Category Archives: Local

This Won’t Fit in Your Suitcase: Zika Virus & Spring Break Travels

By: Lily Reisinger

When asked about their knowledge of Zika virus, students around Princeton’s campus collectively drew a blank. Sophomore Kira Keating, however, is well aware of the prevalence of Zika virus in the Dominican Republic, where she’ll be traveling for spring break. In fact, she says the outbreak almost made her reconsider her trip:

“The threat posed by Zika was mainly my parents’ concern, but they decided to allow me to go regardless because I would be staying at a resort in a generally commercialized area.”

In addition to warnings administered by the CDC and World Health Organization, Princeton University Health Services has also posted a notice on their website. Although there are currently zero reported locally acquired vector-borne cases in the United States, contraction while overseas is still a possibility, as made evident by the 153 travel-associated Zika virus disease cases.

University Health Services was able to address some common concerns regarding spring break travel for students going abroad:

Travelers to areas with local Zika transmission should take every precaution to prevent mosquito bites.  Recommended precautions can be found on the CDC website, and include wearing long-sleeved shirts and pants, staying and sleeping in screened or air conditioned rooms, and using EPA approved insect repellents. Pregnant women and women who are planning to become pregnant should reconsider travel to areas with Zika, at least until more is understood about the risk of microcephaly, a severe birth defect that may be related to Zika virus infection. Travelers should seek advice from their doctors and the CDC website for updates, as the evidence base is evolving.

It is difficult to compare potential for cases of Zika on campus to the outbreak of Meningitis B in 2014, because the illnesses are so different from one another, both in how they are transmitted and the severity of symptoms which typically occur.  At UHS, we encourage and will facilitate evaluation and testing of anyone returning from a Zika affected area who develops Zika consistent symptoms or who is pregnant.  Princeton University is monitoring the Zika situation closely and is working with the CDC and New Jersey Department of Public Health to ensure that we are able to provide timely updates and advice to our students and staff as this situation evolves. Further information can also be found on the UHS website.

As information about Zika virus, its symptoms and risks continues to develop, it is important to stay up-to-date on public health advisories in order remain mindful and protected. There is currently no vaccine for Zika virus; however, President Obama recently made a Congressional proposal for $1.8 billion in emergency funding to partially endow an expedited effort to develop a Zika vaccine.

Concerned about your travel plans? See the UHS Zika virus notice for returning and departing travelers here.

Has fear of the “meng” gone extinct?

By Lily Reisigner

November of 2015 marked the two-year anniversary of the last meningitis B case on the Princeton University campus. While fear of contracting the life-threatening virus has been almost eliminated among the student body, University health officials and the CDC still deem the issue an ongoing concern and continue to recommend that all incoming students receive the vaccination.

The 1,322 new students who arrived on campus this September, however, had one less cause for concern than those of years past: both versions of the meningitis B vaccine administered by University Health Services are now approved by the United States Food and Drug Administration.

Until last October, the only meningitis vaccine administered to Princeton students was Bexsero, which did not receive FDA approval until January of this year. Bexsero requires an initial dose followed a second dose within six months of the first for full protection. Prior to its approval, Princeton University and the University of California, Santa Barbra were the only two locations in the United States permitted to administer the vaccine. These exceptions were made in an effort to prevent further outbreaks of the potentially fatal disease on college campuses.

For Jack Finlay, a member of the Class of 2018, the lack of FDA approval was not a concern when he received both doses of Bexsero last fall. “It didn’t bother me that the shot wasn’t legal in the US mainly because it is approved for use in Western Europe, whose quality of health I consider to be on the same level as in the US,” said Finlay.

“I don’t really think that the shot is necessary, but it is a good safety precaution to take, just in case the disease were to return to the Princeton campus.”

In the October of 2014, however, the FDA approved an alternative drug called Trumemba. Upon Trumemba’s approval, Princeton immediately stocked the vaccine in McCosh Health Center. Students who received only one dose of the University-administered Bexsero vaccine offered in 2013 and 2014 would need to receive all 3 doses of Trumemba to be fully protected against meningitis B.

Although receiving the meningitis B vaccine is completely voluntary for members of the class of 2019, freshmen are “highly recommended” but not required to get vaccinated, according to University Health Services.

