Response to a Serogroup B Meningococcal Disease Outbreak at a University — New Jersey, 2013

BACKGROUND: Meningococcal disease, caused by the bacterium Neisseria meningitidis, is a vaccine-preventable illness that can cause severe sequelae or death. Recent outbreaks of serogroup B meningococcal (MenB) disease have highlighted the difficulty in controlling MenB spread. Although vaccination against other N. meningitidis serogroups is routinely recommended during outbreaks, no U.S.-licensed vaccine against MenB disease exists. To control an outbreak of MenB disease at a university in New Jersey, the university, local and state public health departments, and the Centers for Disease Control and Prevention (CDC) launched a multifaceted effort, including an epidemiologic investigation, health education campaign, and mass immunization activities with an investigational vaccine approved for use in several other countries.

METHODS: An epidemiologic investigation was conducted to characterize the cases and identify possible commonalities among their residences, campus activities, and exposures. The risks and benefits of a vaccination campaign with an investigational vaccine were assessed, and the population recommended for vaccination was defined through a risk assessment. Informational materials on the outbreak and on MenB disease were developed and distributed. CDC received authorization from the Food and Drug Administration for expanded access use of an investigational MenB vaccine for this outbreak.

RESULTS: During March–November 2013, a total of 8 persons with links to the university were infected with the same strain of N. meningitidis. Patients’ ages ranged from 17 to 21 (median: 19.5) years, and 5 (63%) were male. Patients stayed in 7 different residence halls and did not report membership in the same athletic or extracurricular activities. The attack rate of MenB disease among the undergraduate population was 134/100,000, ~1,400 times higher than the background attack rate for U.S. persons aged 17–22 years. Risk communication included consistent messaging on signs and symptoms of meningococcal disease, personal hygiene, the potential severity of disease, and the recommendations for vaccination against MenB disease among the population at highest risk: undergraduates; graduate students, spouses, or caregivers living in dormitories; and faculty or staff with high-risk medical conditions. During the first-dose vaccination campaign, 91% (5,268/5,760) of the recommended population were vaccinated; second-dose vaccination is pending.

CONCLUSIONS: MenB outbreaks in college settings pose unique challenges to school and public health officials regarding risk characterization, risk communication, and implementation of effective control measures, including mass vaccination in the absence of a readily available vaccine. Public health messaging increased campus awareness of the outbreak and might have contributed to the high vaccination coverage achieved.