Bacteria that caused meningococcal illness of CSU student
in December matches outbreak strain

Fort Collins, CO — The Larimer County Department of Health and Environment today reported that the bacteria that caused invasive meningococcal disease in a CSU student in early December match the organisms that caused other cases in Northern Colorado over the last 8 months.

The Colorado Department of Public Health and Environment’s lab has confirmed that the bacteria that caused the recent infection were Group C meningococcal bacteria (also called Neisseria meningitidis, Serogroup C). In addition, special molecular “fingerprinting” tests (called PFGE tests) allowed them to confirm eight of these cases were caused by identical strains.

Including the most recent case, there have been eight cases of meningococcal disease in Larimer County since May, four of which were fatal. Of these cases, the bacteria from seven patients were identical and matched a fatal case in a Metro State student in April 2010. One case of meningococcal disease was unrelated to the others.

The cases include illnesses that killed a Metro State College (Denver) in April; caused a disabling case of meningitis in a CSU student in May; led to three fatal meningococcal cases among three Fort Collins hockey players in June; caused a less severe case in a hockey player’s child in August; and killed a CSU student in October. The student who became ill in early December was released after about a week in Poudre Valley Hospital, and is believed to be doing well at his parents’ home out-of-state.

“We have looked at a number of connections between all the cases,” said Dr. LeBailly, director of the Larimer County Health Department. “We know that for each case of meningococcal infection, there are likely numerous symptom-free carriers of the outbreak strain who never become ill but who can transmit the bacteria to others, most of whom will also never become ill. This makes it impossible to confirm exactly how the bacteria were transmitted between individual cases.”

Meningococcal vaccines provide protection against four meningococcal groups (Serogroups A, C, Y, and W-135). Although the effectiveness of the vaccine is high for the first couple of years, protection wanes quickly, and is largely gone by 5 years after vaccination. For this reason, CSU students were advised to be revaccinated if it had been three or more years since they had received the vaccine. The student who became ill in early December mistakenly believed he had been vaccinated in 2008 for meningococcal disease, but his immunization had actually been given in 2006. He therefore did not attend the recent CSU meningococcal vaccine clinics.

“It appears that this student received his most recent vaccine at least four years ago,” said LeBailly. “While the risk of severe disease remains quite low for any individual, the Health Department recommends that during this outbreak CSU and Front Range (Larimer Campus) students, staff and household members under age 30 be vaccinated if they haven’t been immunized within the past 3 years.”

Everyone should become familiar with the signs and symptoms of meningococcal disease, which can include high fever, headache, severe body aches, vomiting, disorientation, and a characteristic skin rash, among others.

“Getting medical care as early as possible is very important,” LeBailly stressed.

Meningococcal disease is caused by bacteria called meningococci, also known as Neisseria meningitidis. Although meningococcal disease is uncommon, it is a very serious disease. The infection can develop very quickly and can be fatal in 10 per cent or more of patients. If meningococcal disease is diagnosed early enough and the right antibiotics are given quickly, patients can make a complete recovery

Meningococcal bacteria commonly cause:

• meningitis – an inflammation of the membranes covering the brain and spinal cord
• septicemia [or sepsis] – infection in the bloodstream.

Six of the eight Larimer County meningococcal cases have been sepsis, which generally has a higher fatality rate. All the fatal cases in Larimer County have been from meningococcal sepsis, rather than meningococcal meningitis.

For more information on meningococcal disease and vaccination, visit www.larimer.org/health