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    Vaccine May Prevent Meningitis in College Students

    College freshmen who live in dormitories are more than three times as likely as other college students to develop meningococcal disease, researchers said Tuesday.

    However, widespread use of the meningococcal vaccine could cut rates of the disease in college students by about two-thirds, the investigators report in the August 8th issue of The Journal of the American Medical Association.

    "The bottom line is that we found, overall, [that] college students did not have an increased risk of meningococcal disease but that college freshmen living in dorms had an elevated risk and could reduce the risk through safe and effective vaccination," Dr. Nancy E. Rosenstein, a study author and researcher with the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, told Reuters Health.

    Certain viruses and bacteria cause meningitis when they infect the lining of the brain or spinal cord. Meningococcal meningitis is one example of potentially fatal disease that can be caused by the meningococcus bacterium. Because the bacterium can be spread among people living in close contact, dormitory students may have a higher risk of meningococcal disease.

    But it is too soon to suggest changes in living conditions among college students, the authors point out, since the study did not reveal why dormitory living is associated with a higher risk.

    To determine how frequently meningococcal disease occurs among US college students, CDC researcher Dr. Michael G. Bruce and his colleagues reviewed national data gathered from 50 state health departments and 231 college health centers over a 1 year period.

    According to their findings, meningococcal disease occurred in about 5 students per 100,000 college freshman living in dormitories. In comparison, researchers estimated 0.7 cases per 100,000 undergraduates and 1.4 per 100,000 for 18- to 23-year-old non-students in the general population.

    Overall, 96 cases of meningococcal disease were identified among college students, with about one-third occurring among freshman living in dormitories. Among students whose medical information was available to researchers, 68% of cases could have been prevented with the currently available vaccine.

    College students living in dormitories should be vaccinated against meningococcal disease, according to a December 2000 recommendation of the American Academy of Pediatrics. The CDC has also urged doctors to make the vaccine readily available to college students in response to elevated rates of the illness noted among 18 to 22 year olds over the last decade.

    But college students are not the only group at risk for meningococcal disease for whom the vaccine could provide protection, another study published in the journal reports. The second study, led by Dr. Lee H. Harrison from Johns Hopkins University in Baltimore, Maryland, found that nearly one quarter of 295 cases reported in Maryland over 10 years occurred in 15 to 24 year olds. This group also had the highest death rate associated with the disease.

    Infections may have been prevented in nearly 83% of people aged 15 to 24, in 68% of patients younger than 15 years, and in 77% of adults older than 25 years, Harrison and colleagues conclude.

    "Taken together, these studies demonstrate that meningococcal disease in this age group is severe, and a targeted approach of immunizing college freshmen who live in dormitories may be the most efficient way to make an impact on meningococcal disease," Dr. Jay Wenger from the World Health Organization writes in an accompanying editorial.



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