, Salem, MA


July 7, 2014

Column: The meningitis outbreak we weren't prepared for

During the last two years, there have been a couple of outbreaks and sporadic cases of bacterial meningitis that federal health agencies failed to address with sufficient aggressiveness. It could have been much worse, and the experience should serve as a wake-up call.

Meningitis is a devastating infectious disease, often misdiagnosed as flu, and it can become debilitating so quickly that by the time it is recognized, the patient may be too sick for effective treatment.

Over the last four decades, the threat from several types of bacterial meningitis has been significantly reduced by immunization. The first vaccine was approved in 1974, and a newer version was introduced in 2005. However, a vaccine for meningitis B, or MenB, has taken much longer to develop. The first MenB vaccine, brand name Bexsero, was not approved until 2013 by the European Union, Australia and Canada. It has not been approved in the United States.

MenB primarily infects those under the age of 25. College students and prisoners are particularly vulnerable because of their close quarters. About 10 percent of those infected die, and survivors can suffer brain damage, hearing loss and limb amputations. Those infected with less severe or no symptoms may become carriers.

Single fatalities from MenB occurred in New York in 2012, Michigan in 2013 and Pennsylvania this year. Since March of last year, there have been nine cases at Princeton University and four at UC Santa Barbara — none fatal, fortunately, but a Santa Barbara student needed to have both his feet amputated.

In order to make the unapproved vaccine available to Princeton and UCSB students, the Centers for Disease Control and Prevention had to resort to a cumbersome process: filing voluminous Investigational New Drug applications, or INDs, with the Food and Drug Administration for permission to acquire and distribute the European version of the vaccine.

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