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Student's death linked to meningitis outbreak

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EUGENE, Ore. - A University of Oregon freshman died this week from meningococcemia, the fourth case of the bacterial infection in a student there since mid-January.

A mass vaccination clinic is being planned for the first week of March at the University. Local, state and federal health officials have told UO to be prepared to vaccinate as many as 22,000 people, a university official said.

The county medical examiner will be signing the death certificate for 18-year-old Lauren Jones as related to the meningococcemia outbreak based on a "preponderance of the evidence," Dr. Patrick Luedtke said Friday.

"We're 95 percent certain that this is in fact a related death caused by this bacteria," he said at the outset of a 1 p.m. press conference Friday.

He later provided an update from the county's infectious control team that the medical examiner had in fact decided Jones died from the infection.

Public health officials are treating Jones as the fourth confirmed case of meningococcemia at the University since January.

Jones died suddenly Tuesday. She was a student-athlete on the Acrobatics and Tumbling team.

The team held a press conference Friday afternoon about Jones.

"Our team, you know, they are suffering as well but they're so strong," head coach Chelsea Shaw said. "They're coming together as a family and, more importantly, they didn't just lose a teammate, they lost a sister. That's been the hardest part. But I think they're rallying together, and they've decided to dedicate tomorrow's meet and the whole season to Lauren."

Infectious disease investigators are working to identify people with direct contact to infected individuals to provide them with informatin and preventative antibiotics, Luedtke said.

The PeaceHealth emergency rooms have adopted new policies.

"Going forward, we have a procedure for those who are UO students and associated with the UO that come into the emergency department," said Dr. Hans Notenboom with PeaceHealth. "Specifically those that come in with fevers, headaches, rash or non-specific symptoms like this will be put on droplet precautions, and that will be until they are evaluated by a provider."

That will include using masks in public areas, he said. Notenboom did not address any specific of the Jones case.

Vaccinations

The University of Oregon Health Center is also offering vaccinations. There are now 2 vaccines available against this particular strain of bacteria, Luedtke said.

"The CDC committee that issues recommenations about immunizations is actually going to be meeting about this on Feb. 25 and making a recommendation about how these new vaccines should be used more broadly," said Dr. Richard Lehman from the Oregon Health Authority.

"We're scheduling this mass vaccination clinic for the week of March 2," said Mike Eyster, director of the UO health center. "That's the time when we hope to be able to vaccinate a large number of people in a short period of time.

"We're also attempting to make the vaccine available in retail outlets so it would be available to members of the general public and the community as well."

Eyster said the UO is working with the makers of the vaccines to obtain enough doses to inoculate as many as 22,000 people at the recommendation of the county, state and federal CDC.

The vaccine is covered by insurance and costs about $170 to administer, Eyster said.

Students can also call (541) 346-2770 to schedule a vaccination.

The vaccine serves a different purpose than the preventative antibiotics.

"The antibiotic takes care of the problem right now, but it doesn't last very long and it takes awhile after you get the vaccine before you get the antibody to be protected. That's why we use both," Luedtke said.

This is a developing story. This story will be updated

People with meningococcemia have the potential of infecting others, but the bacteria cannot live for more than a few minutes outside the body, according to health officials.

The disease is not spread as easily as the common cold or influenza. College student living conditions, however, contribute to the increased risk of spreading of the disease in student populations.

If you have an unexplained fever, headache or neck pain, please seek medical attention immediately, public health officials said. Meningococcal septicemia, or meningococcemia, is the more dangerous and deadly illness caused by Neisseria meningitidis bacteria, according to the CDC.

When someone has meningococcal septicemia, the bacteria enter the bloodstream and multiply, damaging the walls of the blood vessels and causing bleeding into the skin and organs.

Symptoms may include:

Fatigue
Vomiting
Cold hands and feet
Cold chills
Severe aches or pain in the muscles, joints, chest or abdomen (belly)
Rapid breathing
Diarrhea
In the later stages, a dark purple rash (see photos)

"If you think you or your infant or child has any of these symptoms, call the doctor right away," the CDC says.

Transmission and Symptoms of Meningococcal Infection

Meningococcal infection is contagious and can progress very rapidly. The bacteria are spread person-to-person through the air by respiratory droplets (e.g., coughing, sneezing). The bacteria can also be transmitted through direct contact with an infected person, such as kissing or sharing cups or utensils. It is not typically spread by bacteria left on surfaces or clothing, since the bacteria cannot live for more than a few minutes outside the body. Meningococcal infection is not spread as easily as the common cold or influenza.

Meningococcal bacteria attach to the mucosal lining of the nose and throat, where they can multiply. When the bacteria penetrate the mucosal lining and enter the bloodstream, they move quickly throughout the body and can cause damage to various organs.

Many people in a population can be a carrier of meningococcal bacteria (up to 11 percent) in the nose and back of the throat, and usually nothing happens to a person other than acquiring natural antibodies.

Symptoms of meningococcal disease often resemble those of the flu or other minor febrile illness, making it sometimes difficult to diagnose, and may include high fever, severe headache, stiff neck, rash, nausea, vomiting, fatigue, and confusion. Students who notice these symptoms - in themselves, friends, or others - especially if the symptoms are unusually sudden or severe, should contact their college health center or local hospital.

If not treated early, meningitis can lead to death or permanent disabilities. One in five of those who survive will suffer from long-term side effects, such as brain damage, hearing loss, seizures, or limb amputation.

Persons at Risk for the Disease, Including College Students

Meningococcal disease can affect people at any age. Infants are at the highest risk for getting the disease. Disease rates fall through later childhood but begin to rise again in early adolescence, peaking between the ages of 15 and 20 years.

Due to lifestyle factors, such as crowded living situations, bar patronage, active or passive smoking, irregular sleep patterns, and sharing of personal items, college students living in residence halls are more likely to acquire meningococcal disease than the general college population.

Prior to 1971, military recruits experienced high rates of meningococcal disease, particularly serotype C disease. The United States military now routinely vaccinates new recruits. Since the initiation of routine vaccination of recruits, there has been an 87 percent reduction in sporadic cases and a virtual elimination of outbreaks of invasive meningococcal disease in the military. Not all strains of the meningococcal bacteria are covered by the immunizations, therefore immunized people can still be susceptible to the infection.

In addition to increased risk because of crowded living situations, proximity to a person diagnosed with disease (e.g., being a household contact) also increases one's risk of disease. Other factors also increase risk, such as a compromised immune system (which might be caused by HIV/AIDS or taking certain chemotherapy or immunosuppressant) or having no spleen. Even something as simple as a respiratory tract infection may increase the risk of getting the disease. Certain genetic risk factors also may increase susceptibility to infection.

MORE INFO: Oregon Health Authority | University of Oregon

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