Risk factors for meningococcal disease in college students

Context Elevated rates of meningococcal disease were noted among 18- to 22-year-olds in the mid-1990's. However, national data on rates of meningococcal disease in US college students were not collected until 1998. Objectives To determine rates of meningococcal disease in US college students and to identify risk factors for meningococcal disease in this population. Design, Setting, and Patients Prospective surveillance study with nested case-control study of US college students with meningococcal infection from September 1, 1998, to August 31, 1999. Fifty state health departments and 231 college health centers participated. Main Outcome Measures incidence of and risk factors for meningococcal disease in US college students. Results Ninety-six cases of meningococcal disease were identified. The incidence rate for undergraduates was 0.7 per 100000 persons vs 1.4 per 100000 for the general population of 18- to 23-year-old nonstudents (P<.001). Freshmen living in dormitories had the highest incidence rate at 5.1 per 100000. Of the 79 case-patients for whom information was available, 54 (68%) had illness due to vaccine-preventable meningococcal serogroups. On multivariable analysis of case-control study data, freshmen who lived in dormitories had an elevated risk of meningococcal disease (matched odds ratio, 3.6; 95% confidence interval, 1.6-8.5; P=.003) compared with other college students. Conclusions Freshmen who live in dormitories have an independent, elevated risk of meningococcal disease compared with other college students. Use of the currently vat available quadrivalent polysaccharide vaccine among college students could substantially decrease their risk of meningococcal disease.