Students living in dorms more apt to get meningitis

Risk found to triple, but reasons unclear

May 26, 1999|By Jonathan Bor | Jonathan Bor,SUN STAFF

College students who live in dormitories rather than off campus triple their risk of developing bacterial meningitis, a new study has found.

Researchers at the Johns Hopkins University School of Hygiene and Public Health and the Maryland Department of Health and Mental Hygiene said a Maryland study -- published today in a national journal -- raises a complicated question: Is it housing that makes the difference, or something else?

While the crowded conditions of a college dormitory might be ideal for the dangerous infection, scientists say there might be other explanations -- including tobacco and alcohol.

Smoking might predispose people by irritating the respiratory tract; the bug might travel from person to person through saliva on shared glasses of beer or wine.

As a group, college students are no more prone to the illness than are their peers who do not attend college. Dormitory residents make up a minority that is at particular risk.

Dr. Lee Harrison, an infectious-disease expert who directed the study at Hopkins, said the problem of meningitis among young adults is not just a matter of media-fueled perception.

Meningitis has become a more serious problem across the age group, he said. In the 1980s, national rates were about the same in all categories except infants and the elderly, among whom the disease was more common.

Now, 17-year-olds face more than three times the risk of 10-year-olds or 30-year-olds.

It is possible, Harrison said, that a new strain has taken hold.

"We do know that when you introduce new strains of this organism into a population that has not seen it before, you can get an outbreak," said Harrison, now at the University of Pittsburgh. "And we do know, for example, [of] a strain introduced into Oregon that's led to an increase in cases not just in college students but teen-agers and young adults."

In the recent study, researchers reviewed all cases among college-age residents of Maryland in 1992-1997. The rate was 3.24 cases per 100,000 students living on campus and about one case per 100,000 students living off campus. In the general population, the rate was 1.44 cases per 100,000 people 18 to 22 years of age.

The study, which appears today in the Journal of the American Medical Association, also found that 80 percent of the cases on Maryland's campuses could have been prevented if the students had been vaccinated. The vaccine does not cover all strains but is effective against the meningococcal infection that struck most of the students.

"These are rare events but they have the potential to be devastating when it is the death of a young person," said Dr. Diane Dwyer, chief epidemiologist for the state health department. "Parents and students should consider lowering the risk."

The study comes at a time of mounting concern over meningitis on local campuses. In 1997, three students -- at Morgan State, Loyola and Harford Community College -- died of the disease. This year, it killed a student at Frostburg State. Of the four, only the Harford student lived off campus.

Bacterial meningitis is an infection of the membranes that cover the brain. It causes a severe headache, stiff neck, rash and fever, followed by drowsiness and a loss of consciousness -- symptoms that can progress rapidly. The disease can kill within a few days, sometimes within hours.

"Meningococcus is one of the few organisms left in the United States that can take a relatively healthy young adult and kill within a couple hours," Harrison said. "You get a cluster on a college campus, and it can be quite a dramatic event."

Despite the increase, cases are rare. In the 1990s, Maryland has recorded 30 to 58 cases a year. Nationally, authorities record about 2,600 cases annually. Viral meningitis is much more common and usually clears up within a week or two.

Dwyer said the number of cases in Maryland is probably too small to suggest broad generalizations about risks faced by students. But a national study conducted by the national Centers for Disease Control and Prevention appears to confirm the Maryland results, according to a preliminary report.

"I believe there is a risk in community living, not unlike in the military where people live in close quarters," said Jean Lombardi, who heads Loyola's health service.

Since 1994, three Loyola students contracted the illness, and all three lived on campus. Among them was freshman Gerry F. Case Jr., who died in 1997 of a meningococcal blood infection. The college recommends -- but does not require -- that all students be vaccinated.

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