Student with meningococcal infection released from hospital | Interactive feature

The second of the three students hospitalized last week with meningococcal infection was released yesterday, according to a Student Health Service update.

One of the two students hospitalized over the weekend with flu-like symptoms was also released. That leaves only two students in the hospital of the original five that were brought in - one infection case and one who had flu-like symptoms.

Having three cases of meningococcal infection on a college campus, like Penn did last weekend, is an increasingly rare occurrence since more students have been immunized in recent years - but in the past, college campuses have been common breeding grounds for the infection, experts say.

Every year 1,400 to 3,000 Americans are infected with meningococcal disease, which ultimately leads to about 150 to 300 deaths, according to the American College Health Association Web site.

Adolescents and young adults account for almost 30 percent of all meningitis cases in the United States. Of the 100 to 125 cases of meningococcal infection that occur on college campuses each year, about five to 15 students die as a result.

About 10 to 12 years ago there were a number of outbreaks of meningitis on college campuses, according to James Turner, executive director of student health at the University of Virginia and former and member of the ACHA Vaccine Preventable Diseases Committee.

Any report of three or more cases of the same type of meningitis within a six-month period is considered an outbreak.

In order to prevent further outbreaks on college campuses, the ACHA began recommending routine vaccination at all colleges and universities in 1997.

The available vaccine potentially protects against four of the five dominant strains of meningococcal disease, which cause about 70 to 80 percent of cases in the college-age group.

The strain that was seen on Penn's campus - type B - is not prevented by the vaccine.

According to Turner, the ACHS made a second push to vaccinate students in 2005.

And, with 60 percent of college students now vaccinated nationally, "we have seen a drop-off in the number of student outbreaks," he said.

The disease rate is so high and spreads easily on college campuses due to crowded living, learning and social situations, according to Turner.

Up to 11 percent of people in any given population are carriers of meningococcal bacteria, meaning that the bacteria is harmlessly present in their throats or noses.

The bacteria can be spread by coughing, kissing and sharing drinks and cigarettes. Experts are unsure why it spreads in some cases but not in others.

The college lifestyle "leaves the immune system impaired, which makes it easier for bacteria to leave the nose, get into the blood stream and cause disease," according to Turner, who called contraction of the disease "a rare coincidence of events."

Infections do occur more often in the winter because of the cold weather, said Ralph Manchester, director of the university health service at the University of Rochester and board member of the ACHS.

The protocol for a meningitis outbreak on a college campus is to first encourage everyone to get immunized, assuming that the strain is vaccine-preventable, Manchester said.

At Penn, Student Health Service dispensed more than 3,000 doses of Ciprofloxacin -- an antibiotic prophylactic - to potentially exposed students in order to prevent infection.

"A single dose of antibiotic will wipe out the carrier state," Manchester said, adding that after taking the antibiotics students would have to be re-exposed to the bacteria to get sick.

Manchester said there are no major downsides to taking one dose of antibiotics unnecessarily.

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