Meningitis outbreak sets off probe at Ohio University

Seven students were sickened by same group of bacteria
By Misti Crane

THE COLUMBUS DISPATCH
Seven cases of bacterial meningitis at Ohio University caused by the same group of bacteria also share the same genetic fingerprint, prompting public-health experts to declare an outbreak and delve deeper into an investigation of the illnesses there.

The investigation by federal, state and local scientists will take at least a couple of weeks and aims to uncover what might have made the students susceptible to the bacteria, which don't cause problems for most people, said Dr. Mary DiOrio, assistant state epidemiologist.

Outbreaks are rare. Ohio's last was in 2001 in Alliance, where two high-school students died and a third barely survived.

The linked cases at OU - three from this school year, four from the last - present an opportunity to look for common behaviors or other factors that might have put the students at a higher risk, DiOrio said.

Meningitis is caused by five groups of bacteria. Vaccination offers no protection against group B, the type responsible for the OU outbreak, but does protect against the other forms of the disease.

It sickens about 100 to 125 people on college campuses nationwide and kills five to 15 students a year, according to the American College Health Association. Almost all bacterial meningitis cases are labeled sporadic, meaning they're never linked to another case. In Ohio last year, 42 cases were reported.

The matching genetic fingerprints don't mean that all of the OU students were sickened by the same person. Experts say that's highly unlikely because healthy carriers don't typically spread the bacteria for long.

DiOrio said investigators from the Centers for Disease Control and Prevention and the state and local health departments were still figuring out the specific plans for their study yesterday. It will include surveys of students who were sickened and others who were not in an attempt to decipher what set the ill students apart.

"I think that it will be a fairly lengthy survey," she said.

As of now, investigators haven't unearthed any common characteristics other than the fact that all those sickened attended the same school, she said.

The team also is taking a new look at a dozen other Ohio meningitis cases to see if they match those seen in Athens, DiOrio said.

Andrea Robinson, an 18-year-old from Cleveland Heights, died Feb. 17. The other OU students survived the illness, which is characterized by an inflammation of the membranes that cover the brain and spinal cord.

It comes on suddenly, usually beginning with flu-like symptoms followed by severe symptoms that can include a rash, stiff neck, confusion, vomiting, fever, headache and coma. Prompt treatment is essential.

Public-health experts know that crowded living conditions increase risk, as does smoking.

Students might not be able to avoid close quarters, but they can take some precautions to avoid illness, said Dr. Dennis Cunningham, physician director for epidemiology and infection control at Nationwide Children's Hospital.

"We know we need sleep, good nutrition and exercise, and a lot of times in college, that is not what's happening," he said.

Not sharing beverages and cigarettes also is important, DiOrio said.

And, for the protection it offers against most forms of bacterial meningitis, "This vaccine is absolutely necessary for college freshman going into a dorm," Cunningham said.

Beginning this fall, Ohio University plans to require vaccination for freshman. There might be opt-out provisions for those who are opposed, but that has not yet been sorted out, said Ryan Lombardi, dean of students.

Cunningham said many pharmaceutical companies are working on a vaccine that would protect against group B. So far, those efforts have been impeded by serious side effects, including brain damage, in animal studies.