It’s been more than eight months since the last case of meningococcal disease involving an Oregon State University student was diagnosed, but university and public health officials aren’t breathing easy just yet.
Under guidelines issued by the federal Centers for Disease Control and Prevention, a full year must pass with no new cases before an outbreak can be declared over. In OSU’s case, that won’t happen before late November at the soonest.
“We’re in it until Thanksgiving,” said Charlie Fautin, deputy administrator of the Benton County Health Department.
The crisis began in November 2016 when an unidentified student on the Corvallis campus, believed to be an OSU football player, was hospitalized with what turned out to be serotype B of the potentially deadly infection. OSU and local health officials responded by treating dozens of the student’s teammates and friends with antibiotics as protection against the disease.
A second case was diagnosed shortly afterward, also serotype B. When a third case of the same strain cropped up in February 2017, a formal outbreak designation was issued.
While relatively rare, meningococcal disease is fatal in 10 to 15 percent of cases, according to the CDC. Up to 20 percent of survivors suffer permanent impairments that may include hearing loss, brain damage or amputation of limbs.
The disease primarily afflicts young people, and although not highly contagious, it can spread readily in close quarters, especially in group living situations such as dormitories. In a 2015 outbreak at the University of Oregon, seven people got sick and one student died.
At OSU, the disease lay dormant for several months before resurfacing last fall. A fourth case was diagnosed in October, followed by a fifth in November, both serotype B. (A sixth case diagnosed last December was also identified as type B, but Fautin said additional testing has determined it was not directly related to the other five cases.)
All of the OSU students infected to date have made full recoveries, but the university has been taking a number of steps to reduce the likelihood of additional cases.
OSU has long required incoming students to be inoculated against four common types of meningococcal disease, but the quadrivalent vaccine doesn’t immunize against the B strain. Shortly after the first two cases were diagnosed, OSU Student Health Services began offering shots for that serotype, known as MenB for short.
In March 2017, following the third reported case, the university partnered with state and county health officials to hold the first of several mass vaccination clinics on campus. They also ramped up communications to students urging them to get the MenB vaccine, which requires either two or three shots (depending on the brand) to be effective.
When the fourth and fifth cases were reported last fall, the university redoubled its efforts, scheduling additional vaccination clinics and cracking down on students who didn’t have their shots by withholding grades and blocking registration. After the sixth case was diagnosed in December, the university made the shots mandatory for all students under 25 and gave them a hard deadline of Feb. 15 to comply.
That seemed to do the trick.
As of May 1, a total of 18,150 students had received a full course of vaccinations for MenB, either on campus or through a private provider, said Steve Clark, OSU vice president for marketing and university relations. Another 950 still needed a follow-up dose, while 286 had an approved exemption and 121 were on academic deferral.
According to Clark, that means more than 96 percent of the campus population considered vulnerable to the disease has either been immunized or legitimately excused.
“Students and families have been very responsive,” Clark said.
Even so, the university is still keeping its guard up.
“The requirement for students 25 or younger remains in effect. Students of that age attending OSU must be vaccinated against meningococcus B,” Clark said.
“Any student must have at least one dose before enrolling and must have the second dose within 90 days.”
Fautin said the university’s efforts have already paid important dividends.
“OSU did a fantastic job of vaccination,” he said. “I think that was really effective.”
On the other hand, he pointed out, meningococcal disease tends to be somewhat seasonal, with most new cases occurring in the fall and early winter — just when many young adults, the most vulnerable age group, may be enrolling in college and having their first experience with congregate living in a dorm, frat or sorority house.
With that in mind, Fautin said, the Benton County Health Department is sending out notices to doctors and other health care providers, reminding them to be vigilant for any sign of meningococcal disease.
Up to now, he added, medical professionals in the area have done an excellent job of spotting MenB. But he knows the disease can be deceptive, mimicking the symptoms of a cold or the flu, and could still strike again, further prolonging the outbreak.
At this point, Fautin said, OSU and public health officials are “definitely crossing our fingers.”