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Bruce MG, Rosenstein NE, Capparella JM, Shutt KA, Perkins BA, Collins M. Risk Factors for Meningococcal Disease in College Students. JAMA. 2001;286(6):688–693. doi:10.1001/jama.286.6.688
Author Affiliations: Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Bruce, Rosenstein, and Perkins and Ms Shutt); American College Health Association, Baltimore, Md (Ms Capparella); and Student Health Services, University of Pennsylvania, Philadelphia (Dr Collins).
Context Elevated rates of meningococcal disease were noted among 18- to 22-year-olds
in the mid-1990s. However, national data on rates of meningococcal disease
in US college students were not collected until 1998.
Objectives To determine rates of meningococcal disease in US college students and
to identify risk factors for meningococcal disease in this population.
Design, Setting, and Patients Prospective surveillance study with nested case-control study of US
college students with meningococcal infection from September 1, 1998, to August
31, 1999. Fifty state health departments and 231 college health centers participated.
Main Outcome Measures Incidence of and risk factors for meningococcal disease in US college
Results Ninety-six cases of meningococcal disease were identified. The incidence
rate for undergraduates was 0.7 per 100 000 persons vs 1.4 per 100 000
for the general population of 18- to 23-year-old nonstudents (P<.001). Freshmen living in dormitories had the highest incidence
rate at 5.1 per 100 000. Of the 79 case-patients for whom information
was available, 54 (68%) had illness due to vaccine-preventable meningococcal
serogroups. On multivariable analysis of case-control study data, freshmen
who lived in dormitories had an elevated risk of meningococcal disease (matched
odds ratio, 3.6; 95% confidence interval, 1.6-8.5; P
= .003) compared with other college students.
Conclusions Freshmen who live in dormitories have an independent, elevated risk
of meningococcal disease compared with other college students. Use of the
currently available quadrivalent polysaccharide vaccine among college students
could substantially decrease their risk of meningococcal disease.
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