Meningococcal Meningitis Case Reported on Campus

Updated as of 9/11/2018, 11:38 a.m.

UPDATE: San Diego State University, with help from the San Diego County Health and Human Services Agency, administered preventative antibiotics to 1,840 students. Health officials believe they have treated all SDSU students who may have been in contact with a classmate who was hospitalized for bacterial meningitis last week.

A San Diego State University student has been diagnosed with meningococcal meningitis and is undergoing treatment at a local hospital. The university is monitoring the case and asking campus community to review information, tips and Frequently Asked Questions available below. 

Learn more about the treatment options below and online.

SDSU’s Student Health Services is working with the San Diego County Public Health Services and also notifying individuals believed to have had prolonged contact with the student who has been diagnosed, recommending that they receive preventive antibiotic treatment.

Bacterial (meningococcus) meningitis may be transmitted via direct contact with oral secretions, through the air via sneezed or coughed droplets of respiratory secretions, or even through speaking closely face-to-face, said Dr. Cynthia Cornelius, SDSU’s medical director. Examples of direct oral contact include sharing items, such as cigarettes or drinking glasses, or through intimate contact such as kissing.

The early symptoms usually associated with meningococcal meningitis include high fever, severe headache, stiff neck, rash, nausea, vomiting and lethargy, and may resemble the flu. Because the disease progresses rapidly, often in as little as 12 hours, prompt diagnosis and treatment are critical for recovery.

Individuals who are feeling ill with these symptoms are asked to seek evaluation at an emergency department. SDSU will update the campus community as timely and important information becomes available. 

Frequently Asked Questions

Meningococcal Meningitis: Frequently Asked Questions
Prepared by Cynthia Cornelius, MD, MPH, Medical Director, Student Health Services

How common is meningococcal disease?
Meningococcal disease is relatively rare. In 2015, 375 cases of meningococcal disease were reported nationally (incidence 0.18/100,000 population). In 95% of cases, there is only a single individual involved and so outbreaks are unusual. Out of those who become ill, 85-90% recover.  You can learn more about meningococcal disease by going to the Centers for Disease Control and Prevention (CDC) meningococcal website: http://www.cdc.gov/meningococcal/index.html

Why doesn’t Student Health Services treat everyone with preventive antibiotics?
Using expert advice from San Diego County Public Health Services epidemiologists, we will determine who is at risk of infection. Generally, only close contacts such as roommates and people who share glasses, utensils, food or drink with or kiss an infected individual are treated with antibiotics after exposure to someone with meningococcal disease. People who had contact with those contacts considered “higher risk,” as well as those attending class, working with or even sharing a bathroom with an infected individual are not considered at risk and do not need antibiotics.

Recommending antibiotics to an entire student body is not an effective strategy to stop a meningococcal disease outbreak. Treating many people unnecessarily with antibiotics carries risks, possibly causing more harm than good. Antibiotics can sometimes have unpleasant side effects. Additionally, about 1 in every 100 people has an allergy to an antibiotic and some of them may not even be aware of it. Overuse of antibiotics will further increase the growth of resistance to these drugs, making them less effective, and so it is important to use them only when necessary and appropriate.

Why doesn’t SDSU shut down for a period of time to reduce transmission of meningococcus?
Even in a situation when there is more than one case, CDC has not generally recommended closing schools or universities, restricting travel to or from an area with an outbreak, or canceling sporting or social events. Meningococcus bacteria are NOT airborne, and so are not ascontagious as the germs that cause the common cold or the flu. As stated above, classroom contact is not associated with increased risk.

Should I get tested to see if I’m carrying meningococcal bacteria?
No. At any point in time, 5-10% of us carry these bacteria in our noses and throats and never get sick; very few carry a strain that is potentially illness-causing. Even those carrying a “bad” strain are not necessarily at high risk of becoming sick because their immune system keeps the bacteria from invading the body. Looking for and sometimes finding the presence of these bacteria in someone who is not ill merely causes needless worry. Testing for meningococcus in people who are well is not recommended by infectious disease experts.

How can I protect myself from getting ill from meningococcus?