Current freshman Carolyn MacFarlane, a member of the Varsity Swimming and Diving Team, decided to get the shot, explaining,

“I just don’t want to get meningitis, especially with the diving season at stake if I got sick.”

Carolyn seems to echo the general consensus among the freshman class, a majority of whom attended the vaccination clinics held in Frist at the beginning of the year. Bexsero is currently the vaccine of choice on campus.

While the global market for meningitis vaccines is predicted to triple in the next five years, it remains to be seen whether other universities will follow Princeton’s precedent and offer vaccination against meningitis or if the threat to college campuses will die out entirely.

Measuring up a Vaccine: The Meningitis B Immune Response Study

By Daniel Liu

This past November, students from Princeton University’s incoming freshman class lined up atop Icahn Laboratory’s Oval Lounge to participate in an immune response study to the meningitis B vaccine. That clinic was the second round of a large-scale public health study being conducted by Professor Nicole Basta, an infectious disease epidemiologist in the Department of Ecology and Evolutionary Biology.

After nine cases of meningitis B broke out at Princeton in 2013, University Health Services (UHS) worked with the Centers for Disease Control and Prevention (CDC) to approve an emergency vaccination campaign. The vaccine, called Bexsero, was approved by the Food and Drug Administration for use in the U.S., as of January 2015.

Professor Basta saw Princeton’s vaccination campaign as a unique opportunity to study the impact and efficacy of the Bexsero vaccine. Last April, after the first round of vaccination, she enrolled 600 students among the undergraduate classes to participate—some who received both doses of the vaccine, some who received only one, and some who received neither. Each participant would give a blood sample and complete a brief questionnaire.

“We wanted to understand how well-protected individuals would be against the outbreak strain, as a way to measure the impact of the vaccination campaign on campus”

“We wanted to understand how well-protected individuals would be against the outbreak strain, as a way to measure the impact of the vaccination campaign on campus,” Basta says. “The main question we’re trying to answer with these studies is really two-fold. First, we want to assess the immune response to Bexsero among university students following the outbreak. Second, we are interested in understanding how broadly protective the vaccine is against other meningococcal B strains.”

To answer the question of immune response, Basta plans on analyzing student blood samples using what is known as a serum bactericidal antibody assay (SBA). The SBA is a functional assay where each participant’s blood serum is reacted with meningitis B bacteria. The vaccine’s effectiveness can then by measured by looking at how well antibodies in the serum kill the bacteria at varying dilutions. “The SBA is really the gold standard for measuring immune response. It is what the FDA requires for licensure of meningococcal vaccines.” Collaborating with Basta are researchers at the Vaccine Evaluation Unit (VEU) of Public Health England, as well as a group led by Professor Alexander Ploss of the Department of Molecular Biology.

Basta notes that meningococcal B bacteria vary considerably from one outbreak to another. Bexsero was thus developed as a recombinant vaccine, meaning that it contains fragments from four different outbreak strains, so as to offer the broadest range of protection. “Princeton’s outbreak strain matched two of the four components in the vaccine, so it is likely that it will be highly protective,” she says.

Sarah Hanna ’15 is a current senior in the Department of Ecology and Evolutionary Biology working with Professor Basta on the study. She has been doing analysis on the social aspect of the vaccination campaign, which looks into why some students don’t return to get the second dose, or elect not to get vaccinated at all. The most frequently cited reasons were “I was worried about experiencing side effects,” followed by “I was not particularly concerned about the disease.” Among students who received neither dose, the “Other” option was also prevalent, often citing religious reasons or herd immunity. Hanna notes that it is not yet known which of these differences are statistically significant, though the analysis should be available soon.

Despite the students who elected not to get vaccinated, coverage rates were phenomenally high, with 95% of the undergraduate class receiving the first dose last year, 93% of whom went on to get the second dose.

“Princeton has done a fantastic job in trying to maximize all the resources that they had at their disposal to prevent the outbreak from continuing, both in terms of the social campaigns and the vaccination campaign,” says Basta. “What we are learning will help us know in the future if it makes sense to follow these same types of public health interventions when other outbreaks occur.”

