Meningitis Outbreak on the Princeton Campus

On Friday, November 22, the eighth case of meningitis was reported at Princeton University. This case, like the seven previous ones confirmed at Princeton over the past nine months, was shown to be caused by a rare meningococcal bacterium known as serotype B. While this may be regarded as a small number in a campus of 5,000 undergraduate and 2,500 graduate students, what worries public health officials is that meningitis is a rare disease.  Moreover, group B is particularly rare in the United States.

Meningitis is generally characterized as the inflammation of a membrane that surrounds the brain and the spinal cord. Furthermore, there are in fact five types of meningitis depending on the cause of this inflammation:

  1. Bacterial Meningitis (the cases that are circulating around Princeton University), usually caused by streptococcus, listeria, or haemophilus strains
  2. Viral Meningitis, caused by enteroviruses like herpes
  3. Parasitic Meningitis, which is known to be more common in the developing world
  4. Fungal Meningitis, caused by inhaling spores of certain fungi
  5. Non-infection Meningitis, which is associated with head injuries, cancer, and several autoimmune diseases

Most often, bacterial meningitis is spread by direct contact with saliva, and symptoms include vomiting, nausea, and in some cases, mental confusion. Despite misconceptions, the disease is not transferred via casual contact. According to the CDC, students living in a college dormitory setting are more at risk to spread the disease. Bacterial meningitis can spread easily, as most individuals who are carriers of the disease never show symptoms themselves, although they can pass on the bacteria to other individuals who might in fact have a reaction.

Unfortunately, if left untreated, bacterial meningitis can be fatal in approximately 10-15% of cases. In the United States, those affected are almost always carrying strains A, C, Y, or W135. Accordingly, the CDC has approved vaccines that protect against these four types, but not group B.

Bacterial meningitis can be treated with antibiotics, but it is recommended that the intervention is introduced as soon as possible to avoid death or permanent neurological damage. While early symptoms include nausea, as the disease progresses, an individual with bacterial meningitis might begin having seizures and could fall into a coma. Most patients recover, but ultimately suffer from complications including brain damage, hearing loss, or learning disabilities.

Fortunately, the Centers for Disease Control and Prevention (CDC) has approved the use of a vaccine that will be recommended for all undergraduates, graduate students living in dormitory-style residences, and other members of the Princeton community with medical conditions predisposing them to the disease.  With that said, each individual can choose whether or not to take this vaccine that has not yet been formally approved in the United States.  According to The Daily Princetonian, out of a total of 259 students interviewed a few days prior to the most recent case, 197, or 76%, said they plan to get the vaccine, noting that the risk of disease far outweighs the risk of the vaccine.

Having been granted approval, the University plans to sponsor two rounds of delivering an unlicensed vaccine Bexsero, produced by Novartis, to community members.  Experts leading the CDC’s Meningitis and Vaccine Preventable Diseases stress that two doses of the vaccine are required to protect individuals against meningitis B.  Princeton will make the first of the two doses available in early December, and the second in February.

Bexsero is a relatively new vaccine, approved in Europe and Australia. And it was only in response to the outbreak on this campus that the CDC took the unusual step of allowing the importation of a vaccine not yet approved in the United States. There is no guarantee that the same strains that were circulating in Europe when the vaccine was made are the ones currently affecting those in the Princeton community.

In any case, classes, extracurricular activities, and campus-wide activities still continue: “At this time, the CDC and state health officials recommend that travel plans and activities on the Princeton University campus continue as planned, and the surrounding community can continue to attend events on the Princeton campus,” University spokesperson Martin Mbugua said in a statement to the press. In the meantime, doctors are asking students and faculty to wash their hands and avoid close quarter contact with others— something that is easier said than done on a college campus.

Notably, last week, The Star Ledger reported that a University employee at Monmouth University, not far from the Princeton campus, was diagnosed with bacteria meningitis, although the exact strain has not yet been identified. And sources from the University of California, Santa Barbara, also reported that three students were being treated for meningococcal disease (also caused by type B bacteria). However, according to the Santa Barbara County Public Health Department, no link has been found between the California cases and those at Princeton University.


Centers for Disease Control and Prevention. Bacterial Meningitis Fact Sheet. Mar 2012.

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