Sore arms and talks of a deadly infection flooded the campus last week, a result of students swarming the Southeast Recreational Facility to receive the first of two free meningococcal B vaccines offered by the university’s health services after three UW-Madison students fell ill this past month.
Roughly 20,400 vaccines had been distributed with the help of nursing students, pharmacy students and other Dane County public health officials over the three week period spanning from Oct. 20 until Nov. 2.
“We really want to thank the campus wide community for all of these vaccination clinics, we really could not have done it without them. At this point, I think students can probably best protect themselves by both getting the vaccine as well as practicing good respiratory hygiene behaviors,” Dr. William Kinsey, medical services director of UW-Madison’s University Health Services, said.
All undergraduate students through age 25 were encouraged to get the vaccine, having been identified as the at-risk population, according to Kinsey.
Meningococcal disease is caused by a bacteria, Neisseria meningitidis, that many people carry in their nasal passages, explained the Executive Director of UHS Dr. Sarah Van Orman, MD. In fact, 20 to 30 percent of people carry this bacteria in their nose at all times without contracting any disease, Van Orman explained.
“There’s all this meningococcal bacteria around us all the time, but what we think what happens is you get a particular bacteria that’s more valiant, so more likely to cause invasive disease, so we sort of have a bacteria thats a bad actor in our community. So not all meningococcal bacteria are sort of equal in their ability to cause disease,” Van Orman said.
There are at least 12 serogroups of this bacteria but only five are known to cause most meningococcal disease, more commonly known as meningitis, an infection of the lining of the brain and spinal cord.
This past October, three UW-Madison students contracted meningitis serogroup B. Two of the three students lived in two different on-campus residence halls, and the other student lived off-campus. While two students have been discharged from the hospital, the other remains. Their names have not yet been released.
When a case of meningitis hits campus, UHS works with the Center for Disease Control to conduct as epidemiological investigation in order to provide preventative antibiotics for any individuals the infected student came in close contact with. Results of the investigation can also show whether or not there is a genetic link between cases.
The CDC couldn’t find any connection between the first two cases, meaning they weren’t in any of the same clubs, organizations or groups; they didn’t have any known interactions. However, through whole gene sequencing, a genetic connection was found. According to Van Orman, the bacteria in the first two cases were identical.
“We have people who, they don’t know how they’re connected to each other, but there’s a genetically identical bacteria that’s circulating in the population. So that’s why this is a really unique situation and so much more serious than if we just had a single case,” Van Orman said.
While carrying the bacteria and passing it around may not necessarily lead to an outbreak, Van Orman explained that in a community of students where sharing items that frequently touch the mouth is common, it doesn’t take much for a bacteria to become invasive in a person.
Side effects of meningitis included high fever, severe headache, moderate to severe neck stiffness, muscle aches, confusion and possible vomiting or rash, according to UHS. Neck stiffness is caused by inflammation of the protective covering of the brain, or the meningi, and the protective covering of the spinal cord, Kinsey explained.
Meningitis B has a 10 to 15 percent mortality rate and a 15 percent chance of serious complications such as hearing loss, amputation or cognitive deficit. According to Kinsey, the two students discharged appear to be recovering well, however due to confidentiality, Kinsey could not comment on the third, still hospitalized, student.
The meningitis B, or serogroup B meningococcal, vaccine requires two doses, 30 days apart. The first dose of the vaccine, however, only provides 60 percent immunization. With the second vaccine, individuals are covered up to 80 percent.
Nursing student and clinic volunteer Rachel Merkel stressed the importance of returning for that second vaccination.
“Just because you have the shot doesn’t mean you can’t get the sickness,” Merkel said. She ensured each of her patients were aware to not share drinks, to cover their coughs and that they were still taking preventative precautions.
UHS is urging students to practice good hygiene and not share anything that comes into contact with the mouth. Because meningitis is spread through oral or nasal secretions, they recommend students cover coughs and sneezes, dispose of tissues properly and wash hands frequently.
Merkel added that the shot’s unpopular side effects are a positive thing. According to Merkel, the uncomfortable arm soreness or fever-and-chills responses some experience mean the body is fighting off the sickness. Merkel explained that the side effects indicate the body has built a good immune response to fight the illness in the event the person contracts it, meaning antibodies are already in place ready to fight.
The meningitis B vaccine, unlike other virus vaccines which contain a portion of the disease material itself, is actually a protein contained on the coat of the disease. This technique, Van Orman explained, is common in bacterial vaccines. The vaccine works by triggering protective antibodies against proteins that were found on the coat of the meningitis b bacteria. If the bacteria were to enter the bloodstream, the antibodies are already present and ready to fight, Van Orman reiterated.
“The shot is going to hurt and the side effects are tough to deal with but at the same time, you’d much rather have the side effects of this shot than this sickness,” Merkel said.
Most of the nursing students were required to have prior vaccination experience and knowledge, Merkel explained. For others, it was part of their clinical training. Pharmacy students also helped out at the clinic as part of their volunteer hours, according to Kinsey, and doctors were available to provide clarification or answer any questions.
Despite the University’s urging, some students still chose not to receive the vaccination. Senior Molly Donnellan said that although she is supportive of vaccines, illness prevented her from getting this shot.
“I was cautioned against getting a vaccine whenever your immune system isn’t 100 percent. So, I’m waiting for my immune system to be not compromised before I go in and get that vaccine ... I plan on going in next week,” Donnellan said.
UHS will still offer vaccines for students who were unable to make the clinic. Walk-in vaccination clinics begin Monday Nov. 7 and run through Friday Nov. 18 from 9 a.m. to 5 p.m. on the sixth floor of UHS.
The CDC provided UHS with the meningococcal B vaccines, which cost roughly $150 each, although free to students. As a relatively new vaccine registered only within the past year and a half, the vaccine only lasts for about a year, Van Orman said. She is unsure if any serogroup meningitis vaccination will be required for incoming UW-Madison students in the future.