Basta hopes to have a preliminary report out within a month, and plans on doing presentations around campus for curious students. Her study is funded by the Program on U.S. Health Policy and the Health Grand Challenge in the Center for Health and Wellbeing at the Woodrow Wilson School.

Quarantines in Newark and Princeton

Recently, there have been concerns that Ebola, the deadly virus that erupted in West Africa causing hemorrhagic fever, has made its way to Newark, New York, and Princeton. One such story is that of Ebola nurse Kaci Hickox who has been placed in quarantine for 21 days at the University Hospital in Newark, New Jersey because she helped to treat Ebola patients in Sierra Leone. However, she has been tested and has not contracted the disease. Still, New Jersey governor Chris Christie and New York Governor Andrew Cuomo require that anyone has who worked with or come into contact with Ebola patients must be quarantined, no matter how healthy they may appear.

This policy came into being after a recent New York City doctor was diagnosed with Ebola on October 23. Continue reading Quarantines in Newark and Princeton

Uncertainty of Ebola Concerns Princeton Citizens, Prompts Policies

The Ebola outbreak has resulted in global panic, making citizens question the safety of everything from public transportation to crowded events. Recent developments have brought the crisis directly to Princeton.

On October 1st, NBC cameraman Alexander Mukpo contracted Ebola while cleaning a car that had transported dead Ebola victims in Liberia. Continue reading Uncertainty of Ebola Concerns Princeton Citizens, Prompts Policies

EXCLUSIVE: Interview with the CDC on the Approval of New Meningitis Vaccine

Last year, almost all of the Princeton students received two doses of the meningitis B vaccine called Bexsero, which was developed by Novartis. Bexsero, while not formally approved by the FDA in the US, had been approved in other nations globally and as a result, was recommended by the CDC and FDA for use to control the Princeton outbreak. Data was also collected by Princeton and CDC on the effect of the vaccine on the Princeton outbreak.

However, recently, the FDA approved Trumenba, developed by Pfizer, as a vaccine for meningitis B. At the same time, Bexsero, used at Princeton, has still not been approved by the FDA. Why has the vaccine which was used not only at Princeton but also as UCSB not approved by the FDA? Does data suggest that Trumenba performs better than Bexsero? Or are there other reasons behind approving Trumenba?

Below is a Q&A with Dr. Manisha Patel, who has been involved been involved with the Princeton meningitis outbreak. The discussion focuses on the differences between the two vaccines, reasons why Bexsero was recommended for the Princeton outbreak and reasons why Trumenba was approved first by the FDA.

PPHR: What makes meningitis B so difficult to vaccinate against? I understand that in morbidity and mode of transmission, all serogroups of meningitis are relatively similar.

PATEL: The main question is “Why don’t we have a meningitis B vaccine when vaccines for serogroups A, C, W and Y are available?” Continue reading EXCLUSIVE: Interview with the CDC on the Approval of New Meningitis Vaccine

Approving Trumenba: Why Not Bexsero?

DSC03308-C2-PURPLELast Wednesday, the FDA approved a vaccine for Meningitis B1,2, the same strain of bacterial meningitis that Princeton students faced last year. Yet the newly-approved drug is not Novartis’ Bexsero, which thousands of students at Princeton and UCSB have received in the past year. Instead, the FDA approved Pfizer’s Trumenba. This forces us to wonder why the FDA decided to approve Trumenba first, even though Bexsero has now been used safely and effectively in the United States and is approved in Canada, Europe, and Australia3.

The most straightforward explanation for the earlier approval of Trumenba is that Pfizer filed for approval before Novartis4. Continue reading Approving Trumenba: Why Not Bexsero?

A Critical Look at Bexsero

Although a host of different bacteria, viruses, and fungi can all potentially cause the onset of meningitis, the eight Princeton cases have all been determined to be the work of N. meningitides serotype B1. In a void of FDA approved vaccines, the University is turning to Bexsero, the work of the Swiss pharmaceutical company Novartis.

Because, left untreated, the effects of meningitis can escalate to permanent brain damage, hearing loss, and death2, there has been clear opportunity for vaccine development to reduce this risk. Continue reading A Critical Look at Bexsero