Princeton University Meningococcal Disease Outbreak
Meningococcal Disease Update
March 18, 2014 CDC Media Statement
CDC’s laboratory analysis shows that the strain in Princeton University’s serogroup B meningococcal disease outbreak matches the strain in the Drexel University case by “genetic fingerprinting."
Princeton University is experiencing a prolonged outbreak of serogroup B meningococcal disease, with eight cases reported. CDC, the New Jersey Department of Health (NJDOH), Princeton University officials, and local health authorities have been working closely together since the first case of meningococcal disease associated with Princeton University was reported in March 2013. A serogroup B meningococcal vaccine, which is licensed for use in Europe, Canada, and Australia, is being used at Princeton University. More than 5,000 Princeton University students received the first dose of the vaccine in December 2013; more than 4,700 students received the second dose in February 2014. To date, there have been no unusual patterns of adverse events associated with the vaccine.
Learn more about the serogroup B meningococcal vaccine.
FDA allowed the use of the vaccine at Princeton University under an Investigational New Drug application. Get the latest information and additional questions and answers about the outbreak from the University and the New Jersey Department of Health [9 pages].
Reasons to Get the Vaccine
Q: Who is investigating the meningococcal disease outbreak at Princeton University and what is being done to help protect the University's population?
A: CDC, NJDOH, Princeton University officials, and local health authorities have been working closely together since the first case of meningococcal disease was reported in association with Princeton University in March 2013. At the request of the NJDOH, CDC reviewed the eight cases of meningococcal disease that occurred among Princeton University students and one prospective student since March 2013. All of these cases were caused by meningococcal bacteria known as serogroup B ("strain" B).
The number of cases and lack of direct connection among the cases means this is an outbreak. Given cases have occurred during two school years, it is anticipated that there will be more cases and vaccination is the best option to control the outbreak. A new vaccine that helps protect against meningococcal disease caused by serogroup B is being offered at Princeton University. The vaccine is not licensed in the United States. However, it is licensed, although not routinely recommended for use, in Europe, Canada, and Australia.
Q: I thought the school was doing other things, like telling students not to share cups, to help prevent the disease from spreading. Why is a vaccine needed?
A: The University and NJDOH have taken appropriate public health measures to prevent cases, including offering preventive antibiotics to close contacts of ill students and educating students about meningococcal disease. Students should:
- Know the symptoms of meningococcal disease;
- Avoid activities — like smoking or sharing respiratory secretions (such as saliva, by kissing or close coughing) — that can increase their risk of illness; and
- Seek medical attention immediately if they have any symptoms of meningitis or a bloodstream infection. Symptoms may include sudden onset of a high fever, headache, stiff neck, nausea, vomiting, rapid breathing, or a rash. It is important to remember that someone with meningococcal disease may have a high fever and no other symptoms.
Getting plenty of rest and not sharing saliva are good general hygiene recommendations, but their effectiveness at protecting against meningococcal disease is probably limited. The best protection comes from getting vaccinated.
Q: Why wasn't the vaccine considered earlier?
A: In similar college outbreaks, disease prevention recommendations include encouraging behaviors that minimize the likelihood of catching meningococcal disease and recommending vaccination against meningococcal disease. However, the outbreak at Princeton University is caused by a strain of the bacteria that is not covered by any vaccine licensed in the United States. Once the outbreak was recognized at the University, CDC began looking into whether a vaccine licensed in other countries could be made available.
The initial recommendation for University students was to encourage behaviors that minimize the likelihood of catching meningococcal disease. Given the pattern of cases since March 2013, with the most recent case reported in November 2013, we believe there is a strong likelihood that even with such measures in place there will be more cases.
Q: Will the vaccine help protect students against the strain of meningococcal disease identified at Princeton University?
A: Yes. Based on studies of serogroup B meningococcus that cause disease in the United States, this vaccine covers 91% of circulating strains. Lab testing has been done to establish that the vaccine will help protect against the exact strain of meningococcal bacteria that is causing the outbreak at the University. The outbreak strain at Princeton University is ST409.
Q: Who is the serogroup B meningococcal vaccine recommended for and why?
A: The vaccine is recommended for all Princeton University undergraduate students (those who live in dormitories or off-campus) as well as graduate students who live in dormitories. Certain other individuals associated with the University can be evaluated for vaccination if they have specific medical conditions, including problems with their spleen (including sickle cell disease) or complement pathway (a specific type of immune deficiency). These groups are recommended vaccine because young adults and people with certain medical conditions are at increased risk of getting this infection, especially those who live in close quarters, such as dormitories.
Meningococcal disease can be very serious and sometimes life-threatening. The best way to protect students during this outbreak is vaccination. It is important to get as many students vaccinated as possible to help stop the outbreak of serogroup B meningococcal disease at the University.
Q: Are those recommended to get the vaccine required to get it?
A: No, getting the vaccine is voluntary.
Q: Why are the residents of the town of Princeton not eligible to receive the vaccine?
A: Tracking for cases of meningococcal disease is very good and no cases have been seen in the town of Princeton during this outbreak, which indicates that members of the general public are not currently at increased risk. Rates of meningococcal disease have been declining in the United States since the late 1990s. There are now fewer than 1,000 cases reported each year, and 98 out of 100 cases are sporadic (not associated with an outbreak).
Since the serogroup B meningococcal vaccine is not licensed for use in the United States, an Investigational New Drug application is being used to allow the vaccine for everyone associated with Princeton University who is considered at increased risk for meningococcal disease. The vaccine cannot be given to anyone who does not fit the eligibility criteria established in the Investigational New Drug application. For that reason, only undergraduate students (regardless of where they live), graduate students who live in dormitories, and certain other individuals associated with the University who have a medical condition that puts them at increased risk for meningococcal disease can receive the vaccine.
While anyone can get meningococcal disease, adolescents and college-aged adults are at increased risk. The bacteria that cause meningococcal disease require prolonged (lengthy), close contact in order to spread. The bacteria are much harder to spread than the virus that causes the flu and cannot live outside of the body for very long. The bacteria are not spread by casual contact like being in the same room as someone who is sick or carrying the bacteria or handling items that they touched. You must be in close contact with the person’s saliva (spit) or other respiratory secretions in order for the bacteria to spread. Close contacts include people in the same household, roommates, or anyone with direct contact with a patient's saliva (such as a boyfriend or girlfriend through French kissing).
Getting the Vaccine
Q: When will the vaccine campaign take place at Princeton University?
A: Eligible University community members who still need a first or second dose of the vaccine should contact University Health Services to discuss options for getting the vaccine.
The first dose of the serogroup B meningococcal disease vaccine campaign was offered December 9–12, 2013. More than 5,000 Princeton University students received the vaccine in December. Another vaccine campaign was held in February 2014. More than 4,700 Princeton University students received the second dose at that time. To date, there have been no unusual patterns of adverse events associated with the vaccine.
Q: Who is paying for this vaccine?
A: Princeton University is covering the cost of the vaccine for all eligible individuals who receive it.
Q: What kind of consent is needed to get the vaccine?
A: Those who are 18 years of age and older give their own informed consent. Those younger than 18 years old of age need a signed consent form from their parent or guardian before receiving the vaccine. Before the vaccine campaign began, the University provided further information to everyone who is recommended to get the vaccine and parents of students to assist in the decision-making process.
If you have further questions about the serogroup B meningococcal vaccine, please email email@example.com.
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