Daily Princetonian pieces

Sixth case in U. outbreak recovers from meningococcal disease

Originally published Oct. 8, 2013, at The Daily Princetonian.

The female student who received treatment at a local hospital last week for meningococcal disease has been discharged from hospital care. She is currently recovering, according to New Jersey Department of Health spokesperson Daniel Emmer.

The bacteria responsible for her illness has been identified as serogroup B Neisseria meningitidis, Emmer said. Hers is the sixth University-affiliated case of illness caused by this strain of meningococcal bacteria since March. The student developed symptoms on Oct. 1, Emmer said. She reported to University Health Services on Oct. 2 with a high fever and was referred to a local hospital for treatment.

As a preventive measure, 22 individuals who had come into close contact with her were identified and offered antibiotic treatment at UHS, University Spokesperson Martin Mbugua added.

Mbugua declined to disclose whether the student has returned to campus, citing privacy concerns.

The student’s case of meningococcal disease is distinct from the five previous cases of meningitis in the outbreak. All six cases are now confirmed to have been caused by the same strain of bacteria. In the most recent case, however, the bacteria did not infect her brain and spinal cord but instead resided in her bloodstream, according to an email sent to residential college advisers Tuesday morning by Dr. Peter Johnsen, director of medical services at UHS, and obtained by The Daily Princetonian.

Meningococcal infections that manifest in the bloodstream are referred to as “meningococcal disease,” while infections of the coverings of the brain and spinal cord, called the meninges, are called “meningitis.” “Individuals may become very ill with meningococcal disease without having the signs we usually associate with meningitis, like headache and stiff neck,” the email to RCAs stated.

“Our most recent student was experiencing only a high fever and did not present with signs of meningitis,” the email added. “Because of this, we are encouraging all students who think they have a high fever to report to UHS.”

The University issued a new health advisory email Tuesday afternoon to all undergraduate students emphasizing that “any student with a high fever” should seek treatment at UHS.  The email also stated that someone with meningococcal disease could present only a high fever with no other symptoms.

The email to all students also emphasized that students may become ill with meningitis without coming into contact with someone who is sick. It is estimated that 5 to 25 percent of the general population carries the bacteria without developing symptoms, the email said.

Previous health advisory emails sent by the University to all undergraduate students defined the symptoms of bacterial meningitis as “high fever, headache or stiff neck” and advised students who experience these symptoms to seek medical treatment at UHS. With the outbreak of each case, the University has issued a health advisory reminding students to pay increased attention to personal hygiene practices.

The University has also posted reminders with information on meningococcal disease in bathrooms and dining halls, in addition to providing alcohol-based hand sanitizer and tissues at all event headquarters and meal sites.

The first and second University-associated cases this year, reported on March 25 and April 12, involved a female student and a male visitor to campus, respectively. The third and fourth cases, reported May 7 and May 20, both involved male students. The New Jersey Department of Health designated the cases as an outbreak after the fourth case.

In the fourth case, the student developed symptoms while traveling from campus to his home state, where he was hospitalized.

The fifth case involved a male University student hospitalized abroad after being diagnosed with bacterial meningitis during an academic trip. All five students have since recovered, according to a health advisory email sent to students Oct. 3.

The New Jersey Department of Health is not changing its recommendations to Princeton at this time, Emmer said.

State law requires all college students living in dorms to receive a licensed meningococcal vaccine, which protects against many strains of the bacteria but does not protect against serogroup B.

Cases of meningococcal infection can be treated with common antibiotics.

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