• The most effective measure to protect oneself from meningococcal infection is immunization. There are two vaccines currently available.  The first, MC4 vaccines (Menactra® and  Menveo®), are effective in protecting against serogroups A, C, Y and W-135.  The meningococcal group B vaccines (Bexsero® and Trumenba®), are newer vaccines that protect against serogroup B.  
  • The MC4 vaccines are indicated for: 
    • All people ages 11-18 years
    • All people who are ages 19-21 years who are first year college students living in residence halls
    • People <10 of age and individuals >19 years of age who are at increased risk for invasive meningococcal disease
      • People with anatomic or functional asplenia, including sickle cell disease
      • People with persistent complement component deficiencies 
      • People with HIV infection
      • People who are treated with eculizumab
      • Microbiologists routinely exposed to N. meningitidis 
      • Travelers to regions in which meningococcal disease is hyperendemic or epidemic 
      • Military recruits
  • The meningococcal group B vaccines are indicated for:  
    • High-risk people greater > 10 years of age
      • People with persistent complement component deficiencies 
      • People with anatomic or functional asplenia, including sickle cell disease
      • Microbiologists routinely exposed to N. meningitidis 
      • People at increased risk because of a serogroup B meningococcal disease outbreak
    • Other people up to age 25 years may receive the vaccine as desired
  • You can learn more about the available meningococcal vaccines at https://www.cdc.gov/vaccines/vpd/mening/index.html
• Since meningococcus is transmitted through mouth and respiratory secretions, you can reduce spread and risk by:
  • Avoiding sharing drinks, cups, utensils, water bottles, lipstick
  • Avoiding kissing (especially multiple people)
  • Avoiding exposure to smoke (including secondary smoke)
  • Covering coughs
  • Getting adequate sleep

What should I do if I feel sick?
Some signs of meningococcal disease include sudden onset of fever, headache, stiff neck, nausea and/or vomiting, and altered mental functioning such as confusion. If you experience these symptoms, you need to be evaluated IMMEDIATELY at a hospital emergency department. Because this illness worsens very rapidly, early treatment is essential. Do not go to Student Health Services, your family doctor, or an Urgent Care clinic.  

When can I stop worrying and get on with my normal life?
Given that time from infection to the onset of illness can be up to 10 days, we estimate that by Friday, September 14, the risk from infection for anyone who has had direct contact with the affected SDSU student will have ended. Meningococcal disease is rare, but anyone who exhibits the symptoms at any time in the future should seek care immediately.  

Where can I get more information?
If you have additional concerns, please call SDSU Student Health Services 8:30 am - 4:30 pm at 619-594-4325 and press “1” to ask one of our Registered Nurses or call San Diego County Public Health Services’ Epidemiology Division at 619-692-8499.

Meningococcal Meningitis Treatment: Frequently Asked Questions Prepared by Cynthia Cornelius, MD, MPH, Medical Director, Student Health Services

San Diego State University is encouraging September 1-3 College Panhellenic Association Formal Recruitment activity participants to visit the first floor Nurse Assessment area at Student Health Services in the Calpulli Center for preventive treatment. The treatment will be offered at no cost Thursday, September 6, between noon and 5:00 PM, or Friday, September 7, between 10:00 AM and 4:00 PM. The treatment, most commonly offered in the form of a single pill, is recommended regardless of your prior immunization for meningococcal disease.  

The following FAQ information is presented to provide information about existing treatment to help avoid a meningococcal infection. For further information about meningococcal disease, visit the Centers for Disease Control and Prevention (CDC) meningococcal website: http://www.cdc.gov/meningococcal/index.html  

What preventive treatment will be used?
Ciprofloxacin, a fluoroquinolone antibiotic, is used to help prevent meningococcal infection in people exposed to the infection but not ill from the bacteria. It is given as a single 500 mg dose.  All antibiotics, including ciprofloxacin, have potential side effects, such as change in sense of touch or burning, numbness and tingling in limbs, and also contraindications to use. 

The Public Health Nurse will review these in detail with each student before providing the medication. Alternative medications are available at SDSU’s Student Health Services for those unable to take ciprofloxacin. 

Learn more about Ciprofloxacin via the UptoDate site online: https://www.uptodate.com/contents/ciprofloxacin-systemic-patient-drug-information?search=ciprofloxacin&source=search_result&selectedTitle=3~142&usage_type=default&display_rank=3

Also, learn more about fluoroquinolone antibiotics via the UptoDate site online:  https://www.uptodate.com/contents/fluoroquinolones?search=fluoroquinolones&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

Do I need to take the antibiotic even if I received one or both of the meningococcal vaccines?
Yes. While immunization provides excellent protection, preventive antibiotic treatment is still recommended to individuals with prolonged (8 hours or more) and close exposure (within 3 feet) to the meningococcal bacteria. This treatment is recommended regardless of your immunization status.  

What else do I need to know about side effects?
This drug may cause side effects that include: irritated or torn tendons; nerve problems in the arms, hands, legs or feet; and nervous system problems. These side effects can happen alone or at the same time. They can happen within hours to weeks after starting this drug. Some of these side effects may not go away, and may lead to disability or death. For more information, please speak with a physician. 

Where can I get more information?
If you have additional concerns, please call SDSU Student Health Services 8:30 am - 4:30 pm at 619-594-4325 and press “1” to ask one of our Registered Nurses or call San Diego County Public Health Services’ Epidemiology Division at 619-692-8499.