the U.S., he said.
Princeton’s trustees are deciding how to proceed and whether to inoculate, Martin Mbugua, a spokesman for the school said Nov. 16. “When we have something to announce, we will make an announcement,” he said in an e-mail Saturday.
Students are heeding the campus suggestions, though they are mixed about whether to get the vaccine. Andrew Jeon, a junior, said he isn’t likely to be vaccinated.
“If I got meningitis, I would know early on,” Jeon, an English major from Wayne, N.J., said in an interview. “We’ve gotten plenty of e-mails about how not to share cups.”
Eva Ge, a first-year graduate student in chemistry from Ithaca, N.Y., said she would get the vaccine.
“I know my lab mates and I got the flu shot after a recent e-mail about another case,” Ge said. “It’s less an issue for grad students since undergrads eat and live together.”
Seven people — six students and a visitor to Princeton’s campus — have been infected, with the first diagnosed after a return from spring break in March, according to a statement from the New Jersey Department of Health.
By early May, three students were diagnosed with the bacteria that spreads through kissing, sharing drinking glasses and other forms of close contact. The most recent patient developed symptoms on Nov. 8, almost eight months later.
Bacterial meningitis can occur sporadically, especially in close quarters seen on college campuses. It’s spread through respiratory and throat secretions and close contact, though is typically less infectious than viruses, including influenza.
Not everyone gets sick from the bacteria, which is likely being carried by as much as 10 percent of the Princeton population, Oswald said. The number of cases is occurring in about 1 out of 1,000 students there. That’s significantly higher than most other vaccine-preventable diseases, and 100 times the 1 to 2 in 100,000 seen with other forms of meningitis, he said.
Princeton will send additional notices to students and parents as the Thanksgiving holiday approaches later this month.
“The university continues to provide reminders and additional information on campus via posters and table tents in common areas, and through athletic teams and student groups,” Mbugua said.
Other colleges in New Jersey are watching the Princeton situation, including Seton Hall University in South Orange, said Laurie Pine, a spokeswoman.
No cases have been reported at Seton Hall nor on the campuses of Rider University in Lawrenceville, near Princeton, said John Lenox, a Rider spokesoman.
“We are working with local health authorities to monitor the situation closely,” Lenox said in an e-mail. “We have taken the precaution of putting our student health services on alert and have informed our students of the basic infection prevention activities they can take.”
While the Princeton cases have been contained to illness, meningitis has turned deadly on college campuses. In 1995, at least three students, two in college and one in high school, died in Pennsylvania from meningococcal meningitis.
After one of the deaths, at Villanova University, the school provided free doses of the antibiotic ciprofloxacin, and more than 1,000 students took it, the Philadelphia Inquirer reported.
Meningitis can be caused by viruses, fungi and bacteria, with bacterial meningitis causing about 170,000 deaths globally each year, according to the World Health Organization. The infection is marked by inflammation surrounding the thin lining around the brain and spinal cord, causing such symptoms as stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting. As many as 10 percent of those infected die within 48 hours after symptoms start, according to the WHO. Brain damage, hearing loss or learning disabilities may affect as many as 20 percent of survivors, the Geneva-based agency said on its website.
Novartis’s Bexsero is the first vaccine against the meningococcus B strain of the bacteria, which accounts for 40 percent of cases in the U.S. and as much as 80 percent in Australia and parts of Europe. The vaccine was cleared for sale in Europe last January and in Australia last August.
“We are coordinating with Princeton University, the CDC and the New Jersey Department of Health to address this public health threat,” Novartis spokeswoman Julie Masow said in an e- mail Nov. 16.
Novartis, Sanofi and GlaxoSmithKline Plc all make shots available in Europe and the U.S. that protect against four of the five major strains of the disease, not including the B strain that is circulating at Princeton. The other strains are A, C, Y and W-135. Pfizer Inc., the New York-based drugmaker, has a vaccine for meningitis B that has begun the final stage of development. The company has said it will share data from a phase II trial of the vaccine next year.