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special
investigation: safety
Diseases lurk
beneath the surface
Bacterial
and viral threats pose an insidious threat to the safety of
college students at CSULB.
By John Caldwell
On-line Forty-Niner
Macy Lederer was
more than a little worried that two of her roommates had been
sick.
Despite the fact
that the freshman and resident of the dorms at Cal State Long
Beach had become accustomed to myriad seemingly harmless illnesses
around her, on this day she was notably concerned.
The recent diagnosis
of a fellow student with bacterial meningitis, a highly contagious
and potentially lethal disease, had her wondering about her
safety.
Lederer sat on
a hard-plastic folding chair inside the Soroptomist House
at CSULB waiting her turn at a special meningitis vaccination
clinic March 1. She and numerous other freshmen had come to
get vaccinated after learning that dorm residents face the
highest risk for contracting the disease. She filled out a
questionnaire and paid an $85 fee, a reasonable price from
her perspective.
"I just wanted
to know I'd be safe," Lederer said. "The health
center is really good to provide you with shots and whatever."
Bacterial meningitis,
clinically known as meningococcal disease, is one of two lethal
diseases prevalent on college campuses nationwide. Meningococcal
is the leading bacterial infection, while HIV, the virus that
causes AIDS, is the most prevalent viral threat. Most college
campuses, including CSULB, have health centers that have been
very effective in keeping these diseases under control.
While the possibility of an outbreak is small, the damage
done to those infected can be extreme.
Statistics covering
these diseases come in local and national varieties. Localized
health centers such as the one at CSULB report individual
cases to the city health department where they are pooled
with numbers from other segments of the community. All health
centers are obligated by law to report certain diseases to
the government including meningitis and HIV.
"Our incidents
of disease parallels what happens at most colleges,"
said Dr. Rebecca Wills, chief staff physician at CSULB's Student
Health Services. "There certainly isn't any greater risk
here."
Student Health
Services, and health centers on neighboring college campuses,
do not compile their own numbers on diseases. According to
Wills, calculated percentages of infected students who have
come to individual college health centers would not be useful
because many ill students go to their own doctors off campus
without reporting anything to their schools. A large percentage
of CSULB students live outside the city of Long Beach, and
reportable diseases contracted by those students are not considered
Long Beach cases.
"Often it
comes from the other direction," said Toni Beron, acting
spokesperson for Health Services. "In the recent case
of a student with meningitis, we were notified by the health
department that the person was ill."
After developing
the flu-like symptoms associated with the rapid onset of meningococcal
disease, the student went to an off-campus doctor who diagnosed
then reported the case to the city health department, which
then notified the school. At that point the Health Center
tested and vaccinated that person's closest friends — none
of whom tested positive for the disease — then facilitated
the vaccination clinic.
Beron said that
in her 12 years at CSULB there have not been any other cases
involving bacterial meningitis on campus. But there is national
concern about an increase in the number of meningitis cases
among college students. Even one case of meningococcal disease,
which can lead to hearing loss, brain damage, kidney and heart
failure, and even death, is a serious concern to health officials.
"I think there's
a general sense that it's on the upswing," said Dr. Helene
Calvet, public health physician with the Long Beach Health
Department.
Calvet noted that
in the Southland area there have been three deaths among college-age
people related to meningococcal disease in the last two years
including a University of Southern California student and
two Orange County high school students. She added, however,
that there is a relatively small chance of a large outbreak.
Recent studies
have addressed the outbreak issue. According to the Centers
for Disease Control, 42 meningococcal outbreaks were reported
from July 1994 through July 1997, four of which occurred at
colleges. Overall, the incidence is increasing among teens
and young adults. In 1997, there were 602 cases among people
age 15 to 24, almost double the 310 cases in 1991.
The American College
Association estimates that 100 to 125 individual cases of
meningococcal disease occur on college campuses each year
resulting in five to 15 deaths. The National Foundation for
Infectious Disease estimates the mortality rate for college
students at 10 to 15 percent
Freshmen living
in dormitories face an increased risk of contracting the disease,
which is easily spread through the air in close living areas.
In a 1998-99 study conducted by the CDC, freshman living in
dorms were six times more likely to contract meningococcal
disease than college students overall. And the rate of infection
for freshman dormitory residents was 4.6 cases per 100,00
compared to 1.5 per 100,000 in non-college students18 to 23
years old.
In 1997 there were
seven cases of meningococcal disease in Long Beach followed
by two in 1998. Los Angeles County saw a ten-year low in 1998
with 50 total cases. The average age of infection for the
county was 27 but the highest rate was among infants less
than one year old.
In addition to
the meningococcal bacteria, HIV also occupies a top spot on
the list of lethal threats to college students. HIV shares
the spotlight with numerous sexually transmitted diseases
prevalent on college campuses including chlamydia and gonorrhea.
But unlike bacterial infections, HIV will not go away with
a quick shot of antibiotics. There is no cure for this viral
disease, which requires expensive and life-altering drug regimes
to treat and usually results in the development of AIDS, which
is followed by death.
"The risk
depends on your behavior," Calvet said. "In general
young adults tend to have more partners so they're at higher
risk."
College students,
who tend to be more sexually active than other groups of people,
face a higher risk of contracting sexually transmitted diseases
like HIV. And research compiled by the CDC has shown that
biological factors make people infected with other sexually
transmitted diseases like chlamydia or gonorrhea more likely
to become infected with HIV if exposed.
According to a
study conducted by the City of Long Beach covering all reported
AIDS cases from 1983 to 1998 in that city, there have been
3,353 cases, 62 percent of which resulted in death. In that
62 percent, 15.6 percent were between 13 and 29 years old.
In Long Beach,
males 13 to 24 years old who have sex with other men are at
the highest risk for contracting AIDS, accounting for 85.1
percent. Among women in the same age group, heterosexual contact
is the leading cause of infection, accounting for 61.5 percent,
half of which were black.
"One of the
fastest growing groups nationwide is young black woman,"
Calvet said. "The black community is not as forthcoming
about sexuality, posing a larger risk to women."
Nationally, the
number of AIDS incidents among people 13 to 24 years old has
been declining, but there has not been a comparable decline
in the number of HIV diagnoses in that group. The CDC reports
that recent increases in high-risk behaviors might explain
why HIV has remained prevalent in young people, particularly
black men and women.
Los Angeles has
a high rate of HIV infection with 1,576 cases per 100,000
people reported between July 1999 and June 2000. Only New
York City, Chicago and Washington D.C. had higher numbers.
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