By Sharon Bernstein
(Reuters) - An outbreak of meningococcal disease has sickened four students at a major California university, prompting discussions with federal regulators about using a vaccine approved for use in Europe but not in the United States.
The students, at the University of California at Santa Barbara, were all sickened within a three-week period last month with the disease, a sometimes fatal illness that can affect the brain or the blood, according to a spokeswoman for the Santa Barbara County Department of Public Health.
They were stricken by a form of the bacteria that does not respond to the meningitis vaccine currently approved for use in the United States, said the spokeswoman, Susan Klein-Rothschild.
A vaccine known to be effective against this form of meningitis is approved for use in Europe, and Santa Barbara public health officials were in discussions with the federal Centers for Disease Control and Prevention about using it to protect students at the California university.
The discussions come after federal officials agreed to allow Princeton University in New Jersey to administer the European vaccine, Bexsero, after eight students there were diagnosed with similar infections since March.
The CDC is monitoring the California cases and evaluating whether to request similar permission from the Food and Drug Administration to vaccinate the Santa Barbara students with Bexsero, said Dr. Tom Clark, head of meningitis surveillance at the federal health agency.
Blood samples from the infected students are being tested at the CDC's Atlanta headquarters to see if the bacteria responds to the European vaccine, Clark said. Officials were also watching to see if the Santa Barbara outbreak continues to grow.
"It's an exceptional thing, really, to use an unlicensed vaccine in an outbreak like this," Clark said. "We want to be certain that the antibodies that you get from the vaccine actually kill these bacteria."
GAP IN PROTECTION
The type of the disease infecting the Princeton and Santa Barbara students accounts for about a third of meningococcal disease cases in the United States, and a vaccine that targets more strains of the bacteria is not likely to be approved for several years, Clark said.
"It really has been a gap in our ability to protect against meningococcal disease," Clark said. "Everybody has really been looking forward to the day that there would be a licensed vaccine."
Overall, outbreaks of meningitis have declined significantly in the United States since vaccinations for four strains of the bacteria were recommended for all teenagers in 2005, he said.
Meningitis, which causes the brain and spinal cord to swell, is spread through coughing and exchanges of saliva, and people living in dormitories or other crowded living quarters are especially at risk.
Infections once plagued five to 10 of every 100,000 college-aged adults, but now just one per million becomes ill. Incidence of serogroup B, the type infecting the Santa Barbara and Princeton students, has dropped along with the others, Clark said.
The most severe cases can result in death, hearing loss, brain damage, kidney disease or amputation of limbs.
In the Santa Barbara cases, one student has been left permanently disabled, Klein-Rothschild said, declining to provide further details on the case, citing privacy issues.
To prevent additional cases, Santa Barbara public health officials will provide the antibiotic Cipro to students and others who may have been exposed to the bacteria.
The university is also suspending social events by fraternities and sororities, saying the parties put too many students in close quarters and could cause the outbreak to spread further.
Students and faculty can also protect themselves by maintaining good hygiene and nutrition, and getting plenty of sleep during the stressful exam period, which begins this month, Klein-Rothschild said.
Bexsero, made by Swiss drugmaker Novartis, is designed to protect against serogroup B, a strain of meningococcal infection that is not as common in the United States as it is in other parts of the world.
(Reporting by Sharon Bernstein; Editing by Cynthia Johnston, Steve Orlofsky and Bob Burgdorfer)